Childbirth

When a member or dependent has given birth, the following benefits shall be paid. Abnormal birth such as stillbirth or misbirth and artificial abortion based on the Maternal Protection Act is also eligible if the duration of the pregnancy is four months (85 days) or longer.

Childbirth by a member

Maternity Benefit

  1. Childbirth under the Obstetric Compensation System: 420,000 yen
  2. Childbirth not under the Obstetric Compensation System: 404,000 yen
    Supplementary Maternity Benefit: 50,000 yen

Childbirth by a dependent

Dependent Maternity Benefit

  1. Childbirth under the Obstetric Compensation System: 420,000 yen
  2. Childbirth not under the Obstetric Compensation System: 404,000 yen
    Supplementary Dependent Maternity Benefit: 50,000 yen

Note: When more than one baby (e.g. twins, triplets) were born of a member or dependent, the benefits are payable to each baby.

Payment of Maternity Benefit

Direct Payment System

  • A member or dependent does not need to pay the delivery expense up to the amount of Maternity Benefit (420,000 yen or 404,000 yen) under the system where the maternity hospital is entrusted to directly invoice the delivery expense to us.
  • The Membership Card is required at the maternity hospital to apply for the system. No need to claim to the PMAC.
  • When the actual delivery expense is less than the amount of Maternity Benefit (420,000 yen or 404,000 yen), the balance or difference between the amount of Maternity Benefit and the invoiced amount of delivery expense shall be paid by PMAC together with the Supplementary Maternity Benefit of 50,000 yen.

Proxy Recipient Program

  • The Proxy Recipient Program applies to maternity hospitals that satisfy certain requirements and are registered with the Ministry of Health, Labor, and Welfare. A member must apply for the program through us in advance so that the maternity hospital may receive the Maternity Benefit directly from us on behalf of the member. The program is available in a limited number of maternity hospitals.
  • When a member or dependent will give birth at a maternity hospital under the program, a member submit the ”Application for Maternity Benefit, Dependent Maternity Benefit and Supplementary Benefit (for Proxy Recipient Program)” to us after two months prior to delivery.
  • Under the program, the delivery expenses are compensated with up to the sum of Maternity Benefit and Supplementary Benefit (470,000 yen or 454,000 yen).
  • When the actual delivery expenses are less than the sum of Maternity Benefit and Supplementary Benefit (470,000 yen or 454,000 yen), the difference between the sum and the invoiced amount will be paid by PMAC.

Payment without use of Direct Payment System or Proxy Recipient Program

If you gave birth overseas or you paid the delivery expense in full at the maternity hospital without using the Direct Payment System or Proxy Recipient Program, submit the “Claim for Maternity Benefit, Dependent Maternity Benefit, Supplementary Benefit” to us for reimbursement. Following documents need to be attached.

  1. When you gave birth overseas, submit the following documents.
    1. Member’s statement of childbirth overseas (Signature / Seal)
    2. Doctor’s statement that proves childbirth or official certificate of childbirth
    3. Japanese translation of item II above (Signature / Seal of translator)
  2. When you did not use the Direct Payment System or Proxy Recipient Program, submit the following documents.
    1. Copy of the document issued by the maternity hospital certifying that you have not applied for the Direct Payment System
    2. Copy of receipt of the delivery expense
      • When you gave birth at a maternity hospital under the Obstetric Compensation System, submit a copy of the receipt sealed with a stamp of the Obstetric Compensation System’s member hospital.
      • When you gave birth at a maternity hospital not under the Obstetric Compensation System, submit a member’s statement to such effect. (Signature / Seal)