Important Information Regarding Reimbursement for Medical Services Received After Loss of Eligibility for National Health Insurance
Sagamihara City is issuing a notification regarding the reimbursement of medical expenses incurred by individuals who received treatment after their eligibility for National Health Insurance had expired. This announcement, published on July 31, 2025, at 15:05, aims to clarify the procedures and implications for such situations.
It is crucial for all residents enrolled in the National Health Insurance system to be aware of the correct procedures when their insurance status changes. Receiving medical services when no longer covered by National Health Insurance may result in the patient being personally responsible for the full cost of the treatment.
Understanding the Situation:
When an individual’s eligibility for National Health Insurance ceases, they are no longer covered by the insurance plan. This could occur for various reasons, such as a change in residency, employment status, or becoming eligible for another insurance program. If, after this cessation of eligibility, a person continues to receive medical treatment without having confirmed their new insurance coverage, the medical provider will likely bill the patient directly for the entire amount.
Implications for Individuals:
In such cases, the patient may be required to repay any portion of the medical costs that would have typically been covered by National Health Insurance to the city. This is because the city, having processed the claims under the assumption of continued eligibility, would have effectively made an overpayment. The term “unjust enrichment” (不当利得 – futō ritoku) is used to describe this situation where an individual has received a benefit (medical treatment) without a valid basis (active insurance coverage), leading to a financial obligation.
Why this is Important:
Sagamihara City is committed to ensuring the fair and accurate administration of its public services, including the National Health Insurance program. This announcement serves as a reminder to all residents to proactively manage their insurance status. It is vital to confirm the effective dates of your National Health Insurance coverage and to understand when it terminates.
Recommendations for Residents:
- Verify Your Eligibility: Regularly check the status and expiry dates of your National Health Insurance coverage.
- Update Your Information: If your circumstances change (e.g., moving, starting a new job with company insurance, family changes), promptly notify the Sagamihara City Hall to ensure your insurance details are accurate and up-to-date.
- Confirm Coverage Before Treatment: If you are unsure about your current insurance status, it is advisable to confirm your coverage with the medical institution before receiving treatment.
- Contact the City for Clarification: If you have any questions or concerns regarding your National Health Insurance eligibility or have received medical services after your coverage may have ended, please do not hesitate to contact the relevant department at Sagamihara City Hall. They can provide personalized guidance and assist you in navigating the necessary procedures.
Sagamihara City encourages all residents to be vigilant and proactive in managing their health insurance to avoid any potential financial complications.
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相模原市 published ‘不当利得（資格喪失後の診療）’ at 2025-07-31 15:05. Please write a detailed article about this news in a polite tone with relevant information. Please reply in English with the article only.