日本の保険証-保険組合の切替え期間内での医療機関の対応-“大腸内視鏡検査”を控えて感じた事!!

私にとっての"覚え書き"となります。
2020年7月に珍しい事がありました。

同会社に勤務しておりながら,
医療保険の"組合"が変わったのです。
これは珍しいケースだと思います。
私自身,初めての経験です。

7月初旬に従来の保険組合から除外され,
新規の保険組合へ加入する際に
当然ですがタイムラグが生じました。

会社側の意向で
7月1日から3日間の期間内に従来の
保険証を返還しました。

結果としては勤務する会社の人事部の
手際の良さから,2週間後には新しい保険組合の
加入となり,新しい組合の"保険証"が手渡されました。
企業側の対応は最速であったと評価しています。

しかし,私にとっては
極めて厄介な時期となり,
各医療機関へ何度も電話をして,
検査予約のキャンセルと再予約をしました!

7月中に6カ所もの医療機関の予約があったのです。

例えば,
7/22(水)は眼科の主治医にクリニックの予約日で,
視野の検査,眼圧,眼球の厚み,
視神経の精査を含め,
自費扱いだと12000~15000円との説明を受けました。

↑一回の診察で処方される膨大な量の目薬となります。予約日を7月末に変更した。
↑One It becomes a huge amount of eye medicine formulated by examining times.
The reservation day was changed at the end of July.

先日,風疹の予防接種の記事を書きましたが,
予防接種は無料であった為,
保険証の"ある・なし"は一切関係ありませんでした。

日本の場合は大学病院,総合病院,
クリニックなど,様々な医療機関がありますが,
原則として"保険証"がないと全て"自費"扱いとなります。

自営業者の場合は,
株式会社や有限会社以外は"国民保険証"となります。

保険組合に加入している場合,保険証がない時は,
医療費の全額"立て替え"が生じます。

場合に依ってはそれが国民の全額負担になる可能性が生じます。
その可能性を述べたいと思います。

困った事に,7月15日(水曜日)は
国立病院での大腸内視鏡の検査の予約がありました。

結果的には前日の14日には会社側から新しい保険組合の
保険証を受け渡され問題なかったのですが,
前日まで放置出来る類いの内容の検査ではなかったので,
事前にキャンセルしました。

再予約日は無難に翌月の8月12日
(お盆休みの連休中)に変更しました。

何故そうしたのかと言うと,
大腸内視鏡検査の場合,実際掛かる実費用はおおむね,
2万円前後なのですが,検査中から数年前にポリープ切除をする
緊急手術に移行した事があったので,実際掛かる費用が想定出来なかったからです。

つまり手術になると幾ら掛かるか分からないない・・。

いずれ払い戻して貰うので,
現金もしくはキャッシュレスのカードにて
支払い自体には問題はないものの,
日本の場合は事務上の手続きの問題で
保険証の"提示期間"が非常にタイトになるケースが生じるのが問題です。

つまり当月に自腹で自費で支払った際,
新しい保険証の提示する"猶予"期間が
""当月中""でなくてはならない医療機関が数多く存在するのです。

今回,私の予約していた国立病院もそうでした。もし仮に
7月15日に検査をして自費で支払った場合,新しい健康保険証を
提示して払い戻しが出来る期間は当月=7月以内という非常に"タイトな期間内”となります。

僅か,2週間しかありません。
病院は片道50㎞も離れています。新しい保険証の提示に
間に合わなければ全て自費=自腹になる可能性が生じます。

しかも保険証というものは元来,
FAXなどで送信出来る類いではありません。
再び足を運んで直接,保険証を提示しに医療機関へ出向かなくてはならないのです。
仮に私が7月の6カ所の医療の予約診療を全て行うと,
さらに保険証の提示で合計6回後日,
保険証を持参する必要性が生じてしまいます。

この課題は何も国立病院に限った事ではありません。

どの街のクリニックでも基本は同じです。

但し私の場合,通院している
クリニックでは長年患者として通院しているという事もあってか,
保険証がなくても,"仮打ち"という医療事務の手法を用いてくださって,
保険適応として頂きました。

しかし,これはあくまで"イレギュラー"なケースです。

融通の利かない医療機関(とくに組織が大きくて外来患者数が多い場合)は
患者ひとりひとりの立場に応じた臨機が効く筈もありません。

これは私の"備忘録"となりますが,
あなたにとって将来,
何かの一助になると幸いです。

↑右手首・右膝の故障による医療用サポーター。整形外科の予約も今回7月下旬まで我慢した。
↑ Medical application supporter due to breakdown of right wrist and right knee.
The reservation of the orthopedics department was endured until the end of July this time.

It becomes "Memo" for me.
There was an unusual thing in July, 2020.
"Union" of medical insurance changed though it worked for this company.
I think that this is an unusual case.
I am the first experience.
The time lag was caused though it was natural when
it was excluded by a past insurance union in the first ten days of July, and it joined a new insurance union.
A past insurance policy was restored by
the intention of the company in the period of three days from July 1.

As the result, it became a joining of a new insurance union from the goodness of the workmanship of Personnel Department in the company that worked two weeks after, and "Insurance policy" of a new union was handed.

It is evaluated that the response of the enterprise was the velocity.
However, it called each medical institution many times at extremely troublesome time for me, and the cancellation and the re-reservation of the inspection reservation were done.
The medical institution of six places reserved it by the end of July.
For instance, the explanation with 12000-15000 yen was received from the physician in charge of the ophthalmology department when it was an independence treatment on the day of the reservation of the clinic including the close examination of the thickness and the optic nerve of the inspection, the intraocular pressure of view, and the eyeball at 7/22 (Wednesday).

Because the vaccination was free, none with the insurance policy was not related at all though The other day and the article on the vaccination of rubella were written.
Everything becomes "Independence" treatment if as a rule, there is no "Insurance policy" though there are various medical institutions such as the university hospital, the general hospitals, and clinics for Japan.

Things except the company, Ltd.,
and it becomes "National insurance policy" for the self-employed worker.

The full amount "Pay for" of the medical expense is caused when there is no insurance policy when it joins the insurance union.
The possibility that it becomes the people's full amount loads is caused
when depending on the situation.
I want to describe the possibility.
The inspection of the large intestine endoscope in National Hospitals was reserved in an embarrassed thing on Wednesday, July 15.

The insurance policy of a new insurance union was received from the consequential company on the 14th the day before and it was passed, and because it was not an inspection of the content of [i], it canceled until the day before beforehand belonging ..it was possible to leave it.. though it was unquestionable.
It changed safely on August 12 next month (During consecutive holidays of the Bon Festival recess) on the re-reservation day.
It is because the cost that hangs actually was not able to be assumed because there was a thing that shifts to the emergency surgery to excise the polypus several years ago from the inspection though it is about 20,000 roughly yen in Japanese yen for actual expenses that hang actually in case of the large intestine endoscopy when it did so why is said for Japan.

In a word..operation..very much..hang..understand..provide.
It is a problem to generate the case where "Presentation period" of the insurance policy of the problem of the procedure on clerical work becomes tight very much because it reimburses it sooner or later for Japan though there is no problem in payment in cash or the card of cashless.
A lot of medical institutions "Delay" period that a new insurance policy presents must be "" "On the this moon" when paying at one's own expense with the belly in a word this month exist.
This time, National Hospitals that I had reserved is that's right.
The period when the repayment can be done by presenting a new health insurance card when paying at one's own expense inspecting it on July 15 becomes it in a very tight period within this month = July.
There are only two weeks slightly.
The hospital is away at as much as 50㎞ in one way.
The possibility of becoming independence = belly everything is caused if not in time for the presentation of a new insurance policy.
Moreover ..insurance policy.. originally, it is not ..belonging.. [i] that can be transmitted by the fax etc.

It is ..medical institution.. ..proceeding.. indispensable to present the insurance policy visiting again and directly.
If I do all the consultation by appointment of the medical treatment in six places in July, the necessity for bringing the insurance policy is caused by the presentation of the insurance policy six times in total later in addition.
This any problem is not a thing limited to National Hospitals.
The basis is the same also in the clinic in which town.
However, it got it as an insurance adjustment by using the technique of the medical coding "Virtual Typing"-" even if there was no thing , insurance policy of going regularly to hospital in the clinic to which it went regularly to hospital for years as the patient for me.

However, this is .."Bound irregularly".. case to the end.
An inflexible medical institution (Especially, when the organization is large and there are a lot of numbers of outpatients) doesn't have being sure to work corresponding to a standpoint patient individual.
Will It would be greatly appreciated when being become a help of something for you in the future though this becomes my "Memo".

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