Missing out if you don't know!? Knowledge more important than medical insurance that I realized when my grandmother was hospitalized in an emergency🍀

Hello, this is Sao🍀

There are cases where you don't have to pay the "private room fee" when hospitalized.

Important financial knowledge I learned when I was exhausted and unable to think clearly during an emergency transport in the middle of the night.

Here is the conclusion first.

If you requested a shared room but were placed in a private room due to the hospital's circumstances,
you are essentially "not required to pay" the private room fee (the difference in bed costs).

...Did you know this?

I knew it. But
none of my family members knew it.

And this time,
with the hospitalization of my grandmother who lives with us after being taken by ambulance in the middle of the night,
I faced exactly this "situation where you lose out if you don't know" scenario.

■ Middle-of-the-night transport. Zero sleep. Zero ability to think.

Hospitalization procedures happen suddenly.

It was the same this time.
My grandmother was rushed to the hospital by ambulance in the middle of the night, and my mother-in-law accompanied her.

The first thing my mother-in-law said when she returned in the morning was,
"There were no shared rooms available, so she ended up in a private room.
So... we have to pay 10,000 yen/day, right?"

I said.
...Wait a minute!
That might be a case where you don't have to pay!

When you are sleep-deprived, anxious, and flustered,
it's easy to just say "I see..." and sign the documents.
There is also the psychology of not wanting to cause trouble with the hospital,
and not wanting to be seen as a complainer.

But this is actually a common misunderstanding.

■ Things to remember! Conditions under which you don't have to pay the bed difference fee

According to the Ministry of Health, Labour and Welfare's notification,
in the following cases hospitals are not allowed to charge a bed difference fee.

① When you requested a shared room, but it was full and you were placed in a private room (due to hospital circumstances)
② When you were placed in a private room for reasons such as infection prevention at the doctor's discretion
③ When there was effectively no free choice

In other words, cases like this one

“The shared room is full”
“Then I'll take a private room...”

are often treated as having “no other choice” rather than a request.

Then why does the payment occur?

■ Signing makes it treated as a “request”

This is the pitfall.
No matter how little you heard the explanation,
no matter how sleep-deprived and unable to make a judgment you are,
if you sign the consent form, it is treated as if you “requested” it.

That is why later on,
“I don't want to pay after all”
is basically difficult.

(However, depending on the situation, there are cases where you can ask for a review.
I will explain later)

■ Our family's case this time

🔸 Emergency in the middle of the night
🔸 Shared room full
🔸 My mother-in-law signed after being told “This is the only room available now”
🔸 Private room fee is about 10,000 yen/day

The next morning, I heard about the situation and said,
“Maybe we don't have to pay this. Let's check.”
and my mother-in-law consulted with the nurse.

The reply was,
“I will check with my superiors.”
and it was left ignored for several days...

One week after my grandmother was discharged from the hospital1 week later, the reply finally came.
Or rather, the statement came.

The result was,
✔ Fee up to the 2nd day in a private room → Waived
✔ “Window-side fee 2,500 yen/day” after moving to a 4-person room → Charged

The billed amount was about 24,000 yen.

……No, I didn't request a window seat!?😅

What I realized here is that
even for private room charges,
there is actually a gray area where 'there are cases where you don't have to pay'.

Standards vary by hospital, and explanations are often vague.

My mother-in-law made a calm choice, saying,
“I don't want to make waves... I'll just pay the amount they asked for,”
but this time I was once again keenly aware of the “world of medical expenses where you lose out if you don't know.”

■ Even my mother, a former nurse, thought “private room charge = something you pay”

Actually, this is what surprised me!

My 70-year-old mother is a former nurse who worked at a general hospital for many years.

But she said,
“Isn't a private room charge something you have to pay?”

In the medical field,
the hospital side,
and the patient side,
the reality is that the “original rules” are not widely shared.

That is precisely why I felt that each and every one of us needs to know the correct knowledge.

■ Cases where you can request a review even after signing

According to Papu-chan's explanation👇
● You wanted a shared room but there were effectively no options
● The fee explanation was insufficient
● You were put in a private room by doctor's orders

In such cases, even if you have signed,

“I wanted a shared room”
“I was not in a situation where I could choose”
“The explanation was insufficient”

By conveying this,
there is a possibility that it can be reviewed. Actually, this time, it was partially exempted because of this.

■ Where to consult if you are charged by any chance

If you are in trouble, you can consult the following offices.

🔹 Hospital consultation desk
🔹 Medical Affairs Division
🔹 “Medical Safety Support Center” in each prefecture
🔹 Health insurance consultation desk

It seems reassuring because they will give you advice from a neutral standpoint.

■ Knowledge can sometimes protect your household finances better than monthly "hospitalization insurance premiums"

Hospitalization insurance is certainly important, but
simply knowing which cases you can refuse can prevent unnecessary expenses
is a huge financial benefit✨

Knowledge becomes a "talisman" for when you need it most.

■ In conclusion

Anyone would panic in an emergency.

If you are called in the middle of the night, surrounded by paperwork while sleep-deprived, and told, "This is the only room available," of course you're going to sign. That is precisely why

having knowledge allows you to make calm choices.

I hope this experience helps someone else so that you and your loved ones can receive medical care with peace of mind.

I truly hope that when you or your family face a hospitalization or need to provide care,
you will be able to make calm decisions✨