The treatment for Intracerebral Hemorrhage (ICH) is often long-term, spanning from acute life-saving procedures to recovery rehabilitation, with total medical expenses commonly reaching several million yen. Anxiety over this financial burden is a major concern for patients and their families.
However, by properly utilizing Japan’s public health insurance system and the High-Cost Medical Care Benefits (Kōgaku Ryōyōhi) system, the actual out-of-pocket payment at the hospital window can be significantly reduced.
Cost and Medical Fee Estimates for Intracerebral Hemorrhage (Japan, Current as of 2025)
The cost of ICH treatment varies significantly depending on the duration of hospitalization, severity, and treatment content (presence of surgery). In principle, public health insurance applies, and the patient’s share is 10% to 30%(depending on income). The High-Cost Medical Care Benefits system caps the monthly out-of-pocket maximum (e.g., approximately ¥80,000 for standard income), which substantially reduces the actual burden.
Below are estimates based on 2025 data. Figures are averages and may fluctuate depending on the hospital and region.
1. Estimated Hospitalization and Treatment Costs (Assuming 30% Patient Self-Pay)
The average total hospital stay is about 77 days (Acute + Recovery Phase). Total medical expenses run into millions of yen, but the self-pay amount is limited by High-Cost Medical Care Benefits.
| Severity / Content | Estimated Hospital Stay | Total Medical Expenses (Before Insurance) | Estimated Out-of-Pocket (After High-Cost Benefits) | Notes (Current as of 2025) |
| Mild (Small bleed, no surgery) | 2–6 Weeks | ¥1.0M ∼ ¥2.0M | ¥100,000 ∼ ¥300,000 (≈¥80,000/month ×2–3months) | Focus on rehab. Additional ¥50,000 ∼¥100,000/month for post-discharge outpatient visits. |
| Moderate(Medium bleed, hemiparesis) | 3–5 Months | ¥3.0M ∼ ¥5.0M | ¥200,000 ∼ ¥500,000 (≈¥80,000/month ×3–6months) | Increased costs due to transfer to a recovery/rehab hospital. Rehab is ≈ ¥3,000 per session (30% co-pay). |
| Severe (Large bleed, surgery performed) | 5–10 Months | Over ¥5.0M | ¥300,000 ∼ ¥800,000 (≈¥80,000/month ×6+months) | Hematoma removal adds ≈ ¥140,000 (for surgery alone). ICU stay adds ≈ ¥200,000 ∼¥300,000. |
| Cerebellar Hemorrhage(Surgery) | 2–4 Months | ¥2.0M ∼ ¥4.0M | ¥150,000 ∼ ¥400,000 | Emergency surgery causes a sharp increase in cost. |
| Pontine Hemorrhage(Survivors) | 1+ Year | Over ¥6.0M | Over ¥500,000 (Long-term) | Additional costs for tracheostomy and PEG tube. |
Example Breakdown (Moderate Case, 3-Month Stay, 30% Co-pay):
- Basic hospitalization fee: ≈ ¥500,000 (≈ ¥5,000/day ×90 days, 30% co-pay).
- Tests (CT/MRI): ¥50,000 ∼ ¥100,000.
- Medication/Procedures: ¥100,000 ∼ ¥200,000.
- Rehabilitation (PT/OT/ST, 3 hours/day): ¥200,000 ∼ ¥300,000.
High-Cost Medical Care Benefits: Out-of-pocket maximum is refunded for amounts exceeding the monthly cap (application required). The cap is even lower for those aged 70+ (max ≈ ¥50,000 ∼ ¥60,000/month).Note: In 2025, total healthcare costs are rising due to the aging population. Many use private medical insurance to supplement costs.
2. Main Medical Fee Points (Shiryō Hōshū) (April 2025 Revision)
In Japan, 1 point=10 yen. Hospitals bill the insurer using these points, and the patient pays 10% to 30% of this. Below are key excerpts for ICH (based on MHLW fee schedules). Note that after June 2025, more items require specific facility criteria (e.g., for acute care add-ons).
| Service Item | Points (Est. per day) | Estimated Cost (¥10 per point) | Applicable Conditions/Notes |
| Basic Hospitalization Fee(7:1, Stroke Response) | 1,844 points | ¥18,440 | Acute care hospital. Add-ons available if stroke patient ratio is >20%. |
| Acute Care Enhancement Add-on | 500 ∼ 1,000 points | ¥5,000 ∼ ¥10,000 | Severe ICH cases. Facility criteria tightened after June 2025 transition period ends. |
| Emergency/Life-Saving Ward Fee | 1,790 points | ¥17,900 | Required for ICU admission. Essential for severe ICH. |
| Cerebral Hematoma Evacuation | 47,020 points (per surgery) | ¥470,200 | Craniotomy/Endoscopy. 30% co-pay is ≈¥140,000. |
| Ventricular Drainage | 5,000 ∼ 10,000 points (per procedure) | ¥50,000 ∼¥100,000 | For concomitant hydrocephalus. |
| Rehabilitation Fee (PT) | 360 points (20 min) | ¥3,600 | ≥3 units per day possible. Focus in recovery phase. |
| Neurological Tests(CT/MRI) | 1,000 ∼ 3,000 points | ¥10,000 ∼¥30,000 | For diagnosis. |
Total Example: A moderate case for 1 month is ≈100,000∼200,000 points (¥1.0M ∼ ¥2.0M). Varies based on hospital classification (DPC status). 2025 Revision Highlight: Enhanced fees for blood pressure management based on updated stroke guidelines. Rehabilitation points show a slight increase for the maintenance phase.
Tips for Reducing the Financial Burden
- Public Support: Utilize the High-Cost Medical Care Benefits + Certificate of Application for Ceiling Amount(apply beforehand to cap out-of-pocket payment at the window).
- Private Insurance: A daily hospitalization benefit of ≈ ¥5,000 can cover the monthly out-of-pocket maximum.
- Consultation: Speak to the hospital’s Medical Social Worker (MSW). Seek advice beforehand if there is a family history of stroke.
