Subarachnoid Hemorrhage (SAH), classified as a type of “stroke,” is covered by medical and life insurance policies. It is particularly advantageous if the policy includes a rider for Critical Illnesses (Cancer, Acute Myocardial Infarction, and Stroke). The benefit amount varies based on the contract details (daily hospitalization benefit, surgical payout, and riders). The average hospital stay is 2–4 months (approx. 60–120 days). You can reduce the financial burden by combining the payout with the public health insurance’s High-Cost Medical Care Benefits (monthly cap ≈¥80,000). Below are typical benefit examples and precautions. For actual amounts, consult your policy or insurance company.
1. Medical Insurance Payout Examples (Focus on Hospitalization and Surgery)
Medical insurance typically covers a daily hospitalization benefit of ¥5,000∼¥10,000. For SAH, benefits are added for procedures like Coiling or Clipping. A Critical Illness lump-sum rider further increases the payout.
| Case (Severity) | Est. Hospital Stay (Days) | Total Medical Cost (30% Co-pay) | Est. Payout (Daily benefit ¥5k, Hospitalization ¥10k/Surgery ¥50k) | Notes |
| Mild (Grade 1–2, Coiling, Small bleed) | 2–6 Weeks(14–42 days) | ¥100,000∼¥250,000 | Hospitalization: ¥70,000∼¥210,000Surgery: ¥50,000∼¥100,000 Total: ¥620,000∼¥810,000 | Focus on short-term stay. Rehab adds +¥50,000. |
| Moderate (Grade 3, Coiling, Clear consciousness) | 2–4 Months(60–120 days) | ¥200,000∼¥400,000 | Hospitalization: ¥300,000∼¥600,000 Surgery: ¥100,000 Critical Illness LS: ¥500,000∼¥1,000,000 Total: ¥900,000∼¥1,700,000 | Days extended due to recovery rehab. Medication benefit (e.g., Eril infusion) adds extra ¥10,000s. |
| Severe (Grade 4–5, Impaired consciousness, Complications) | 4–10 Months(120–300 days) | Over ¥300,000∼¥600,000 | Hospitalization: ¥600,000∼¥1,500,000 Surgery: ¥150,000∼¥200,000 Critical Illness LS: ¥1,000,000 Total: ¥1,750,000∼¥2,700,000 | Additional benefits for hydrocephalus/vasospasm. ICU daily rate may be increased. |
Calculation Key Points:
- Hospitalization Benefit: Daily amount × Days (e.g., ¥5,000×90 days=¥450,000). While 60-daylimits are common, unlimited duration is recommended for SAH due to its potential for chronicity.
- Surgery Benefit: ¥50,000∼¥100,000 for Coiling; ¥100,000∼¥200,000 for Clipping (if inpatient surgery riders apply).
- Critical Illness Lump Sum (LS): ¥500,000∼¥1,000,000 upon stroke diagnosis (depends on the rider). Payment requires meeting the “specified condition for stroke (e.g., condition lasting ≥60 days),” which includes SAH. Caution: There is a risk of benefit denial for failure to disclose previous medical history (e.g., undiagnosed headaches). No benefit is paid if onset occurs during the exclusion period (90 days).
2. Life Insurance Payout Examples (Focus on Death and Disability)
Life insurance primarily offers death benefits, but a Critical Illness rider adds a lump sum. Income protection riders provide compensation for missed work.
| Case | Coverage Type | Est. Payout (Death benefit ¥5M, Critical Illness Rider ¥500k) | Notes |
| Survival with Sequelae (e.g., Memory loss, Hemiparesis) | Critical Illness LS + Income Protection Benefit | Critical Illness LS: ¥500,000∼¥1,000,000Income Protection: ¥100,000/month×3–6 months=¥300,000∼¥600,000 Total: ¥800,000∼¥1,600,000 | ¥500,000∼¥3,000,000 may be added based on residual disability grade (1st∼14th grade, e.g., Grade 5 is ¥1M). Useful for long-term care costs. |
| Death (e.g., Re-bleeding) | Death Benefit | ¥5,000,000 (Base) + Critical Illness Rider ¥500,000 Total: ¥5,500,000 | Applies to severe cases with a 30–40%mortality rate. Useful for funeral expenses. |
| Severe Residual Disability(Vegetative State) | Severe Disability Lump Sum | Grade 1: ¥3,000,000 Total: ¥3,000,000 | Disability grade determined by stroke sequelae. Supplements rehabilitation costs. |
Calculation Key Points:
- Critical Illness Coverage: Lump sum of ¥500,000∼¥1,000,000 upon SAH diagnosis. Condition: “Specified condition lasting ≥60 days” or surgery completion.
- Income Protection: Compensation for the period unable to work (average 3–6 months). Monthly salary of ¥300,000 may yield ¥180,000/month benefit.
- Death Benefit: Full base contract amount (¥3M∼¥10M). Re-bleeding is the primary cause of SAH-related death. Caution: Benefits can be limited to one payment or unlimited depending on the product. Stroke conditions are often stricter than cancer (which is paid upon diagnosis).
Overall Financial Burden Reduction Example (Moderate Case, 3-Month Stay)
- Public Burden: High-Cost Medical Care Benefits cap at ¥80,000/month→ Total medical cost of ¥400,000→Actual self-pay burden ¥240,000.
- Private Insurance Payout: Hospitalization ¥450,000 + Surgery ¥100,000 + Critical Illness ¥500,000=∗∗¥1,050,000.**
- Net Financial Impact: ¥240,000 (burden) – ¥1,050,000 (payout) =∗∗¥810,000 surplus** (Excess benefit). This can cover rehabilitation and living expenses.
Joining Insurance After Experiencing SAH
It is often difficult to join standard medical and life insurance policies after a history of SAH, as applications may be denied or restricted by non-coverage clauses due to disclosure requirements.
- Simplified Issue Policies: Products that accept applicants with pre-existing conditions (e.g., Aflac’s Medical Insurance EVER Simple). Enrollment may be possible with a non-coverage clause (excluding SAH-related benefits). Monthly premium is approx. ¥2,000∼¥5,000.
- Recommendation: If onset was within the last 5–10 years, consider simplified issue policies from companies like AXA Direct or Orix Life. Seek a free consultation (e.g., Hoken no Madoguchi) for a simulation before applying.
Tips for Utilization (2025 Latest)
- High-Cost Medical Care Application: Obtain the Certificate of Application for Ceiling Amount in advance to cap the window payment at ¥80,000/month.
- Recommended Products: Co-op Kyosai Critical Illness Insurance (¥500,000 lump sum ∼, monthly fee ≈¥2,000s). Dai-ichi Life Specific Disease Coverage (Lump sum for three critical illnesses).
- Consultation: Utilize free consultations (e.g., Money Career or NaviNavi Hoken). If there is a family history (unruptured aneurysm), secure coverage beforehand.
