2 Types of Checkup and Expenses to be Borne by a Member The types of checkups you can take depend on your age. We also offer and recommend the simplif

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Medical Checkup Guide for Dependent Family Members and Special Retired Members Sony Health Insurance Society offers a medical checkup service, which includes "Specific Health Checkup and Specific

1 Medical Checkup Guide for Dependent Family Members and Special Retired Members Sony Health Insurance Society offers a medical checkup service, which includes "Specific Health Checkup and Specific health guidance, for members aged between 40 and 74 1 Requirements Valid Period Dependent family members and special retired members aged from 40 to 74.(Special retired, voluntarily continued member after retirement) Dependent spouses and special retired members aged 39 or younger. (voluntarily continued member after retirement) Available only to those who possess a Sony Health Insurance Card (qualified as a member) at the time of the checkup. Those who are not qualified as members of the Sony Health Society at the time of the checkup are not eligible to take it. If a non-member takes the checkup, the expenses will be invoiced on a day following the checkup. Those who have already taken or plan to take a checkup at their companies are not eligible. The checkup can only be taken once before the end of December 2016 (Heisei 28). Reservation period Early March, 2016 to December 15, 2016 Checkup period April 1, 2016 to December 31, 2016 Reservations and checkups are not available outside the above periods. This checkup can be taken only once a year. Make sure to take it before the checkup period is closed. 1

2 2 Types of Checkup and Expenses to be Borne by a Member The types of checkups you can take depend on your age. We also offer and recommend the simplified Complete Physical, which allows you to receive annual cancer screening. Note that the eligible age for checkups is based on your age as of March 31, Age Classification Selectable Courses Self-pay Ages 39 and younger (Spouse Only) 012 Cancer Screening (Optional) Name of Cancer Screening Self-pay EWEL. B Course (Spouse Checkup) 1,000 yen 031 Cytology of Uterine cervix 1,000 yen Ages between 40 to EWEL. C Course (Specific Health Checkup) No charge Including Chest X-Ray Recommended Checkup 014 EWEL. A1Course (Simplified Complete Physical ) 3,000 yen 034 Upper Gastrointestinal Tract Imaging 035 Upper Gastrointestinal Endoscopy 031 Cytology of Uterine cervix No charge 3,000 yen 1,000 yen Either one 032 Mammography 1,000 yen The checkup items and fees for the Complete Physical differ between medical institutions. Check them with the medical institution before making a choice. Including Chest X-Ray Including Stool Occult Blood 020 EWEL. A Course (Complete Physical ) Including Chest X-Ray Including Stool Occult Blood Including Upper Gastrointestinal Tract Imaging Expenses beyond 20,000 yen 033 Breast Ultrasound 035 Changes to Upper Gastrointestinal Endoscopy 031 Cytology of Uterine cervix 032 Mammography 033 Breast Ultrasound (Either one) Entire fee self-pay Expenses beyond 3,000 yen Expenses beyond 3,000 yen (Either one) The checkup items and fees for a Complete Physical differ between medical institutions. Make sure to contact and request the medical institution for this information before making your choice. 2

3 Medical Checkup Courses GOT(AST) Liver&Pancre GPT(ALT) as γ-gtp(ggt) Renal Function Metabolism Stool Occult Blood Digestive organs Ultrasound Uric Acid(UA) Urea Nitrogen-BUN(BUN) Creatinine(CRE) Fasting Blood Sugar HbA1c Electrocardiogram Fundus Erythrocyte(RBC) Hemoglobin(Hb) Hematocrit(Ht) Platelet(PLT/PL) Blood Counts MCH Lipid Questionnaire Measuremen Medical History t & Physical examination Measuremen BMI ts Lung Subjective Symptoms Objective Symptoms Height Weight Audiometry(Hearing ) Urine Test Checkup items /Medical Checkup Course Name Waist Circumference Blood Pressure Measurement Eyesight Chest X-Ray Sputum Cytology Glucose in Urine(US) Protein Urine Occult Blood Urobilinogen MCHC MCV Leukocyte(WBC) Total Cholesterol(T-cho) Triglyceride(TG) HDL-cholesterol LDL- cholesterol 2 days method Upper Gastrointestinal Tract Imaging Upper Gastrointestinal Endoscopy 012 Spouse Checkup Either one 312 Specific Health Checkup 014 Simplified Complete Physical (Recommended Checkups) Either one 020 Complete Physical (Complies with the criterion specified by the Japan Society of Ningen Dock) "Government-mandated Checkup Items" A Complete Physical customized by the medical institution which includes the "Specific Health Checkup Items" and For the checkup items and fees, inquire the medical institution directly. Mandatory Checkup Items Selectable checkup items based on the doctor s judgment(when receiving these checkup items, you must bear their entire fees.) Selectable checkup items 3

Selectable checkup items Checkup items /Medical Checkup Course Name Upper Gastrointestinal Tract Imaging Upper Gastrointestinal Endoscopy Changes to Upper Gastrointestinal Endoscopy Cytology of

4 Selectable checkup items Checkup items /Medical Checkup Course Name Upper Gastrointestinal Tract Imaging Upper Gastrointestinal Endoscopy Changes to Upper Gastrointestinal Endoscopy Cytology of Uterine cervix Mammography Breast Ultrasound Selectable checkup items 012 Spouse Checkup 312 Specific Health Checkup 014 Simplified Complete Physical (Recommended Checkups) 020 Complete Physical Select either Included in the Course Select either Select either 3 Medical Institutions and How to Get a Checkup Phone the medical institution directly and make a reservation Make sure to communicate the following when making your reservation. Name of the health insurance society:you are a member of - the Sony Health Insurance Society Name of agency that we entrust checkups EWEL,Inc. Preferred date for checkup Medical Checkup Course and optional checkup items you wish to have checked Your full name, home address and contact information Contact the medical institution directly for questions or concerns about the checkup. Be sure to make your reservation at least two weeks before your preferred checkup date. Fill in the Checkup Card Request Form and either fax or mail it to the following: EWEL,Inc. Fax: If you cannot use the above fax number, fax to[ ] Mailing address: Medical Checkup Reservation Desk, EWEL,Inc. Health Support Center, P.O.Box 59, Akabane Post Office, Japan Post Co., Ltd., When filling in the Checkup Card Request Form refer to 4. Example of filling in the Checkup Card Request Form. 4

5 Take the checkup using the Checkup Card you receive from EWEL,Inc. You will receive the Checkup Card from EWEL,Inc. via fax or standard mail no later than two weeks after you have sent the Checkup Card Request Form. On the day of your checkup, bring all of the following with you and take the checkup. Checkup Card Cash (for your optional checkup items) Health Insurance Card Specimen Container (if you receive one from the medical institution) Check the information on your Checkup Card by referring to 5. Checkup Card example. Delivery of Checkup Results The medical institution will mail the checkup results directly to your home address. If you require a recheck (follow up checkup), make sure to take it using your own health insurance card. Health Guidance Note that EWEL,Inc. will submit your checkup results and medical interview sheet to the Sony Health Insurance Society. This is to provide government-mandated specific health guidance. Those who require the specific health guidance will be contacted by the Sony Health Insurance Society via letter, phone, or interview. Bookable Medical Institution Shinjuku-Kaijo Building Clinic Medical Institution Code: 2876 Address: Yoyogi, Shibuya-ku, Tokyo Transportation: 5 minute walk from JR Yamanote Line Shinjuku Station, direct access from Toei Shinjuku Line Keio Line Shinjuku Station TEL: Business hours: Monday - Friday: 8:30~17:00, Saturday: 8:30~12:00 Website: 5

6 4 Examples of filled in the Checkup Card Request Form and Checkup The Checkup Card Request Form is not available in English. Please refer to the example when filling in the form. Make sure to right-align all numerical information you write. Do not write a 0 before single-digit days and months. Make sure your entry is right-aligned. Write your name and home address in Japanese as much as possible. FY 2016 Checkup Card Request Form FAX: Make sure to fill in all items and either fax or send the form to EWEL,Inc. within three days. If you cannot use the above fax number, fax to[ ]. Make sure to right-align all numerical information you write [1] Enter your reservation information Medical Institution Checkup Date and Time Medical Checkup Course Checkmark the Optional Checkup Items you wish to reserve Medical Institution Code レ [2] Enter information on person to take checkup Health Insurance Society Code Health Insurance Society Name Your Name メアリースミス Your Name Address 3 6 Mon th (Last Name) Medical Checkup Course メアリー 1 6 Day 012.Spouse Checkup 312.Specific Health Checkup 014.Simplified Complete Physical Recommended Checkups 020.Complete Physical 7138 Sony Health Insurance Society (First Name) スミス Date of Entry 5 Month 1 3 レ Morning Afternoon レレ Insurance Card Medical Institution Name 新宿海上ビル診療所 031.Cytology of Uterine cervix 034.Upper Gastrointestinal Tract 032.Mammography レ 036.Changes to Upper Gastrointestinal Endoscopy Date of Birth Year 6 Mont h 1 6 Day (Gregorian calendar) Age/ Sex 4 0 Years of Age Male レ Female 都道東京府県港区港南 Mor Phone Number Hours レ ning you can (9:30~12:00) be Fax Number reached Afte rnoo (12:00~15:00) Note that it will take two to three days to confirm receipt of your fax [3] Enter medications and smoking habits Make sure to respond to these questions since the checkup may include "Specific Health Checkup 1Do you take medication for hypertension? Yes レ No 2Do you take insulin injections or medication to lower blood glucose level? Yes レ No 3Do you take medication to lower your cholesterol? Yes レ No 4Do you currently smoke on a regular basis? Yes レ No ( Persons who smoke on a regular basis refers to those who have been smoking during the last month and smoked more than 100 cigarettes in total or have been smoking for 6 or more months) 5Do you wish to have health guidance for the improvement of your lifestyle habits? レ Yes No Code Number 999- ソニーマンション 909 Optional Checkup Items Hou r 035.Upper Gastrointestinal Endoscopy 033.Breast Ultrasound If you wish to have a Digestive Organs Checkup with the 014.Simplified Complete Physical, make sure to select it in the Optional Checkup column. 5 4 Day Min ute Eve ning (15:00~17:30) Anytime 1Write the Code and Name of the medical institution. 2Write the date and time of your reservation. If the time is not fixed, leave the column blank. 3Place a checkmark on the Medical Checkup Course you reserved. 4If you have selected optional checkups (cancer screening), make sure to place checkmarks on them as well. 5Write the number of your Health Insurance Card so it is right-aligned. 6Leave the fax number blank if you prefer to have the Checkup Card sent to your home address. 7If you wish to have it faxed, write your fax number. (The Checkup Card will be mailed to your home address if your fax number is not indicated.) 8For Measures to protect the confidentiality of personal information, visit the Sony Health Insurance Society website at kojin/main_frame.htm. 8 Notice The Checkup Card sent from EWEL,Inc. is not available in English. Confirm the information on the Card by referring to the sample. Applications sent by mail may require some time (about two weeks) to issue the Checkup Card. 6

7 5 Example of the Checkup Card The Checkup Card sent from EWEL,Inc. is not available in English. Confirm the information on the Card by referring to the sample Address Name 東京都港区港南 999 ソニーマンション 909 メアリースミス様 For changes or cancellation For changes or cancellation, contact the medical institution and then phone the below to take the necessary procedures. 1 EWEL,Inc. Health Support Center TEL: Checkup Card Date of issue: Inquiries can be answered only in Japanese. On the day of your checkup, submit this Checkup Card at the medical institution. Also, make sure to bring your health insurance card since some checkup items may be covered by health insurance. Reservation Number Health Insurance Society Name ソニー健康保険組合 Checkup Person s Name Date of Birth (Gregorian calendar) メアリースミス 1976 年 6 月 16 日 Date or Checkup Start time of Checkup Medical Checkup Course Optional Checkup Items Amount to pay at the reception desk Medical Institution Informatio n Code No. Medical Institution Address Contact /6/16 午前 9 時 30 分イーウェル一般健診 A1コース胃部内視鏡検査子宮頸部細胞診検査 +マンモ2 方向 Optional Checkup Items which are not subsidized by your Health Insurance Society are not indicated. 4 8,000 Note that the actual amount may vary from the amount indicated here 新宿海上ビル診療所東京都渋谷区代々木 The Checkup date and time you reserved are indicated. 3The Medical Checkup Course and Optional Checkup Items you reserved are indicated. 4The amount you will need to pay at the reception desk is indicated. Medical Institution s seal Remarks About treatment of personal information 5 5For Measures to protect the confidentiality of personal information, visit the Sony Health Insurance Society website at kojin/main_frame.htm 7

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