Tips on National Health Insurance
- What is Japan's National Health Insurance
System, and What types of health Insurance are available?
- What is the structure of the National Health
Insureance Plan?
- When do we have to submit forms of National
Health Insureance?
- When I enroll the National Health Insurance
Plan, what do I get as proof of my enrollment, and how do I pay
my insurance premiums?
- What medical benefits am I eligible for under
the National Health Insurance Plan?
- Are all medical treatment services covered
under the National Health Insurance Plan?
- What about traffic accidents?
 1.
What is Japan's National Health Insurance system, and What types
of health insurance are available?
The National Health Insurance Plan is a public medical
insurance program in which all people residing in Japan are enrolled.
This is a mutual support system based on each member paying a
certain amount of income toward insurance premiums and which
covers the member in case of illness or injury.
There are two types of public medical insurance. One
is the Worker's Health Insurance Plan provided by one's employer
and the other is the National Health Insurance Plan managed by
the municipality. Anyone not enrolled in the Worker's Health
Insurance Plan is required to enroll in the National Health Insurance
Plan.
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NOTE:
Mutual insurance plans provided independently by educational
institutions are not Public Health Insurance. Therefore, even
if you belong to such a plan, you are still required to enroll
in the National health Insurance Plan. |
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2.
What is the structure of the National Health Insurance Plan?
Medical treatment costs are covered partly by members
who pay insurance premiums, and the remainder is made up by the
national government and through a member of prepared subsidies.
It is managed by your municipality. The personal expenses for
medical fees is 30%. The remainder is paid to the medical institution
by National Health Insurance.
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3.
When do we have to submit forms to National Health Insurance?
Application for enrollment in the National Health Insurance
Plan can be made at the Citizens' Affairs Section which is responsible
for the National Health Insurance Plan, following foreign resident
registration.
(1) Everyone who has undergone foreign resident (non-Japanese)
registration, has a visa for a period of stay longer than one
year and is not enrolled in any other public health insurance
system is required to enroll in the National Health Insurance
Plan.
(2) Foreign residents with a visa period of stay under one year
who have a certificate from their employer or school stating
that they will be in Japan over one year can join the National
Health Insurance Plan. Those with Temporary Visa status are not
allowed to enroll in this plan.
(3) When you discontinue enrollment in your employer's health
insurance program, you are required to join the National Health
Insurance Plan immediately.
You must submit forms for withdrawal from the plan
when:
(1) you leave Japan permanently.
(2) you move to another municipality.
(3) you join your employer's health insurance plan.
(4) your period of stay has expired.
Forms are also necessary when:
(1) there is a birth in the family.
(2) there is a death in the family.
(3) there is a change of address, head of household, nationality,
etc. (due to marriage. divorce, etc.)
(4) your insurance card is lost.
Your insurance card is invalid if:
(1) the expiration date on the card has passed.
(2) your period of stay has expired.
(3) the address on your foreign resident's registration card
has changed.
(4) you leave the country and come back without a re-entry permit
and try to use your old insurance card.
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NOTE:
When you renew your foreign resident's registration card, complete
the appropriate procedures for renewing your insurance card as
well. |
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4. When
I enroll the National Health Insurance Plan, what do I get as
proof of my enrollment, and how do I pay my insurance premiums?
One insurance card is issued per household.
(1) Enrollment in the National Health Insurance Plan is based
on all the people in one household sharing the same household
economy.
(2) Be sure that no mistakes were made in the items mentioned
on your insurance card.
(3) Lending / borrowing an insurance card to / from others is
punishable by law. (4) When you move to another municipality
or join your employer's health insurance plan, be sure to submit
the appropriate application and return your insurance card.
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NOTE: A "household"
is generally thought of as consisting of immediate family members.
If you are living with a friend, their household economy is considered
to be separate from yours and is therefore not considered part
of your household. |
The head of household is the person responsible for
paying insurance premiums based on the number of people in the
family enrolled in National Health Insurance and the yearly income
of the family
(1) Medical costs are paid by all of our insurance premiums.
You may be healthy now, but you never know when you or your family
will fall ill. Insurance coverage is most vital when one becomes
sick or injured.
(2) Insurance premiums are figured on a yearly basis from April
to March of the following year. The method for calculating insurance
premiums is based on an "income variable for each household"
plus a "fixed amount for each family member / family regardless
of income or age." However, the premium will not exceed
530,000 Japanese yen per year (as of fiscal 1999), as this is
the maximum insurance premium amount.
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NOTE: As calculation of insurance
premiums differs slightly depending on the municipality, and
those whose previous year's income was below a certain fixed
amount will have their premiums reduced, please inquire at the
Citizens' Affairs Section for more detailed information. |
There are two ways to pay your insurance premiums.
One is paying the bill in person and the other is by automatic
bank transfer.
(1) Paying the bill in person You will be sent a bill along
with your final premium assessment notice. Please pay your bill
at the Citizens' Affairs Section's counter, post office or financial
institution by the end of each month.
(2) Paying by automatic bank transfer Your insurance premiums
will be automatically transferred from your bank, credit union,
agricultural cooperative, or any other financial institution
account.
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NOTE: Insurance premiums
are calculated from the month one becomes a member. Even if you
join at the end of the month, it will be calculated as one month.
The month in which you become a member is based on when you registered
as a resident, moved into the city or withdrew from your employer's
health insurance plan, etc. The month of enrollment is not based
on when you submit an application for enrollment in the National
Health Insurance Plan. |
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5. What
medical benefits am I eligible for under the National Health
Insurance Plan?
You are eligible to have 70% of your medical costs
paid for by National Health Insurance, with the remaining 30%
being paid by you. If you have fallen ill or been injured, present
your insurance card at a participating hospital or clinic before
receiving medical attention. Though nearly all hospitals in Japan
accept National Health Insurance, please confirm that they will
accept your insurance card prior to receiving any medical treatment.
The following medical services are available under
the National Health Insurance Plan:
(1) Consultation
(2) Treatment (i.e., surgery, inoculation)
(3) Medicine (a phased extraordinary cost may apply to outpatients
who received assistance for medicine.)
(4) Hospitalization (meals not included) and nursing care, etc.
If you have paid your entire medical costs under any
of the following circumstances, apply at the Citizens' Affairs
Section with the necessary documents for reimbursement. Based
on the judging committee's approval, you will be reimbursed for
70% of the medical costs paid.
(1) When you have paid the medical costs in full after receiving
medical treatment at a time of emergency or other unavoidable
situation or when traveling in Japan, etc., and did not present
your health insurance card before treatment.
(2) When medical equipment is purchased according to doctor's
orders, such as a surgical corset or a cast.
(3) When you receive treatment from a judo physical therapy doctor
after suffering a sprain or broken bone.
(4) Fees for nursing care or transport required for extremely
ill persons as determined by a physician.
(5) Fees for massage, acupuncture, moxibustion, etc., as determined
by a physician.
(6) Fees required for blood in a blood transfusion.
When the personal expenses born at a medical facility
exceed the maximum amount, the excess amount will be reimbursed
at a later date.
(1) When the personal expenses borne by the same person who
has received medical treatment at the same medical institution
in one month exceeds 63,600 Japanese yen (as of fiscal 1999).
(2) When the personal expenses borne by two individuals of the
same household is over 30,000 Japanese yen each per month and
the total of the two is over 63,600 Japanese yen (as of fiscal
1999).
(3) If either of the two cases above happens four times or more
in one year, the excess amount over 37,200 Japanese yen from
the fourth time of occurrence will be reimbursed (as of fiscal
1999).
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NOTE: Only standard medical
treatment expenses will be reimbursed by the National Health
Insurance high medical expenses coverage. Costs for hospitalization
and outpatient care are calculated separately. In addition, general
hospitals calculate medical treatment separately according to
the department. |
Medical costs during hospitalization will be partially
reimbursed. Personally-borne expenses for meals during hospitalization
are 760 Japanese yen per day. Meal costs are not treated as high
medical expenses.
Live births (including stillbirths or miscarriages
after 85 days or more) of National Health Insurance members will
be reimbursed 300,000 Japanese yen for each child.
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NOTE: There are some instance
in which the child-birth allowance is not awarded of a child
is born in another country, depending on the conditions when
leaving the country and foreign resident (non-Japanese) registration. |
When a member of the National Health Insurance Plan
dies, the person in charge of the funeral arrangements will be
paid a fixed funeral allowance.
The City offers health service to the National Health
Insurance members for health promotion. Major health services
include general health examinations, specific health examination
services (i.e., infant health examinations, zen health examinations),
health consultation, nutritional guidance and so on.
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6. Are
all medical treatment services covered under the National Health
Insurance Plan?
The following medical treatment service are not covered
by National Health Insurance.
(1) Health diagnosis and group health examinations
(2) Vaccinations
(3) Cosmetic surgery
(4) Normal pregnancy and childbirth
(5) Orthodontic work
(6) Abortion or contraception induced for financial reasons
(7) Treatment received outside of Japan
The following are also excluded from treatment under
the insurance plan.
(1) Injury due to an illegal act, fighting or drunkenness
(2) Self-inflicted illness or injury
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NOTE: Having precious metals
and any other materials used in dental work not recognized under
National Health Insurance standards will not be covered by National
Health Insurance. |
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7.
What about traffic accidents?
National Health Insurance will cover costs for victims
of traffic accidents when the perpetrator cannot be reached or
is financially incapable of paying the victim's medical costs.
When one is injured in a traffic accident or other circumstances
by the careless or illegal acts of another person, that person
is liable for all medical expenses incurred by the victim. After
receiving medical treatment, National Health Insurance will invoice
the person responsible for the accident, so please be sure to
submit the necessary documents to the Citizens' Affairs Section
of the Takayama Municipal Office soon after the accident. And
be sure to submit the necessary forms before a court settlement
is reached.
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NOTE: If the victim of an
accident has received money for medical costs from the perpetrator,
National Health Insurance cannot be used. |
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Contact |
International Affairs Office, Mayor's Office
Takayama Municipal Office
2-18 Hanaoka, Takayama, Gifu 506-8555
Phone : 35-3134(direct) Fax : 35-3174
E-mail : takayama@gix.or.jp
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