Medical Insurance System

Any resident in Japan must belong to a public health insurance program. In Japan, public health insurance programs are divided into “health insurance” participated in by employees of companies and other business entities, and “national health insurance” participated in by other people.

Health insurance

  1. Eligibility

    Employees of companies and other business entities are eligible for health insurance programs.

  2. Entry procedures

    The procedures differ among companies and business entities. Please enquire at your workplace.

  3. Insurance cards (health insurance card: kenkou hoken hihokenshashou)

    After you have completed the entry procedure, you receive your health insurance card. As a card that proves your membership to an insurance program, it must be kept with care. An insurance card bears the holder’s name and address. It must be shown at the reception of a medical institution every time you receive clinical services there. It is advised to carry it when you travel inside Japan. No borrowing, lending, sale or purchase may be made with an insurance card.

  4. Obligation fees at medical institutions

    When you receive medical care due to sickness or injuries, your portion of the cost is 30% of the whole medical fees spent for your treatment. However, for insured persons aged 70~74, whether the contributors or their dependents, the portion of the cost borne by the contributor is 10% or 30% depending on their incomes. The portion borne by the contributor is 20% of the medical fees spent for his/her dependent children from birth up to starting compulsory education.

    ●Health Insurance obligation rates (by the contributor, contributor’s dependents)

    Up to entering compulsory education

    high-income / average / low-income

    20%
    After entering compulsory education ~ 69 years old high-income / average / low-income 30%
    70 years old ~ 74 years old income similar to an employed person
    30%
    average / low-income

    20%

    10% of the cost to be paid by the contributor is being frozen until March 2012

    (Note) Persons over 75 years old (or those 65~74 years old who have certain disabilities) are eligible to be covered by the medical treatment system for senior citizens (koki-koreisha iryo seido)

  5. Insurance contributions

    Insurance contributions are deducted directly from the salaries of the contributor. The amount depends on the size of the salary and other factors, and is borne evenly by the contributor and his/her employer.

  6. Types and contents of health insurance payments

    Classification

    Types of payment

    In cases of sickness and injuries

    Contributor Dependent
    In cases of receiving treatment with the insured card

    Medical benefit
    Medical expenses for food during hospitalization
    Medical expenses for food, heating, etc. during hospitalization
    Medical expenses for treatment outside that covered by insurance

    Expenses for home visiting nursing service expenses

    Family medical expenses

    Expenses for home visiting nursing service for the family
    In cases of paying the entire medical expenses

    Medical expenses
    Sizable medical expenses

    Sizable medical and nursing expenses

    Family medical expenses
    Sizable medical expenses

    Sizable medical and nursing expenses
    In cases of being transported for emergency, etc. Transportation fees Family transportation fees
    In cases of taking leave from work due to medical necessity Invalidity benefit  
    In cases of childbirth Lump-sum payment of childbirth and childcare Family lump-sum payment of childbirth and childcare*
    In cases of death Burial fees Family burial fees
    After retirement (continuous or fixed period benefits)

    Invalidity benefit
    Lump-sum payment of childbirth
    and childcare

    Burial fees
     

National health insurance

  1. Eligibility

    National health insurance programs cater to people who do not belong to workplace health insurance programs. Non-Japanese people are required to enter national health insurance programs, if they have made the alien registration, are entitled to stay in Japan for one year or longer and do not belong to workplace insurance programs (except for those who are on the status of “short-term stay.”) Even though people enter Japan with a permit to stay for shorter than one year, if they are later allowed to stay for one year or longer, they must enter into the national health program.
    * Note: To prevent dual membership of social security, people from countries which have joined a social security agreement with Japan are exempt from entering the national health insurance program. (Proof of having relevant insurance to cover the cost of medical treatment received in Japan is required.) For details, please see the Social Insurance Agency’s homepage. http://www.sia.go.jp/seido/kyotei/system/index.html

  2. Entry procedures

    Each resident makes the entry procedures at the municipal administrative office where he/she registered as alien.

    Required documents

     

    Alien registration certificate

    For people who have been staying in Japan for less than one year: a document certifying that they will stay in Japan for one year or longer (a letter of acceptance from a school, student registration certificate, etc.)

  3. Insurance cards (insured certificate card of national health insurance: kokumin kenkou hoken hihokensha shou)

    After you have completed the entry procedure, you receive your health insurance card. As a card that proves your membership to an insurance program, it must be kept with care. An insurance card bears the holder’s name and address. It must be shown at the reception of a medical institution every time you receive clinical services there. It is advised to carry it when you travel inside Japan. No borrowing, lending, sale or purchase may be made with an insurance card.

  4. Obligation fees at medical institutions

    When you receive medical care due to sickness or injuries, your portion of the cost is 30% of the whole medical fees spent for your treatment. However, for insured persons aged 70~74, whether the contributors or their dependents, the portion of the cost borne by the contributor is 10% or 30% depending on their income. The portion borne by the contributor is 20% of the medical fees spent for his/her dependent children from birth up to starting compulsory education.

    ●National Health Insurance obligation rates

    Up to entering compulsory education

    high-income / average / low-income

    20%
    After entering compulsory education ~ 69 years old high-income / average / low-income 30%
    70 years old ~ 74 years old income similar to an employed person

    30%

    average / low-income

    20%

    *10% of the cost is being frozen until March 2012

    (Note) Persons over 75 years old (or those 65~74 years old who have certain disabilities) are eligible to be covered by the medical treatment system for senior citizens (koki-koreisha iryo seido)

  5. Insurance contributions

    Contributors of national health insurance programs pay insurance contributions by themselves through financial institutions and by other means. They can bring the payment document sent from the municipal administrative office to a financial institution or the municipal administrative office and pay there or use an account transfer at financial institutions. In some cases, collectors visit contributors for the contribution payment.

    The amount of insurance contributions differs among municipalities. It is determined every year based on the income level of the contributor’s household and the number of family members. However, non-Japanese contributors in their first year in Japan are charged with the minimum level of the insurance contribution since these people have no income record in Japan. They are charged with different levels of contribution in their second year and afterwards of their residence in Japan. Contributors aged 40 or older and below 65 years pay an amount including the nursing care insurance.

    If a contributor defaults in the contribution payment, he/she will return his/her insurance card and instead receives a certificate of the insured status. During his/her holding of the certificate, he/she will have to pay all of the medical fees incurred to him/her (at later times, he/she can claim what is dubbed “medical costs payments” at the municipal administrative office or at his/her workplace.) It is advised to pay the contribution regularly without default. In some cases, the contributor is exempted from the contribution payments when he/she is unable to pay due to a disaster, unemployment, bankruptcy of his/her workplace, etc. In such cases, the contributor is advised to consult staff in charge of national health insurance at the local municipal administrative office.

  6. Types and contents of national health insurance

    Classification

    Types of payment

    In cases of sickness and injuries  
    In cases of receiving treatment with the insured card Medical benefit
    In cases of paying the entire medical expenses Medical expenses
    In cases of bearing medical fees above a certain level Sizable medical expenses
    In cases of being transported for emergency, etc. Transportation fees
    In cases of taking leave from work due to medical necessity Invalidity benefit
    In cases of childbirth Lump-sum payment for childbirth and childcare
    In cases of death Burial fees
  7. What notifications to make in various cases.

    Once you enter into a national health insurance program, you will not be withdrawn from it automatically. If you have entered into your workplace health insurance program, you should notify this at the national health insurance counter of your local municipal administrative office within 14 days of its occurrence. Likewise a notification within 14 days is also necessary for events including the following: when insured persons have lost their insurance card or have it damaged; birth of a child; change in the head person of the household; death.

    Notification is furthermore necessary when contributors have changed their address as a result of moving out from one place and moving into another place. When they move out, they present their insurance card at the local municipal administrative office governing the place they are to move out from and notify the date of moving out. When they have moved into a new place, they notify it at the local municipal administrative office governing their new address within 14 days of their moving in.

    When you move out of Japan, you notify it in advance, bringing your insurance card, seal (if you have one), alien registration certificate, airplane ticket, etc.

    (For people aged over 75 years old who are covered by health insurance or the national health insurance there is the medical treatment system for senior citizens - koki-koreisha iryo seido)