Praised by the WHO! The Japanese National Health Insurance

When visiting a foreign country, one of the biggest worries is what to do when you get hurt or sick. In Japan, the National Health Care system helps you get medical care while only having to pay 30% of the actual medical bill in exchange for a monthly insurance fee. Foreigners who live in Japan for more than three months are also obligated to get the National Health Insurance, unless their workplace is taking care of their health insurance. Today, I will introduce the National Health Insurance and how to get it.

The National Health Insurance System

Generally, if you are registered in Japan, you are obligated to get health insurance, regardless of your nationality. If you are working, usually the company will take care of the health insurance. But if your company for some reason does not offer health insurance, or if you are a freelance worker or student, you will get National Health Insurance.

The Fees

The insurance fees are calculated based on your income from the previous year, and are paid to the municipal town or city you live in. You will receive a National Health Insurance Certificate, which you take with you when visiting a doctor. 70% of the medical fees are paid by the insurance, so it makes the doctor visit much less expensive. Of course, it also means that even if you do not go to the doctor, you still need to pay the monthly fee. ???? , so make sure to inquire first. Some towns even have special aid programs for students.

What if I’m late to register?

What you have to be careful about is that when you are too late to register for National Health Insurance, you will be charged for the entire time you have not registered before. You are obligated to get health insurance if you stay in Japan for more than three months, so registering right after coming to Japan might be the safest way to do it.

Foreigners who do not have to register

Some foreigners on the other hand do not have to register. I have summarized them in the list below.

If you stay less than three months (there are exceptions depending on your visa status)
If your health insurance is covered by their employing company
If your visa status is “temporary visitor”
If your visa status is “diplomat”
If your visa status is “designated activities” and “medical services” or “housekeeping”
If your visa status is “designated activities” and “tourism, recreation and similar” and you are over 18 years old, and your dependants
If your visa has expired
If you are from a country that has a social security agreement with Japan, and you have an insurance certificate issued in that country (as of January 2016, there are 15 of these countries including the USA, UK, France, Germany, Canada and Australia)
If you are on welfare
If you are over 75 years of age

How to register

You can register for National Health Insurance at your city’s municipal office. Only yourself or a family member can register for you. If you have someone else register for you (for example, if you do not speak Japanese, asking a Japanese friend to do it for you), you need a letter attorney.

Necessary Documents

Residence Card (alien registration certificate)
An ID such as passport, student certificate
A proof of residence or “My Number” such as the personal number card, notification card, resident card
Certificate of designation (those with a “designated activities” residence status need to submit a proof of the nature of their designation)

A bill will be sent to you which you can pay at the municipal office, the bank or a convenience store. If you set up an automatic transfer, the fees will be transferred automatically every month. You do not have to pay any fees at the registration, so do not worry about bringing a lot of cash.

What the National Health Insurance covers

If you register for National Health Insurance, the insurance will cover 70% of the medical fees in the following cases. If you pay the entire amount at first, you can apply for cash reimbursement later.

Medical fees for an examination at the doctor’s or a hospital
Medical fees for an examination at a bonesetter’s office after breaking or spraining a bone
Food and utilities needed while being hospitalized
When using a corset or cast
When acupuncture or moxibustion is specifically needed for medical treatment
Blood transfusion
Transportation costs when a transfer to a different hospital is necessary
Home Care when found necessary
If you had to be hospitalized after an injury without having your insurance card with you, and you have paid the entire fees
If you were hospitalized abroad and have paid the entire fees

Apart from that, there is aid for excessively expensive medical treatment or child birth (usually, the hospital is paid directly by the insurance), or funeral allowance when an insured person has passed away. But in any case, you cannot receive these benefits unless you apply, and the exact aid can vary depending on the city’s system, so make sure to check out your city’s health care system.

Exceptions

Since the National Health Insurance only provides the basic necessary medical care for its members, high quality or preventive treatment must be covered at one’s own expense.

When moving to a different bed in a hospital (dormitories are covered by an insurance, private rooms must be covered at one’s own expense
Dental treatment such as replaceable teeth out of gold or ceramic, implants, or teeth correction
Easy child delivery (Caesarean section is covered by the insurance)
Health check or physical examination
Plastic surgery
Vaccination

Summary

The health care system is very different in every country, so there might be a few things that surprise you when you come to Japan and learn about the differences in health care compared to your country. But in 2000, the Japanese National Health Insurance received a very good valuation from the World Health Organization (WHO), so it is actually very good compared to international standards. The registering procedure might be a bit bothersome, but having health insurance enables you to get medical treatment when you need it.

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