National Health Insurance

Japan has a mandatory public medical health insurance policy in which everyone who lives in Japan must enroll in some form of public health insurance. Everyone who lives in Nakano City, has completed foreign resident registration and plans to stay in Japan for one year or longer must enroll in health insurance.

Those Who Cannot Enroll in National Health Insurance

1. Those who are already enrolled in another form of public medical health insurance (such as the health insurance plan of the place of employment) and their dependent family members
2. Recipients of financial assistance for everyday living
3. Those whose visa status on their foreign resident registration is "short-term stay"
4. Those whose visa period of stay on their foreign resident registration is less than one year
5. Those whose visa status is "Diplomat" or "Official."

* Even if you have an "Official" visa and have not completed foreign resident registration, you can enroll in National Health Insurance if you are authorized to stay in Japan for one year or longer.

Notifications

If any of the following applies to you, please complete the designated procedures within 14 days at the Eligibility Assessment Desk of the Medical Health Insurance Section. Please note that eligibility for health insurance begins not from the day the form is submitted, but from the date eligibility requirements are fulfilled.

Enrollment in National Health Insurance

• If you complete foreign resident registration in Nakano City
• If you withdraw from the health insurance program at your place of employment (Worker's Insurance)
• If you are no longer a recipient of financial assistance for everyday living
• If a child is born in the family (if both parents are members of National Health Insurance)

Withdrawal from National Health Insurance

• If you move out of Nakano City or leave Japan (file notification before leaving the country)
• If you enroll in the health insurance program at your place of employment (Worker's Insurance)
• If you become a recipient of financial assistance for everyday living
• If a member dies

Other

• If the information on your foreign resident registration card changes
• If there is a change in the household members or in the home address
• If you need a reissuance because you have lost your health insurance card or some other reasons

• Inquiries: Eligibility Assessment Desk, Medical Health Insurance Section
• Tel: 3228-5512

How National Health Insurance Premiums Are Calculated

Those who enroll in National Health Insurance become members and must pay insurance premiums. The insurance premiums for the year are calculated with the household assessed as one unit, based on the number of household members enrolled in National Health Insurance and the amount of Resident's Tax paid. The head of the household must pay the designated premiums.

How to Pay Insurance Premiums

The breakdown of insurance premium is basic premium (insurance cost to cover the healthcare) and premium for nursing-care insurance (for those aged 40 through 64) to be contributed for the nursing-care insurance system.
In fiscal 2008, the amount on a per capita basis for basic premium has been revised to 36,900 yen (35,100 yen in fiscal 2007), and the amount on income basis for it has been revised to 1.17 times (1.24 times in fiscal 2007) as high as the amount of inhabitant tax.
In fiscal 2008, the amount on a per capita basis for nursing-care insurance (for those aged 40 through 64) has been revised to ?11,100yen (12,000 yen in fiscal 2007), and the amount on income basis for it has been revised to 0.21 times (0.23 times in fiscal 2007) as high as the amount of inhabitant tax.
Notice of payment for the fiscal will be sent to you once a year (in June). You are required to pay premium in 10 installments (in June thorough in March of the following year).

Insurance Benefits

If you are hospitalized or treated on an outpatient basis for an illness or injury at a hospital or clinic that accepts National Health Insurance, the personally borne cost is as listed below if you show your health insurance card. In addition, charges for meals during hospitalization and a part of prescriptions received on an outpatient basis must be personally borne.
0 years of age to 2 years of age: 20% of the medical expense
3 years of age to 69 years of age: 30% of the medical expense
70 years of age or older: 10% of the medical expense (30% for those with a designated level of income or higher.)

When Benefits are Not Provided

1. If you do not show your health insurance card. However, you can be reimbursed for the amount that National Health Insurance should pay if you file an application.
2. If you use a medical institution that does not accept health insurance, even when other medical institutions that accept health insurance are available
3. If you undergo treatment outside those stipulated by National Health Insurance
4. If you incur an illness or injury on purpose, when you are committing a crime, when you are involved in a fight or when you are drunk

High Medical Expense Benefit

If the personally borne portion of expenses paid at medical institutions exceeds a designated amount, you can be reimbursed for the difference as a high medical expense if you file an application. The application period is two years from the day after you pay the personally borne expense.
For hospitalization expenses, if you show the medical institution the Ceiling Amount Applied Authorization Certificate issued prior to hospitalization, the personally borne expense to be paid at the time of hospitalization will be restricted to the ceiling amount. In addition, a Ceiling Amount Applied/Standard Personally Borne Expense Reduction Authorization Certificate, which reduces total expenses for hospitalization and meals, is issued to those households excluded from resident's tax.
To be issued the Ceiling Amount Applied Authorization Certificate, you must apply in advance. To apply, you must bring the health insurance card of the applicant. (A representative may complete the application procedures on behalf of the applicant.) Furthermore, please note that for those who are behind in their payment of insurance premiums, authorization is issued on a case-by-case basis.

Lump-Sum Childbirth Benefit and Funeral Expense Benefit

If a National Health Insurance member gives birth, a lump-sum childbirth/child-rearing benefit of 350,000yen is provided to the head of the household.
This also applies to miscarriages and stillborns from a pregnancy of 12 weeks or longer. However, National Health Insurance does not offer this benefit to those who receive a similar benefit from a different health insurance plan.
If you plan to give birth in Japan, there is a program (Lump-Sum Childbirth Benefit Proxy Recipient Program) in which, by applying in advance, the head of the household can designate the medical institution as the proxy recipient, and the lump-sum childbirth benefit will be paid directly to the medical institution.
The application period is up to two years following the day of childbirth.
Since certificates are required in the application process, please call in advance for more information.
In the event subscribers of National Health Insurance died, 70,000 yen as funeral assistance is paid to the person who organized a funeral. The application period is up to two years following the day of the funeral.
Since funeral receipts and other items are required in the application process, please call in advance for more information.

• Inquiries: NHI Benefits Desk, Medical Health Insurance Section
• Tel: 3228-5508