How does Japanese Health Insurance work?
There are several different insurance providers in Japan, but here we will discuss the three major insurers.
National Health Insurance (NHI)
Non-Japanese residents with alien registration cards (Zairyu Card) who intend to stay more than 3 months can join National Health Insurance. Japanese hospitals and clinics do not accept insurance from overseas, so even if you have insurance from your own country, joining NHI is strongly recommended.
NHI is mainly aimed at students and self-employed or freelance workers. Full-time company employees are generally offered to join company’s Health Insurance through their employers. Each person in a household must enroll in NHI as an individual member, and the premiums will all be charged to the head of the household.
Under NHI, patients are required to pay 30% of the total cost of care at clinics and hospitals. More than 90% of Japanese hospitals and clinics, including dental clinics, accept National Health Insurance. NHI also provides benefits for high medical costs associated with surgery and hospitalization. It also provides birth allowances and in some cases will cover overseas medical expenses.
To apply for those benefits, contact us. We can provide a language assistance to apply.
Premiums are charged monthly and rates vary depending on you annual income and the area in which you live. These premiums can be discounted depending on your financial situation.
When you move to a new town you are required to make an income statement to your new city. If you forget to do so, NHI may charge you higher premiums.
To join, visit the NHI department at your local city hall or ward office. They are usually open Monday through Friday, 9 am to 5 pm. They are generally closed on Saturdays, Sundays and public holidays.
An appointment is not necessary. Bring your alien registration card (Zairyu Card) and a passport. Payment is not needed at the time of enrollment; you will be billed later.
If you do not join NHI as soon as you move to Japan, you will be charged for back payments during this period, in addition to your first month’s premiums. For example, if you move to Japan in August and join NHI in October, you will also initially be billed for the August and September period in addition to the first regular payment.
If you seek treatment at a hospital or clinic but forget to bring your insurance card, you can get reimbursement from NHI. However, it will take a few months to process the reimbursement.
Social Health Insurance/Employees’ Health Insurance
Full-time employees are generally offered to enroll in Social Health Insurance through their employers. (Keep in mind, there are some exceptions. Check with your company). The family of the covered employer can join as dependents.
Like NHI, under Social Health Insurance, patients are required to pay 30% of the total cost of care at clinics and hospitals. More than 90% of Japanese hospitals and clinics, including dental clinics, accept Social Health Insurance.
SHI also provides benefits for the high medical costs of surgery and hospitalization, birth allowances, and covers some costs of care overseas under certain circumstances. To apply for any of these benefits, contact your company’s person in charge first. If they cannot help you we are happy to provide assistance for application.
The premiums will be charged monthly through your employer. Your company is responsible to pay half of the price of the premiums.
The largest difference to NHI is that family members do not have to pay their portion of the premiums; the total premiums for a family are charged as one amount to the head of the household. However, if the income of any of the dependents exceeds 1,300,000 yen per year, they will lose dependent status and must enroll in NHI or SHI themselves.
When joining SHI, a person in charge in your company will file the application on your behalf. Often this person is a member of your company’s HR Department.
If you seek treatment at a hospital or clinic but forget to bring your insurance card, you can get reimbursement from SHI. However, it will take a few months to process the reimbursement.
International Travel Insurance
Most Japanese clinics and hospitals do not accept private health insurance and do not provide medical services without cash payment. If seeking care under travel insurance, you will need to make full payment for treatment upfront and file a refund application yourself.
Often private insurance companies require a medical certificate and receipt for the refund, so it is best to contact your insurance company before visiting a hospital.
Some international travel insurance companies do not have information of Japanese healthcare providers. We will provide clinic or hospital information and assist you with your visit. Contact us.