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Three medical insurance programs
operate in Japan: a health insurance program for employees of companies, an
older senior citizen health insurance program for persons 75 years or older (and
persons 65 or older who have been certified with certain specified
disabilities), and a national health insurance program for others.
●Portion of medical expenses to be borne by patient with public health
insurance.
| Those aged 70 to 74: |
10% or 30% |
| From April 1st if they are 6 years old to 69 years old: |
30% |
| 0 years old to before March 31st if they are under 6: |
20% |
When you are hospitalized, a fee for meals is additionally required.
※Those aged 70 to 74 are legally required to pay 20% of their medical costs; however, between April 1, 2008, and March 31, 2011, 10% of medical costs were subsidized by the government, meaning patients paid only 10%.
●Health Insurance Certificate
You receive a health insurance card when your application for Helath Insurance
is completed and accepted. If you join the Health Insurance System for
the Elderly, you will receive a health insurance card once you reach a
certain age. This card identifies the insured person, so you should keep
it in a safe place. You must present this card when seeking treatment at
a hospital or clinic. It is recommended that you carry this card with you
when you travel within Japan. For more detailed information, please contact
the Social Insurance Office, Health Insurance Association or National Health
Insurance and Pension Section of your local ward office. |
①Health Insurance
Those who are employed by their companies and their dependents are automatically
enrolled in the Health Insurance Program. The company for which you work
handles the application procedures and automatically deducts the premium
from your salary.
②National Health Insurance
Those who have registered as foreign
residents and have obtained permission to live in Japan for at least one year,
but who are not covered by the Health Insurance Program at their place of work,
are required to join the National Health Insurance Program. (Those with a
temporary visitor visa are excluded.)
If you initially obtained permission
to live in Japan for one year or less but expect to live in Japan for more than
one year, you are required to join the National Health Insurance Program.
NOTE: In accordance with the Japan
Social Security Agreement (issued 1st October, 2005), those persons applicable
under the United States Statute for Cost Reimbursement (Gasshukoku Hiyou Futan
Horei) and are judged to be adequately insured against costs incurred by
receiving medical care in Japan by the Social Security Administration of the
United States, will not be covered by National Health Insurance.
(Same agreement is made with Kingdom
of Belgium from January 1st, 2007, the French Republic from June 1st, 2007,
Kingdom of the Netherlands from March 1st,
2009 and Czech Republic from June 1st, 2009)
(1)Application and payment of Premiums
TTo enroll in the National Health Insurance Program, apply at your
local Ward office. You must present your Foreign Registration Card when you
apply. If your permitted period of stay in Japan is less than 1 year, please
present some form of documentation to prove that you will be staying in Japan
for more than 1 year. Please use an automatic transfer service to pay your
insurance premiums in Osaka City. If not, Osaka City staff bearing official
National Health Insurance Collector Certification will call at your home to collect
the premium. Be sure to check their certification before the paying. If using a
payment slip, please pay at your nearest financial institution, post office, Ward
office or convenience store.
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●Changing residence / Moving to a different municipality /Enrolling in
a different health insurance scheme
You must complete the proper formalities at your local Ward office
in your new address within 14 days of the above changes.
＜Documents required＞
National Health Insurance Certificate, personal seal (if you have one), Foreign Registration Card, Health Insurance Certificate given by your employer and Alternative Health Insurance Certificate if you are under a health insurance other than the National Health Insurance.
※Before returning to your home country, visit the National Health Insurance and Pension Section (National Health Insurance) of your Ward office with the required documents and your air ticket.
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③Health Care Insurance for the Elderly
Those who 75 years old and over (or 65 years old and over with certain
Disabilities who made an application) are eligible to receive medical care
according to Health Insurance System for the Elderly. For more details,
please ask asked to apply for these services at your local ward office. |
④Qualifying for Financial Assistance with Medical Bills
If you are a person with a severe disability, or over 65 years old and fulfil certain prerequisites, or are a single parent family and all children are under 18 years of age and child (infant) receive healthcare services provided by health insurance, you can receive assistance in paying medical expenses as covered by the National Health Insurance Program in cases where the parent’s income is under a certain level. You can apply for assistance at the Public Health and Welfare Operation Section, Public Health and Welfare Center of your local Ward office. |
⑤Obtaining Refund on Medical Expenses
iIf you receive medical treatment when you are not carrying your insurance
card, you will be required to pay the entire amount of the bill (including
cases where you receive treatment while abroad), however you can file for
a refund pro rata.
If you are covered by National Health Insurance, you can file a claim at
your ward office. If you are covered by Health Insurance, you can
file a claim at the Social Insurance Office or Health Insurance Society.
When applying you will need to bring your health insurance card, personal
seal and your head of household’s bankbook (or applicable bank documents).
Also you will be required to submit the receipts and documents detailing
the medical treatment received and the corresponding expenses. Following
the satisfactory investigation of your claim, you will be refunded the
amount that your insurance would normally have covered.
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⑥Excessive Medical Payments Refund
Those who have paid large amounts in medical expenses during the same month
that exceeds a certain limit are eligible for a refund. When applying for
Health Insurance, please go to the Japan Health Insurance Association’s
Branch Offices or National Federation of Health Insurance Societies; to
apply for National Health Insurance, please refer to your local ward office.
Make sure to bring your health insurance card, personal seal, and your
head of household’s bankbook (or applicable bank account documents) with
you. Part of your expenses will be refunded after examination. In case
a person under 70 is hospitalized, Limited Cost Certification will be issued
after the application. If you have Limited Cost Certification, your payment
at a medical institution will be determined at a limited amount.
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⑦Refund for Excessive Medical Care and Nursing Care Payments
The following applies to households that are under the medical care and
nursing care systems. If your household pays more than the required medical
care and nursing care costs, you may be eligible to receive a refund for
the exceeded amount of payment. During a one year period, payments made
from every August 1st to July 31st are applicable. However, in the fiscal
year of 2008, it applies from April 1st 2008 to July 31st 2009. When applying
for this refund, please bring your health insurance card, personal seal,
and your head of household’s bankbook (or applicable bank account documents).
If you registered for medical insurance since July 31st 2009 and you are
under the health insurance system provided by your workplace, you can apply
at the Japan Health Insurance Association’s Branch Offices or at the National
Federation of Health Insurance Societies. If you are under the National
Health Insurance or Health Insurance System for the Elderly, please apply
at your local ward office.
If your medical insurance or nursing care insurance changes, it is
required that you bring a “self-payment certificate” issued by your previous
insurance during the application process.
⑨Lump sum Birth Allowance
If you have joined the National Health Insurance Program in Osaka, you
are eligible to receive benefits that will assist you in paying expenses
related to child birth. This system applies after 85 days of pregnancy
and the baby is stillborn. You can apply for the benefits at your
local ward office.
There is also a system that Osaka City pays Lump Sum Birth Allowance directly
to medical institutions (domestic only). For further information,
please ask the medical institution where you are planning to have a baby.
If you have joined the Health Insurance Program offered by your workplace,
you should go to the Health Insurance Section (Health Insurance Association,
Japan Health Insurance Association’s branch offices.
⑨Allowance for Funeral Expenses
National Health Insurance provides an allowance for funeral expenses following
the death of the insured person. Please apply at the Insurance Section of your local Ward office. In the case you are insured by a Health Insurance Program offered by your
company, you can apply at the Social Insurance Office or Health Insurance Association.
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⑩Cases where the Medical Insurance is not Applicable
In principle, Health Insurance does not cover the following
cases:
（１）Medical treatment and drugs which are not covered by Health Insurance nor
does the National Health Insurance cover extra charges incurred by
a private patient’s room or non-essential dental treatment.
(2) Normal pregnancy and child birth.
(3) Medical checkups, inoculation and vaccination
(4) Cosmetic Surgery
(5) Straightening of teeth
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