When You Are Ill

Having an Examination

<Clinical Examination>

Should you feel sick, take your Health Insurance Certificate and some money and go to a hospital that treats the symptoms you are experiencing as soon as possible. Each hospital sets its own office hours of outpatient care for new patients, but they are usually open on weekday mornings, and are closed on Sundays and national holidays (some hospitals are also closed on Saturdays).
At most hospitals other than dental clinics, you can see a doctor on a first-come, first-served basis. You may have a long wait at a large hospital. Sudden illnesses and emergencies on Sundays, holidays, and during the night are handled by emergency clinics.

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2 Medical Insurance System

Everyone who lives in Japan is required to enroll in one of the following public health insurance programs: Employee Health Insurance, in which company employees and their dependent family members are enrolled, Medical Care System for the Elderly for those aged 75 years or older (and those aged 65 or older with certain disabilities (by application)), and National Health Insurance for others.

Percentage of medical expenses to be borne by insured persons.

Medical Care System for the Elderly: 10%, 20% or 30%
70 years old to 74 years old: 20% or 30%
6 years old (from April 1st) to 69 years old: 30%
0 years old to 6 years old, until March 31st: 20%

If you are hospitalized, a fee for meals is additionally required.

What to present when visiting a medical institution

If you have an Individual Number card that has been registered as a National Health Insurance Certificate, please present your Individual Number card when visiting a medical institution. All others must present a certificate of eligibility. For more detailed information, please contact Japan Pension Service branch offices, Health Insurance Association or your local ward office. For more detailed information, please contact Japan Pension Service - Branch Offices, Health Insurance Association or your local ward office.

1 Employee Health Insurance

Company employees and their dependent family members are enrolled in the Employee Health Insurance Program. The company for which you work handles the application procedures and automatically deducts the premium from your salary.

2 National Health Insurance

Those who have registered as residents of Osaka City, but who are not covered by health insurance at their workplace, are required to join the National Health Insurance Program. For people who have a status of residence of 3 months or less and have an address, if your status is “Entertainer,” “Technical intern training,” “Dependent,” or “Designated activities,” and materials affirm that your stay will exceed 3 months, you cannot register your residency but you can still purchase National Health Insurance.

NOTE: 1 In accordance with the U.S.-Japan Social Security Agreement, 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 be exempt from National Health Insurance.
(Japan has concluded similar social security agreements with the Kingdom of Belgium, the French Republic, the Kingdom of the Netherlands, the Czech Republic, the Swiss Confederation, Republic of Hungary, and Grand Duchy of Luxembourg.)
2 If your status of residence is “Official,” you don’t need to register as a resident, but you do need to establish National Health Insurance coverage if your stay in Japan will be longer than three months.
3 Please note that individuals whose status of residence is “Designated Activities” in which the contents of activities that have been described in the designation form apply to the following items (1) and (2) are not eligible for national health insurance
(1) Individuals whose status of residence is “Designated Activities” for receiving medical care and persons that are designated to assist the daily life of those individuals.
(2) Individuals whose status of residence is “Designated Activities” for engaging in “sightseeing, recreation, or other similar activities” and spouses that have accompanied those individuals.

Application and Payment of Premiums

To enroll in the National Health Insurance Program, apply at your local Ward office. You must present your passport and Residence Card (or Foreign Registration Card) when you apply. If your permitted period of stay in Japan is less than 3 months, please present some form of documentation to prove that you will be staying in Japan for more than 3 months. Please use an automatic transfer service to pay your insurance premiums in Osaka City. If using a payment slip, please pay at your nearest financial institution, post office, Ward office or convenience store. Convenience stores will accept your payment anytime when they are open, at night or holidays.

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>

Whichever of the following you have: National Health Insurance Certificate, certificate of eligibility, Individual Number card, or notification of eligibility details
Documents showing your Individual Number (only those who have it)
Residence Card or other identity verification document
If you have joined a health insurance plan other than the National Health Insurance, your company insurance card (stating your eligibility details and the date you acquired eligibility)
*For those who are leaving Japan, please bring your health insurance card, documents showing your Individual Number (only those who have it), residence card or other identification documents and flight ticket beforehand to the ward office.

3 Medical Care System for the Elderly

Those who have reached the age of 75 years old or older (65 years old or older with certain disabilities (by application)) are required to enroll in the Medical care System for the Elderly and be insured under that system. For more details, please refer to your local ward office.

4 Qualifying for Financial Assistance with Medical Bills

If people with severe disabilities, children up to 18 years of age, or single-parent families (children up to 18 years of age and their parents) receive medical treatment covered by insurance, they may be able to receive subsidies for part of their medical expenses. However, there is an income limit for persons with severe disabilities and single-parent families. If you would like to receive aid, please apply at the health and welfare center of the ward in which you live.

5 Obtaining Refund on Medicine Expenses

If, for unavoidable reasons, you visit a doctor without your health insurance card and pay the full cost of the examination or other procedures, the full amount will be reimbursed, minus the co-payment. Please bring your health insurance card, a bankbook for a Japanese financial institution in the name of the head of the household (or a document showing the bank account for bank transfers), a detailed statement of medical treatment and original receipts, and apply to your prefectural branch of the Japan Health Insurance Association, or your health insurance association if you have health insurance, or to your ward office if you have national health insurance.
*If a National Health Insurance policyholder is forced to visit a doctor outside of Japan due to sudden illness or injury and pays the expenses incurred for the medical examination or other procedures, he or she will need to submit original copies of the detailed statement of medical treatment and receipts (with Japanese translations attached), documents verifying the fact that the person traveled overseas (passport, airline ticket, visa, etc.), and a consent form allowing the insurer to inquire about the details of the medical treatment overseas.

6 High-cost Medical Expense Benefit

Those who have paid large amounts that exceed a certain limit in medical expenses during the same month are eligible for a refund. Please bring the insurance card, bank account in Japan under the name of the householder to the prefectural branch of the Health Insurance Association for social insurance, and those with National Health insurance should apply at the local ward office.
The portion of your expenses that exceeded the limit will be refunded after examination.
On the other hand, by presenting a certificate of eligibility for reduced co-payments (Gendogaku Tekiyo Ninteisho)), the payment at the medical institution will not exceed the limit amount (not applicable for judo-orthopedics, acupuncture, or Japanese traditional massage). Queries regarding the application process should be directed to your insurance agency.

Below the age of 70
Classification（*1）		Up to three times in the past 12 months, Self-pay limit	Four times and more in the past 12 months【Multiple visits】 Self-pay limit
A	Households with incomes over JPY 9.01 million after basic deductions	JPY 252,600+ (total medical expenses – JPY 842,000) X 1%	140.100 yen
B	Households with incomes over JPY 6 million and JPY 9.01 million or less after basic deductions	JPY167,400+ (total medical expenses – JPY 558,000) X 1%	93.000 yen
C	Households with incomes over JPY 2.1 million and JPY 6 million or less after basic deductions	JPY80,100+ (total medical expenses – JPY 267,000) X 1%	44.400 yen
D	Households with incomes over JPY 2.1 million and JPY 6 million or less after basic deductions	57.600 yen	44.400 yen
E	Household that is exempt from residence tax	35.400 yen	24.600 yen

(*1) Classification is determined based on the incomes of the head of household and all subscribers to the national health insurance in the household in the previous year, and is applied from August. In addition, households with members whose income cannot be confirmed are in Classification A, and households with members who do not have an address in Japan as of January 1st are in Classification D or above.
Note: The “total medical expenses” in the table refers to the amount of medical expenses (100%) for hospitalization, outpatient treatment, etc., that are eligible for high-cost medical expense benefits.

Above the age of 70
Classification（*1）	Limit for outpatient care (for individuals)	Limit for the sum of inpatient and outpatient care (for households)
Individuals with an income level that is equivalent to persons of working age Ⅲ（Taxable income of JPY 6.9 million or more）	JPY 252,600+ (total medical expenses – JPY842,000) X 1% 【Multiple visits 140.100 yen】
Individuals with an income level that is equivalent to persons of working age Ⅱ（Taxable income of JPY 3.8 million or more）	JPY 167,400+ (total medical expenses – JPY558,000) X 1% 【Multiple visits 93.000 yen】
Individuals with an income level that is equivalent to persons of working age Ⅰ（Taxable income of JPY 1.45 million or more）	JPY 80,100+ (total medical expenses – JPY267,000) X 1% 【Multiple visits 44.400 yen】
Standard	18.000 yen (Annual total amount: 144,000 yen)	57.600 yen 【Multiple visits 44.400 yen】
Household that is exempt from residence tax, Classification Ⅱ	8.000 yen	24.600 yen
Household that is exempt from residence tax, Classification Ⅰ （For households where all members have no income.)	8.000 yen	15.000 yen

(Note): The term “total medical expenses” in the table is the amount for medical expenses (100%) paid for inpatient or outpatient care that is subject to high-cost medical care benefits.

By using your Individual Number card at a medical institution that accepts Individual Number card, and by agreeing to use the high-cost medical expense benefit, you will only have to pay up to the limit at the counter. Also, for persons age 70 and older using National Health Insurance for in-patient or out-patient services, by showing your Old-Age National Health Insurance card, the amount that you pay out of your own pocket shall be no more than the upper limit under the High-Cost Medical Expense Benefit system.
The Eligibility Certificate for Ceiling-Amount Application is necessary for households that are 70 years old or older, exempt from citizen's tax, and have the same income level as active workers I and II. Please apply at the local ward office with your National Health Insurance Recipient Card for Seniors.

7 Refund for Excessive Medical Care and Nursing Care Payments

Separate programs apply to medical treatment and nursing care costs incurred by households. If the total of copayments paid for either category during a single year (calculated as running from August 1 to July 31) exceeds a certain level, you will be reimbursed for the payments in excess of that level.
Please bring the insurance card, bank account in Japan under the name of the householder and apply to the health insurance plan you subscribe to as of July 31.
※For Social Insurance contact the prefectural branch of the Health Insurance Association.
※For National Health Insurance, Medical Care System for Older Senior Citizens should apply at the local ward office.

8 Lump Sum Birth Allowance

If a policyholder bears a child—this includes stillbirths and miscarriages—a lump-sum benefit for childbirth will be provided in line with the regulations outlined in your health insurance policy. For information about application procedures, provision requirements, and monetary amounts, etc. please refer to your insurer.

9 Allowance for Funeral Expenses

If a policyholder dies, funeral expenses and certain associated costs will be covered in line with the regulations outlined in your health insurance policy. Queries regarding the application procedure and qualifying conditions should be directed to your insurance agency.

10 Cases Where the Medical Insurance is not Applicable

Health Insurance does not cover the following cases:

Medical treatment and drugs that are not covered by Health Insurance
Extra charges incurred by a private patient’s room or non-essential dental treatment.
Normal pregnancy and child birth.
Medical checkups, inoculation and vaccination
Cosmetic Surgery
Straightening of teeth
If massage or other service is being sought solely for the purpose of fatigue recovery or comfort

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Services For Health

Public Health and Welfare Centers in Osaka City offer various services that contribute to citizens’ health.

1 Health Counseling

Counseling on health and dietary habits.

2 Maternal and Child Health

Free services such as counseling on maternal and child health, issuing of the Maternal and Child Health Handbook, prenatal classes along with vaccinations and checkups for the baby.

3 Tuberculosis (TB) Prevention

Tuberculosis (TB) examinations are provided free of charge for persons 15 years old and over who have not received a health checkup at their school or workplace. There is also a system to bear the medical public expenses patients who are hospitalized or receiving outpatient treatment for tuberculosis.

4 HIV, AIDS, STDs (Sexually Transmitted Diseases)

For more information about tests and consultations, please see the “HIV/AIDS and Infectious Disease Guide.”
https://www.city.osaka.lg.jp/kenko/page/0000549405.html

All tests are free and anonymity is guaranteed
(Test results will be received within a week. However, the result will be received approximately 2 hours later on the same day for the rapid test.)

HIV (AIDS), Syphilis, and Chlamydia tests at the Ward Health and Welfare Center (No reservation required)

※Except National holidays and Year-end/New Year holidays)

Kita Ward Public Health and Welfare Center:
TEL 06-6313-9882
Monday and Friday, 9:30 - 11:00
Wednesday, 14：00 - 15：30
Generally, 5th Friday 18:00–19:30 (capacity: 100 people)
Chuo Ward Public Health and Welfare Center:
TEL 06-6267-9882
Tuesday–Thursday, 9:30–11:00
Note: Only HIV (AIDS) testing takes place on the first Friday of the month at Chuo Ward.
Yodogawa Ward Public Health and Welfare Center:
TEL 06-6308-9882
Monday 14:00 - 15:30, Tuesday 9:30 - 11:00

HIV (AIDS), Syphilis, and Hepatitis B testing in other locations

HIV Antibody Testing (capacity: 50 people) (also available on some national holidays , including New Year’s)

Tuesdays 18:00 - 19:50 (No reservation required / the first 50 people will be served)
Thursdays 18:00 - 19:30 (Rapid testing / Reservation required)
Saturdays and Sundays 14:00 - 15:30 (Rapid testing / Reservation required)
For more information about same-day testing with an interpreter (reservation required), please see "For Foreigners" in the "HIV/AIDS and Infectious Disease Guide.”
https://www.city.osaka.lg.jp/kenko/page/0000556213.html

(Address/TEL)

Osaka Testing, Counseling, Education and Support Center "chot CAST"
TEL 06-4708-5035 (Only available during testing hours)
4th floor, 1-7-30 21 Shinsaibashi Building, Higashi-shinsaibashi, Chuo Ward
4-minute walk from Shinsaibashi Station on the Osaka Metro Midosuji Line, or 1-minute walk from Nagahoribashi Station on the Osaka Metro Sakaisuji Line

Counseling

AIDS Consultation
Osaka City Public Health Center, Infectious Diseases Prevention Department
TEL 06-6647-0656 (9:00-17:30 Excludes Sat/Sun, National holidays, Year-end/New Year holidays).
Public Health and Welfare Center of your local Ward
Monday to Friday 9:00 - 17:30 (except National holidays and Year-end/New Year holidays)
AIDS Counseling
Kita Ward Public Health and Welfare Center
<Date> First and Third Wednesday
<Time> 14:00 - 16:00 TEL 06-6313-9968
Chuo Ward Public Health and Welfare Center
<Date,Time>
First and third Thursday 9:30 - 11:30
TEL06-6267-9968
Phone counseling for HIV and STDs (Sexually Transmitted Diseases) in foreign languages
<Date> Tuesday: English, Spanish, Portuegese
Wednesday: Chinese
Thursday: English
<Time> 16:00 - 20:00
(except Year-end/New Year holidays)
<Inquiries> NPO “Charm” TEL 06-6354-5901

4 Medical Consultation