Public Health Insurance Systems in Japan

 By Japanese law, all people living at an address in Japan are required to have health insurance 健康保険 Kenkou Hoken. The health insurance includes two public systems; one is Social Insurance (Shakai Hoken 社会保険) from one’s place of employment, and other is National Health Insurance (NHI or Kokumin Kenko Hoken 国民健康保険) operated by municipalities depending on the area. 

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Who to enroll Social Insurance (Shakai Hoken 社会保険) ?

If you are a company employee, you are to buy Social Insurance (Shakai Hoken) and the insurance premium is supposed to be withheld from your monthly wage. In the case of family, the householder is to subscribe to the Social Insurance for dependents in his/her family. Insurance premiums are calculated in accordance with income (of the householder). 

Who to enroll National Health Insurance (NHI or Kokumin Kenko Hoken 国民健康保険)?

If you are not a company employee (if you are a self-employed or part-time worker, student etc.), you are to enroll National Health Insurance. To enroll National Insurance, you need to apply at a social insurance office Shakai Hoken Jimusho Office (社会保険事務所) in the city you live. In case of a family, the householder is to subscribe to the National Insurance for dependents in his/her family. Insurance premiums are calculated in accordance with income (of the householder). 

When required to enroll the National Health Insurance? 

- If you immigrate to Japan
- If you withdraw from another form of public health insurance, for example, When you withdraw from the social insurance as you leave a company to become a self-employed
- If you no longer receive public financial assistance for daily life. (Person who receives public financial assistance for daily living is not obligated to enroll the public insurance)
- If a child is born in your family

When required to withdraw the National Health Insurance?

- If you leave Japan
- If you enroll in another public health insurance, for example, when you become a company employee and enroll the social insurance program.
Important: If you forget this withdrawal procedure, you will have to redundantly pay for both social and national insurance.
- If a family member dies

The person who has the National Health Insurance System only need to pay a certain percentage of the total medical fees;
30% for age 6 up to 69 years old
20% for age 70 up to 74 years old
10% for 75 years old or older
20% for childrend 5 (6) years old and younger

If you are for staying in Japan less than one year, you don’t have to buy the National Insurance. However, it is strongly recommended that you have some form of health insurance as the medical fee is expensive.

Also, remember that the Public Health Insurance does not cover these kinds of medical fees, including hospitalization in a private room in a hospital, cosmetic surgery, dental beauty treatments, and abortions.

For detailed information, these web pages are helpful

Council of Local Authorities for International Relations
http://www.clair.or.jp/tagengorev/en/f/

Study in Japan : FAQ by Ministry of Foreign Affairs of Japan
http://www.studyjapan.go.jp/en/faq/faq02e.html

Information by Ministry of Health, Labour and Welfare (Japanese website)
http://www.mhlw.go.jp/english/