MBA Japan

Health Insurance System


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Since the Health Insurance Law went into effect in 1961, all Japanese citizens and resident aliens cover at least one of six health insurance systems. These systems of universal health coverage provide financial security from incidences such as illness, injury, and death, but exactly how it applies to any given person depends on several factors: whether you're working, visiting or a student, your age and so on.

Among the most important are:

Social Health Insurance System

Usually, "Social Insurance" covers most private-sector employees (this is often referred to as Kenko Hoken). Most employers are in the obligation of joining the health insurance system and pay half of the monthly contributions for their employees excepting the part-time workers. The estimate of amount of the contributions is based on salary incomes.

The employer provides employees with a health insurance card. Whenever you get medical treatment you should show your health insurance card and you will only pay 20% of the total medical cost. 80% of total treatment fees are covered for the insured. Families of the insured are also covered by the system at a rate of 70% of the fees for outpatient treatment and 70% of hospitalization fees.

National Health Insurance System

The "National Health Insurance" covers the self-employed, the unemployed, the retired, and others not qualified for employee health insurance (this is often referred to as Kokumin Kenko Hoken). This type of Japanese insurance is most often used by foreigners; they are eligible to apply for National Health Insurance if their visa and period of stay is over one year.

Everybody that wishes to be insured must enroll in the National Health Insurance Section managed by the Kyoto City Government. When you enroll you obtain a Health Insurance Card which allows you to pay only 30% of the total medical fees. 70% of the total treatment fees are covered for the insured.

Applications are made at the National Health Insurance Section of the municipal office of your district. Because of this, you need your Foreign Registration Card, evidence that you are eligible to stay in Japan for a year or more, and your personal seal. (If the period of stay stamped in the passport is less than 1 year, you must show evidence that you will be living in Japan for one year or longer). Once approved, you will be given a "Health Insurance Card", and you should carry it at all times and submit it to the registration desk whenever medical or dental treatment is required. One card is issued per household.

The fee for the National Health Insurance fluctuates according to your area of location. In the case of the 23 wards within Tokyo, the monthly payment in fiscal 1998 for those who did not need to pay a metropolitan residents tax was 2,175 Yen. Those with an annual salary less than a required amount can get a 70% or 50% reduction of their insurance fee if they make an application. The reduction is based on the previous year's salary, so make sure to make a residents tax declaration even if you do not have any salary to declare.

Is everybody eligible?
Not all people are eligible. Following some reasons listed:

  • You are not registered as a foreign citizen.
  • You do not have condition of residence.
  • You are probable to stay in Japan for less than one year.
  • You are covered by some other health insurance.
  • You are a low-income earner and are getting unusual subsidies.

Other Systems

Other systems offer coverage for seamen, national public-service employees, local public-service employees, and private-school teachers and employees. Under Japan's Health insurance systems, members aged 3 to 74 are required to pay 30% of the total medical cost, with those under 3 paying 20% and those over 74, 10% or 20%. The insurance carrier then remunerates the doctor, hospital, clinic, or other medical care provider directly for the remainder on a fee-for-service basis as determined by the Ministry of Health, Labour and Welfare.

The system of universal health coverage gives all citizens admission to adequate medical care, thus contributing greatly to their peace of mind and to the overall level of health in society.

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