What are the types of health insurance in Japan? Explanation of distinctions by occupation, coverage, and enrollment methods

update date 2024/06/11

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If you live in Japan, you are required to have health insurance. However, there are multiple types of health insurance in Japan, and many people may find the system complicated and difficult to understand. Especially for foreign residents who have just started living in Japan, it is very important to understand the types of health insurance and an overview of the system.

In this issue, we will explain in detail and in an easy-to-understand manner the types of health insurance in Japan, the distinction by occupation (company employee or self-employed, etc.), the coverage, and how to enroll. We will also provide detailed information on premiums and payment methods, so please be sure to read this article to the end.

If you would like to know more about social insurance in general, including not only health insurance but also pension insurance and long-term care insurance, please take a look at the related articles below. This is an easy-to-understand explanation of the social insurance system that foreign residents should know about when living in Japan.
▶︎ What foreigners should know about Japan's social insurance: Health Insurance, Pension Insurance, and Long-Term Care Insurance explained.

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What are the two types of health insurance in Japan?

There are two major types of health insurance in Japan: National Health Insurance and Health Insurance. As a general rule, all residents in Japan must join one of these health insurance plans.

Note that although the two health insurance policies have similar names, there are significant differences in who is eligible to enroll and what is covered. Let's take a look at the characteristics of each.

(1) National Health Insurance (for self-employed, part-time workers, etc.)

National Health Insurance is a health insurance program mainly for self-employed persons, workers in the agriculture, forestry, and fisheries industries, and part-time and part-time workers.

In addition, people who do not have an occupation, such as pensioners and students, are also eligible for National Health Insurance. In other words, all people who are not covered by health insurance, regardless of occupation or age, are required to join the National Health Insurance program administered by the municipality in which they live.

National Health Insurance premiums are determined by the municipality in which the subscriber lives, based on the subscriber's income and household situation in the previous year. In principle, the subscriber must pay the full amount.

(2) Health insurance (for company employees and public employees)

Health insurance, on the other hand, is mainly for company employees and government employees. Not only full-time employees, but also part-timers and employees who work more than 20 hours per week are eligible to join the health insurance program.

Spouses and children who are dependents of company employees can also enroll in health insurance if certain conditions are met. However, the conditions for being covered by health insurance vary from health insurance association to health insurance association, so please check with your health insurance association for more details.

The premiums for health insurance are shared equally by the company and the enrollee. In other words, the company shoulders half of the original insurance premiums, so the burden on the enrollee is lighter than with National Health Insurance.

Coverage and Contents of Japanese Health Insurance

Japanese health insurance provides the following coverage

As a general rule, the co-payment ratio for medical expenses is 30%. The remaining 70% is covered by health insurance. (Both National Health Insurance and Health Insurance)
In principle, 420,000 yen is provided as a lump-sum childbirth and childcare allowance. (both National Health Insurance and Health Insurance)
If you are absent from work due to illness or injury, you will receive an injury and illness allowance. You can receive an amount equivalent to two-thirds of your daily standard remuneration for up to one year and six months. (Health insurance only)
If you are absent from work due to childbirth, you are entitled to a maternity allowance. Two-thirds of the standard daily remuneration is paid per day within 6 weeks before and 8 weeks after childbirth. (Health insurance only)

Thus, it is important to remember that the sickness and maternity benefits are covered only by health insurance and not by the National Health Insurance. This is one of the major differences between the two health insurances.

How to enroll in Japanese health insurance

The enrollment procedures differ between National Health Insurance and Health Insurance.

If you are staying in Japan for more than three months, you are required to enroll in the National Health Insurance program. Procedures for enrollment in the National Health Insurance system are handled at the National Health Insurance counter of the municipal office of the city, ward, town or village where you live. Foreign residents should bring identification such as a residence card. Please note that the procedure must be completed within 14 days from the date of entry into Japan, the date of moving in due to moving out of the country, or the date of losing eligibility for the health insurance you have been enrolled in due to resignation (the day following the date of resignation).

On the other hand, the enrollment procedure for health insurance is handled by the company where you work. When you join the company, the company will provide you with the necessary documents to enroll in health insurance. Fill out the necessary information and submit it to the person in charge at the company, and the enrollment procedure is complete. A health insurance card will be issued by the company at a later date. The details of the procedure vary from company to company, so if you have any questions, please check with the person in charge in your company.

Japanese Health Insurance Premiums and Payment Methods

National Health Insurance and Health Insurance differ in the way premiums are determined and paid. Let's take a closer look at the features and payment methods of each type of insurance premium.

National Health Insurance

National Health Insurance premiums are determined by the municipality in which you live, based on the previous year's income and the number of people in your household. Premiums are calculated on a household basis, not on an individual basis, and in principle, the head of the household is obliged to pay the premiums.

Premiums are generally paid by account transfer or by payment slip. If you have completed the account transfer procedure, you can rest assured that your premiums will be automatically deducted from your designated account, or you can pay conveniently at a convenience store with a payment slip.

In addition, an increasing number of municipalities offer online payment via credit card or Internet banking.pay-zeroallows you to easily pay premiums from your home computer or smartphone. In some cases, payment apps such as PayPay and d-payment are supported, so you can easily make payments with the apps you are used to using.

Health Insurance

On the other hand, health insurance premiums are calculated based on the monthly standard remuneration and the insurance premium rate. The monthly standard remuneration is the average salary for the three-month period from July to September each year applied to the grade, and the insurance premium is calculated based on this amount.

The premiums for health insurance are split equally between the company and the insured. In other words, the company automatically pays the premiums by deducting them from your salary.

If you retire from your company and become a voluntarily insured person, you must pay the premiums to the health insurance association by yourself. The most common payment method is account transfer, but some health insurance societies accept payment by payment slip, credit card, or Internet banking, so please check with your health insurance society.

Which insurance should I purchase, National Health Insurance or Health Insurance?

Whether to enroll in National Health Insurance or Health Insurance depends on your occupation.

Self-employed persons, agriculture, forestry, and fisheries workers, and freelance workers should enroll in National Health Insurance. Part-time and part-time workers are also usually enrolled in National Health Insurance. However, some employers may offer health insurance, so please check the terms and conditions of your employment contract or other documents.

As a general rule, company employees are covered by their employer's health insurance. Part-time workers and those who work more than 20 hours per week should also be eligible for health insurance. Since the coverage of health insurance is more generous than that of the National Health Insurance, and the premium cost can be split equally between the company and the insured, it is advisable to join the health insurance program as much as possible.

If you are new to Japan and do not understand the details of the health insurance system, you can consult with the municipal office of the city, ward, town or village where you live. They should be able to provide careful consultation for foreign residents.

Troubles to be aware of and countermeasures to be taken during health insurance procedures

Failure to follow proper health insurance procedures can lead to a variety of problems.

For example, if you are late in enrolling in health insurance, you will be in arrears of premiums and may be subject to a fine. The fine is calculated based on the period of nonenrollment, so it is important to consult with your local government office or employer as soon as possible after your arrival in Japan to proceed with the necessary procedures.

In addition, if you fail to pay the premiums, your health insurance card will expire and you will not be able to receive medical care at medical institutions. If you continue to be in arrears, you may be subject to dispositions such as seizure, so be sure to check the due date for payment of premiums and pay them by the due date. If you have financial difficulties in paying the premiums, you can consult with the municipal office or health insurance association and use the installment payment system.

Furthermore, if there are any changes in your address, place of employment, or household situation, you will need to go through the health insurance procedures. Failure to follow the procedures can lead to problems such as incorrect calculation of insurance premiums or failure to receive important notices, so please report any changes promptly to the municipal office or health insurance association, and prepare the necessary documents (residence certificate, employment contract, etc.) to complete the procedures.

It is important to understand the key points of the procedure and to prevent problems before they occur. If you have any questions, please consult with the person in charge at the municipal office or your place of employment.

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summary

Let us review some important points about the Japanese health insurance system.

There are two types of health insurance in Japan: National Health Insurance and Health Insurance.
The health insurance to be joined differs depending on the occupation. Self-employed persons and others are covered by National Health Insurance, while company employees and others are covered by health insurance.
Health insurance offers better coverage than national health insurance.
The subscriber pays all the premiums for the National Health Insurance, and the premiums for the Health Insurance are split equally between the company and the subscriber.
Enrollment procedures for National Health Insurance are carried out at the municipal office of the city, ward, town or village where you live. The company where you work handles the procedures for health insurance.

For foreign residents who have just started living in Japan, health insurance procedures may be confusing and confusing. However, once understood, it is not so difficult.

If you have any questions, please do not hesitate to ask the municipal office of the city, ward, town or village where you live or the person in charge at your place of work. Make sure you have a correct understanding of Japan's health insurance system and live a life with peace of mind.