Medical Insurance System in Japan
Social Insurance and National Health Insurance
All those living in Japan are required to be covered by some form of medical insurance. There are two medical insurance systems in Japan: “Social Insurance System” for those working at a company or office and “National Health Insurance System” for everyone else. Foreign students living in Japan, who are considered a resident for 1 year or more may apply for National Health Insurance. Those covered by health insurance are issued a Health Insurance Card. Always take it with you when going to the see the doctor in Japan.
Receiving Medical Care without Insurance
Without health insurance, you will have to pay the full charge for medical treatment directly to the medical institution (Ironically, this is referred to as free treatment). In such cases, be aware that the fee and method of payment will be determined after negotiating with the health care facility.
Employees health insurance system
Employees health insurance system covers employees at offices and factories. For more information including registration procedures, please check with your employer.
National Health Insurance covers:
Payment of Medical Costs
In some cases such as the following, you may be reimbursed up to 70% of the medical cost paid if you request an assessment and it is approved.
- If you are injured in an unavoidable accident and treated at a hospital that does not accept National Health Insurance.
- If you are injured or become ill during travels and receive medical treatment without your health insurance card.
- If and/or when a doctor instructs you to receive treatment at a facility other than a medical institution for massage, acupuncture, moxa cautery, rubbing, etc.
- If and/or when you receive treatment at an orthopedic clinic for bone fracture, bruises, sprain, etc.
- Expenses incurred for supplemental equipment such as corsets and casts.
- Expenses incurred for blood due to blood infusion during surgery.
Arranging payment of high medical fees
If your payment to one medical institution in a one-month period exceeds a certain limit, the excess amount will be refunded to you at a later date.
Please apply at the insurance division of your town or village office or the national health insurance society. Your hospital receipt, personal seal, health insurance card and account book are necessary for application.
Other Major Benefits
- In some cities and towns, a lump sum birth allowance is payable.
- In some cities and towns, a lump sum funeral allowance is issued for death.
- An system for aiding medical charges incurred due to specified diseases (intractable diseases) * is available.
- A partial payment may be issued for medical care charges incurred during overseas travel. Take your detailed list of medical services, receipt and their translations to the municipal government office, and you will be partially reimbursed in accordance to the standard charge of health insurance treatment in Japan.
*: Specified diseases(intractable diseases)are, for example, Behcet’s disease, multiple sclerosis、myasthenia gravis, and other diseases of unknown causes and method of treatment, needing long-term medical treatment. In the Osaka Prefecture, as of March 1, 2001, there are 45 designated disorders.
National Health Insurance does not cover:
In some instances, your National Health Insurance may not be applicable, leaving you to pay for the expenses out of your pocket. Your insurance will not cover the following cases:
When National Health Insurance is not applicable
- When you receive medical care at a medical institution that is not authorized by the government to accept health insurance.
- Normal pregnancy/childbirth, artificial termination of pregnancy: However, complications during pregnancy and/or irregular delivery of pregnancy is applicable for insurance.
- Costly and special medical care that is unauthorized by health insurance.
- Health examinations
- The “extra charge for the special room in hospital” when hospitalized in a private room. Other incidental costs related to hospitalization may not be applicable for insurance.
- Special treatment for teeth such as crowns
- Treatment for injury due to traffic accident assailant is aware of: In general, payable by automobile insurance enrolled by assailant.
If you are involved in a traffic accident
If you are involved in a traffic accident, immediately notify the police AND the insurance division of your town office. If your case is not registered properly and national health insurance will not cover your expenses if: (1) You have received medical treatment, (2) You have received treatment expenditure from the other party or (3) You have reached an out-of-court settlement.
When you have been in an accident on the job (part-time)
According to the Labor Standards Law, if a laborer is injured on the job or becomes ill due to work, the employer is responsible for the medical costs and may be liable for disability compensation. For that purpose, both full-time employees and part-time employees included, the business owner is required to have “Worker’s Compensation Insurance” coverage and is liable for payment of insurance in its entirety.
Hence, employees are eligible to receive “Worker’s Compensation Insurance” for on-the-job injuries and/or illness as well as for disasters while commuting to work.
If you forget your health insurance card
If you have health insurance, but forgot your insurance card at time of treatment, you will have to pay for the full charge at that time. If you take your receipt to the medical institution later, the amount covered by insurance may be reimbursed.
If you move to another city:
Please return your national health insurance card to the municipal, town or village office you are leaving and apply for a new one at the municipal, town or village office where you will move.