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Kokumin Kenko Hoken – National Health Insurance

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Japanese Health Insurance is mandatory for all residents of the country, whether they are natives, permanent residents, or foreigners visiting the country for three months. Kokumin Kenkou Hoken is available to those who do not have employee health insurance as required by law.

  • Kokumin Kenko Hoken – 国民健康保険

Kokumin Kenko Hoken is aimed at those who work as self-employed people and workers who, for some reason, are not registered with shakai hoken. Registration is done by the interested party at the city hall and the fee is calculated based on the previous year’s income, number of dependents and family income. At Kokumin Hoken, an insurance fee is charged per dependent.

  • Register

To register, you must go to the local city hall with your documents and complete the registration form. It is mandatory to register within two weeks of becoming eligible, whether due to job loss or change of residence. Those who do not register are subject to paying up to two years in arrears.

  • Plan Value

The National Health Insurance rate is calculated annually according to the family’s total income from the previous year. 10 installments will be charged per year, which can be easily paid at any convenience store.

  • National Health Insurance Benefits

When the insured person undergoes consultations or treatments at a medical institution, only 30% of the total value of the medical expense must be paid and for pre-school children it is 20%, for the elderly over 70 years old it is 20 or 30%. And there will be benefits in the event of childbirth or death. And if you have high medical expenses, the part that exceeds the base amount established according to the family’s income may be reimbursed.

  • High Medical Expense

When the value of medical expenses becomes too high within a period of 1 month, the amount that exceeds the established base amount may be reimbursed later by the National Health Insurance. But the amount varies from region to region. The request form will be sent by the City Hall only to people who meet the established requirements. To receive this benefit you will need to have a receipt for payment of the medical expense.

  • Maternity Benefit

Pregnancy is not considered an illness in Japan. Therefore, insurance does not cover exams and birth expenses. But pregnant women can receive maternity allowance (shussan ikuji ichiji-kin), granted to mothers for each child born. When the birth takes place in a medical institution that has an emergency compensation system (Sanka iryo hosho seido) and the baby is born with more than 22 weeks of gestation, 420 thousand yen will be provided (in the case of birth with less 22 weeks of gestation, it will be 390 thousand yen). In addition, in the case of miscarriage or stillbirth the benefit will also be provided if you are more than 4 months pregnant.

The benefit will be transferred directly to the medical institution as requested by the applicant. If the cost of childbirth is less than the value of the benefit, the difference will be provided to the applicant (it will be necessary to apply to the National Insurance and Pension Department of the City Hall). To receive this benefit you will need to have a receipt for payment for the birth or medical specification.

  • Bonus for the Birth of a Child

The birth bonus is offered to families whose baby is about to be born. In cases of miscarriage or fetal death after 85 days from the date of conception, it is also possible to receive the bonus. For more information, contact the city hall’s national health insurance and pension department.

※ 育児休業 – ikuji kyugyou – Leave to take care of a child up to one year old.

  • Reimbursement for medical treatment abroad

Those who have had to use medical services abroad while traveling can request reimbursement of expenses from the city hall. Reimbursement will not apply in cases where the person traveled abroad for the purpose of receiving medical treatment. For more information, contact the city hall’s national health insurance and pension department.

  • Funeral Expense

When the insured dies, and if the wake ceremony is held, 50,000 yen will be provided. You will need to have the Document that can confirm the person representing the wake (cremation certificate, etc.). Funeral assistance can be requested, upon the death of a relative, by the family member responsible for the funeral (moshu). The period for making the request is two years from the day following the funeral.

  • Medical Expenses for Patients with Tuberculosis

In the case of patients who fall under the law on medical assistance for the prevention of infection and infected patients (article 37), the medical expense is fully covered by the National Health Insurance. No special procedures are required, local Insurance and Pension Sector National City Hall.

  • Specific Exceptions that insurance does not cover

If policyholders do not follow medical orders; injury or illness resulting from fights or drunkenness; injury or illness resulting from suicide attempts; upgrade to private or semi-private rooms during hospitalization; work-related injuries (are the employer’s responsibility); periodic preventive exams; induced abortion; dentist; Ophthalmologist…

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