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Enrollment in National Health Insurance
Health Insurance—A Program That Everyone Is Required to Join
Section in charge: National Health Insurance Eligibility Section, Medical Insurance and Pension Division
●What Is Health Insurance?
Foreign residents who live in Japan must also be enrolled in some form of health insurance operated by a public institution so that everyone can receive medical treatment with peace of mind in case of illness or injury.
Registered residents in Shinjuku City must become members. However, the following people are exempt:
●National Health Insurance Does Not Apply to the Following
1.Those who are to enroll in the health insurance plan at their place of employment
2.Those who can enroll as a dependent of an insurance member through the latter’s place of employment
3.Those who are receiving public financial assistance for everyday living
4.Those who are in Japan for the purpose of receiving medical treatment under the visa status of designated activities, etc.
5.Those who engage in tourism, vacation or other similar activities under the visa status of designated activities, etc.
6.Those with a diplomatic visa
7.Those who stay in Japan beyond the designated period of stay
8.Those whose visa is good for only three months or less. (This excludes those with a visa status of entertainer, technical intern/trainee, dependent, or des-ignated activity who have some form of documentation that verifies their actual period of stay will be longer than three months.)
9.Those who are eligible for the Medical Care System for the Older Senior Citizen
●Enrolling, Withdrawing and Other Procedures
If any of these conditions for enrolling and withdrawing apply, please be sure to complete the designated procedures within 14 days. The head of the household is responsible for filing the notification form. Please call for more information.
○ Procedures for Enrollment
Eligibility for health insurance does not begin from the day you file the form, but from the day you should have enrolled in health insurance.
1.If you have moved into Shinjuku City from another city or country
2.If you have withdrawn from the health insurance plan of your place of employment
3.If you are no longer eligible for public financial assistance for everyday living
4.If a child is born in your family
○ Procedures for Withdrawal
1.If you have moved out of Shinjuku City
2.If you plan to leave Japan (return to your home country)
3.If you have enrolled in the health insurance plan at your place of employment
4.If you become eligible for public financial assistance for everyday living
5.If a member dies
●National Health Insurance Premiums
National Health Insurance premiums comprise a medical portion, support portion, and Long-Term Care Insurance portion (only for those between 40 and 64 years of age). Each portion is determined by adding together an income-based amount from the previous year and per-capita amount. The latter is calculated based on the number of all enrollees of the National Health Insurance (NHI). To ensure that NHI premiums are calculated correctly, an income tax report for the entire household is necessary. Your cooperation in this matter would be appreciated.
Also, please note that insurance premiums are calculated for the household as a unit, and the head of a household of insured members is responsible for paying insurance premiums. Therefore, please be careful and do not forget to pay your insurance premiums.
●How to Pay the National Health Insurance Premium
Payment Promotion Section, Medical Insurance and Pension Division
Insurance premiums can be paid by using the invoice, by direct debit from your financial account, or by deduction from your pension. If you pay premiums by using the invoice or by direct debit, the total amount owed for the entire year will be broken down into ten installments, from June through March of the following year, and will need to be paid by the end of each month.
Insurance premium invoices are sent out twice a year, in June and October. You can pay insurance premiums at financial institutions, such as banks and post offices, at the City Office or Branch Offices, or any city-designated convenience store. If you pay by direct debit, premiums will be paid automatically from your financial account at the end of each month.
If the head of the household is a pension recipient and fulfills the designated requirements, premiums will be deducted from the pension in the months the pension is paid (i.e., six times a year); this excludes those who pay by direct debit. If you have questions about deducting premiums from your pension, please ask the National Health Insurance Eligibility Section.
●Health Insurance Premium Payment Consultation
Payment Promotion Section, Medical Insurance and Pension Division
As a rule, if you are behind in paying your National Health Insurance premiums, you must pay any overdue premiums in one lump sum. However, please take advantage of our consultation services if payment is difficult due to special circumstances.
If you are behind in paying your insurance premiums, you may be issued an eligibility certificate in lieu of the regular health insurance card.
If You Are Enrolled in Kokuho (National Health Insurance)
Section in charge: National Health Insurance Benefits Section, Medical Insurance and Pension Division
National Health Insurance is a medical treatment health insurance plan that charges insurance premiums according to your income and covers medical expenses when you are ill or injured. If you show your National Health Insurance card (those 70 years of age or older must also show their Elderly Subsidy Recipient Card) at the hospital reception counter when receiving treatment for an illness or injury, then you only need to pay a portion of the medical expense. National Health Insurance will cover the remaining portion.
There are also benefits for childbirth and funeral expenses. You must file an application to receive these benefits. Please call for more information.
●Personally Borne Expense of Members
These are subject to change due to revisions in the law.
|Insurance Member||Insurance Member’s Personally Borne Percentage||Percentage Borne by National Health Insurance|
|Under compulsory-education age||20%||80%|
|Above compulsory-education age to 69 years of age||30%||70%|
|70 to 74 years of age||20%||80%|
*Those with a designated level of income or higher. Please call for more details.
●High Medical Expense
If you have paid high medical fees in a one-month period and fulfill designated conditions, the portion of the personally borne expense that exceeds the designated amount can be reimbursed. The personally borne expense ceiling is determined by age, household income and total medical expenses.
Public Health Programs
Section in charge: General Affairs Section, Medical Insurance and Pension Division
●Kokuho (National Health Insurance) Resort Facilities
For the health and relaxation of Kokuho members, there are year-round resort facilities as well as partial subsidy programs for summer lodging fees.
○ Resort Facilities
Kokuho is contracted with hotels and lodging facilities operated by Japan Post Holdings, Co., Ltd. so that members can use them at discounted rates throughout the year. To apply, please refer to Anata-no kurashi to kokuho (Your life and Kokuho), which is distributed to Kokuho households, or information flyers. You can then apply to the particular facility directly.
○ Partial Subsidy Programs for Summer Lodging Fees
If you use lodging facilities offered by travel agencies approved by Shinjuku City, part of the lodging fee is subsidized. Information on application procedures and other details are announced in Koho Shinjuku (the Shinjuku City bulletin) and through other means.
●Special Health Checkups and Guidance
Section in charge: Health Checkup Section, Health Promotion Division
Special health checkups that focus on metabolic syndrome are given to Shinjuku City National Health Insurance members between 40 and 74 years of age. This checkup is given together with the health checkup described on page 9. Those who are eligible will be sent a health checkup slip in the mail.
Special health guidance is given to those whose special health checkup results show that they have a high risk of lifestyle-related diseases. This includes support to improve their lifestyle, such as through proper meals and exercise.
Special health checkups and guidance for those who are enrolled in a Health Insurance Union, Mutual Benefit Society, Japan Health Insurance Association or National Health Insurance Union (including dependents) are conducted by the respective health insurance agency. For more information, please call your health insurance agency.
April 1, 2020