4-2 Health insurance
(1) Eligibility
Employees of companies and other business entities are eligible for health insurance programs.
(2) Entry procedures
The procedures differ among companies and business entities. Please enquire at your workplace.
(3) Insurance cards (health insurance card: kenkou hoken hihokenshashou)
After you have completed the entry procedure, you receive your health insurance card. As a card that proves your membership to an insurance program, it must be kept with care. An insurance card bears the holder’s name and address. It must be shown at the reception of a medical institution every time you receive clinical services there. It is advised to carry it when you travel inside Japan. No borrowing, lending, sale or purchase may be made with an insurance card.
(4) Obligation fees at medical institutions
When you receive medical care due to sickness or injuries, you pay 30% of the whole medical fees spent for your treatment. However, for insured persons aged 70 or older, whether the contributors or their dependents, the contributors bear either 10% or 30% depending on their income. The contributor bears 20% of the medical fees spent for his/her dependent children up to two years old.
●Obligation rates
| Contributor |
General |
30% of medical fees |
| Senior beneficiaries |
10% of medical fees (30% if the income of the insured is above a certain level) |
Contributor’s
Dependent |
Children below three years |
20% of medical fees |
| People aged three years or older and below 70 |
30% of medical fees |
| Senior beneficiaries |
10% of medical fees (30% if the contributor’s income is above a certain level) |
(5) Insurance contributions
Insurance contributions are deducted directly from the salaries of the contributor. The amount depends on the size of the salary and other factors, and is borne evenly by the contributor and his/her employer.
(6) Types and contents of health insurance payments
| |
Classification |
|
| |
Types of payment |
|
| |
In cases of sickness and injuries |
|
Contributor |
Dependent |
|
| In cases of receiving treatment with the insured card |
→ |
Medical benefit
Medical expenses for food during hospitalization |
Family medical expenses |
| In cases of paying the entire medical expenses |
→ |
Medical expenses |
| In cases of bearing medical fees above a certain level |
→ |
Sizable medical expenses |
| In cases of being transported for emergency, etc. |
→ |
Transportation fees |
Family transportation fees |
| In cases of taking leave from work due to medical necessity |
→ |
Invalidity benefit |
|
| In cases of childbirth |
→ |
Lump-sum payment of childbirth and childcare* |
Family lump-sum payment of childbirth and childcare* |
| In cases of death |
→ |
Burial fees |
Family burial fees |
* When the contributor gives birth to a child, the lump-sum payment of childbirth is given, while when a dependent of the contributor gives birth to a child, the family lump-sum payment of childbirth is given. Both types of payments are 350,000 yen for a baby.
|
