This page Sumida City Guide National Health Insurance and Pension Programs

National Health Insurance and Pension Programs

Health Insurance (Kenko hoken)

There are two types of health insurance programs in Japan. One is the Workers' Health Insurance Plan, which covers company employees automatically, and the National Health Insurance Plan, which covers city, town and village residents. By enrolling in a health insurance plan and paying the premiums, you pay only 20 to 30% of the cost for the medical treatment you receive when you become ill. Foreign residents who have lived in Japan for more than a year are eligible to enroll in the National Health Insurance Plan by showing their foreign resident registration card. Those foreign residents whose period of stay is less than a year may be eligible if they can prove their stay will be more than one year. Once you enroll in the National Health Insurance Plan, you cannot voluntarily withdraw (see exceptions page 62).

For more information on National Health Insurance, contact the National Health Insurance Division, Sumida City Hall, 2nd Floor, Tel. 5608-6121.

Insurance Policy

Coverage of Medical Costs:
When you become ill or get injured and receive medical treatment or hospitalization, the National Health Insurance Plan covers up to 70 percent of the cost. The member pays the remaining 30%.
*When hospitalized, you are responsible for paying the cost of your meals.

Reimbursement for Medical Expenses:
If you receive any medical treatment while you are traveling, or when you suddenly become ill and you do not have your National Health Insurance Certificate with you, you must pay all medical expenses at the time of treatment. Later, when you apply for reimbursement to the Sumida City Hall, attach an itemized list of the medical expenses, along with a receipt. That portion covered by National Health Insurance Plan (70% of the medical cost designated by NHI program) will be reimbursed to you.

Reimbursement for High Medical Expenses:
When the amount paid by the same member in the same month to the same medical facility exceeds 63,000yen, the exceeded portion of the total amount will be reimbursed upon filing a claim.

Cost of Birth/Child Rearing Allowance:
When a child is born, 350,000yen is paid to the head of the household.

Funeral Cost Allowance:
When a covered member dies, 20,000yen is paid to the person in charge of funeral arrangements.

Registering for National Health Insurance

In the following cases, please bring your foreign resident registration card and your health insurance certificate and report to the National Health Insurance Division at the City Hall office within 14 days:

When to Join the National Health Insurance Plan

1. When you move from another city to Sumida City.
2. When you withdraw from the health insurance plan provided by your employer.
3. When a baby is born in your family.
4. When you no longer receive public welfare payments.

When to Withdraw from the National Health Insurance Plan

1. When you move from Sumida City to another city (don't forget to rejoin in the new city).
2. When you enroll in a health insurance plan provided by your employer.
3. When a covered member dies.
4. When you begin receiving public welfare payments.
5. When you leave Japan.

Please Also Report When:

1. You change your address within Sumida City.
2. The name of the head of your household, or others in your household, changes.
3. Other items recorded on your foreign resident registration card change.
4. You lose your health insurance certificate.

Useful Phrases

National Health Insurance Premiums

• Your premium is determined by your annual income. A bill is sent to you four times per year; each bill notifies you that a three-month premium is due. You can pay your premium through the end of the month of billing at the National Health Insurance Division branch offices or financial institutions, such as banks, credit associations or the post office. You can arrange for this procedure at the financial institution. If you apply to your financial institution by the 25th of the month, automatic transfer should start from the following month.
• It is very convenient if you use the automatic account transfer system offered by financial institutions for payment of premiums.
• When you initially become a member of the National Health Insurance system, the premium for the month in which you enrolled is included in your statement. When you withdraw, you pay the premium up to the previous month of your withdrawal date.
• If your annual income during the previous year fell below a certain level, your premium may be discounted for the following year.

National Pension Plan Program (Kokumin nenkin)

If you are not a member of any corporate or group plan which is done automatically by your employer, you are eligible for the National Pension Plan Program (those aged 20 to 60). This also includes foreign residents in Japan. If the total number of years you paid the premium between the ages of 20 to 60, and the number of years which satisfies the following conditions below adds up to more than 25 years, you are qualified to receive the standard sum of the pension.

• Your length of stay in Japan between April 1961 and December 1981.
• Your length of stay abroad from April 1961 to the time you are granted permanent residence status. Those who have already paid the premium six months or more but leave Japan without getting the pension are qualified to receive a lump sum payment.

For further information, please contact the National Pension Division, Sumida City Hall, 2nd Floor, Tel. 5608-6129.

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