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National Health Insurance/ kokumin kenkou hoken 国民健康保険 Publice health insurance in Japan is based on a system of universal health coverage, whereby the population is required to be enrolled in either National Health Insurance (NHI) or employer-based insurance (there is also public health insurance for the elderly). NHI is provided by the local government (city, ward, town or village) and is financed mainly by individual contributions called NHI tax and Treasury disbursements. When you receive medical treatment that is covered by NHI, you will only have to pay between 10 to 30 percent (depending on your age) of the cost of the treatment and the rest will be covered by the NHI. The following foreigners can be enrolled in NHI. ・those who are not enrolled in an employer-based insurance at their workplace. ・those who have an address in Kutchan Town. ・those who have an Alien Registration Card and a valid visa to stay in Japan for at least a year as of the entry to Japan.. ・those who have an Alien Registration Card and a valid visa to stay in Japan for less than a year but are approved by reference materials such as an employment contract for more than a year, to stay more than one year, can enroll in NHI. ※ Note that those who stay in Japan for one year or more as a result of a renewal of period of stay on visa cannot be enrolled in NHI. Please make an application for the enrollment of NHI when; ・ you apply for an Alien Registration Card. ・ you move from one municipality to another. ・ you cancel an amployer-based insurance (apply on the first day of your retirement). ・ your child is born. Please make an application for the cancellation of NHI: ・ when you move to another municipality.. ・ when you enroll in an employer-based insurance. ・ when you die, a family member must cancel your membership. ※Please make above application within 14 days of the event. For application and further information, please contact: National Health Insurance & Medical Care Section of The Resident's Affair Division at the Kutchan Town Office (Tel. 0136-22-1121 ext. 104, 105, 106)
Percentage of expenses to be paid by the individual (Self-burden expenses)
Self-burden meal charge during a hospitalizaion (per day)
1. If the head of the household, as well as the person insured, are from a Resident-tax-free household. 2. I f the head of the household, as well as the person insured, are from a Resident-tax-free househols and the income of the household is 0 yen after deducting living expenses.
In the following cases, you have to pay for the medical expenses upfront. However, you will be reimbursed for the expenses that would normally be covered by the NHI if you apply with the correct documentation at the Town Office. 1. When you receive medical treatment at a hospital which is not covered by NHI due to an accident or unforeseen disaster, or when you are suddenly taken ill while traveling and see a doctor without your NHI Certificate. 【Documents required】 NHI Certificate, application form, a detailed statement of the medical treatment, receipt and your personal seal. 2. The cost of a blood transfusion during an operation 【Documents required】NHI Certificate, application form, medical certificate or written opinion prepared by a doctor, Certificate of receipt of blood for blood transfusion, receipt of a blood donor and your personal seal. 3. The cost for personal medical equipment approved by a doctor such as a bandages, neck brace etc. 【Documents required】NHI Certificate, application form, medical certificate or written opinion prepared bu a doctor, receipt and your personal seal. 4. When you receive medical treatment such as acupuncture, moxibustion and massage (you need your doctor's consent). 【Documents required】 NHI Certificate, application form, doctor's written consent, detailed receipt and your personal seal. 5. When you have a broken bone or a sprain and receive medical treatment from a Judo practitioner that is not covered by NHI. 【Documents required】NHI Certificate, application form, detailed statement of medical examinations and receipt (if they are written in a language other than Japanese, Japanese translations are required) and your personal seal.
1. When the insured has a baby, a lump-sum payment for a childbirth and child-rearing is paid. If the insured has a stillborn baby or a miscarriage, the insured can receive the lump-sum payment if she is in the twelfth week of pregnancy or later. 【Documents required】NHI Certificate, application form, Maternity Health-Record Book, a Doctor's Certificate in the case of stillbirth or miscarriage and your personal seal. 2. When the insured dies, funeral expenses are paid to the chief mourner. 【Documents required】NHI Certificate, application form, a document proving the death and the chief mourner's personal seal. 3. If a seriously ill patient is transferred to a hospital or changes hospitals, then the transfer expenses may be paid if approved by the Town Office. 【Documents required: NHI Certificate, application form, a doctor's written opinion, receipt and your personal seal.
When you suffer damage or sickness from a third person such as a traffic accident, you can receive medical treatment covered by NHI. Please file a report of the damage or sickness suffered from the third person at the time. If you receive medical expenses from the third party or settle out of court for the accident before the report, then the expenses will not be covered by NHI. Documents required: NHI Certificate, Certificate of the Accident (issued by the police) and your personal seal.
1. The following are not covered by the NHI: Medical examination, thorough medical checkup, vaccination, normal pregnancy, childbirth, teeth straightening, slight underarm odor or blemish, cosmetic surgery and abortion due to economic reasons. 2. An injury or illness from performance at work is covered by workplace accident insurance.
Deliberate crime or accident, sick or wounded due to a quarrel or drunken behaviour or when the insured does not follow the instructions of a doctor and an insurer.
National Health Insurance & Medical Service Section, Residents' Affair Division (Kokuho Iryou Kakari, Juumin Ka) Tel. 0136-22-1121 ext. 124, 104 E-mail: kokuho@town.kutchan.hokkaido.jp If you are under 70 years old If your medical expenses, paid at the same hospital or clinic within the same month, are higher than the self-burden medical expenses limit shown in the following table, the balance will be reimbursed to you. Table of the limit of self-burden medical expenses to be paid by the patient (per month)
Note: 1. A High Income Household means the household whose total income after tax is higher than 6,7 milion yen. 2. Medical expenses must be calculated as a calendar month. 3. If you go to more than two hospitals or clinics, the medical expenses must be calculated separately. 4. The medical expenses for your dental treatment, outpatient and inpatient must be calculated separately, even if you receive these treatments in the same hospital or clinic. 5. The expenses for meals during hospitalization and for a hospital bed not fully covered by the NHI are excluded. ※ Example (for a general household) 1st to 3rd allowance Total medical expenses: 1 million yen ↓ (You have to pay 30% of the expenses) Self-burden expenses: \300,000 ↓ Limit of self-burden expenses \72,300+(\1 million-\241,000)×1% = \79,890 ↓ (Surplus) Allowance: \300,000-\79,890 = \220,110, \220,110 will be reimbursed. 4th allowance or more If you receive allowances for four times or more during the last 12 months, the amount of allowance is calculated based on the column for "4th allowance or more" in the above table. ・When memebers of the same household combined expenses exceed the limit of self-burden expenses There must be at least two household members who go to the hospital for treatment. Each household member's self-burden expense has to be 21,000 yen or more. If the total of the househod's medical expenses is higher than the limit of self-burden expenses, the surplus will be paid. ※ Example (for a general household) Medical expenses: Husband 200,000 yen, Wife 100,000 yen Total 300,000 yen ↓ (You have to pay 30% of the expenses) Self-burden expenses: Husband 60,000 yen, Wife 30,000 yen Total 90,000 yen ↓ Limit of self-burden expenses \72,300+(\300,000-\241,000)×1% = \72,890 ↓ (Surplus) Allowance: \90,000-\72,890 = \17,110, An allowance of \17,110 will be reimbursed.
Calculation of NHI Tax: NHI Tax is calculated by one of the following four categories. For those who are between 40 years old and 64 years old, NHI Tax is comprised of the Medical Care Tax and the Nursing-Care Insurance Tax.
※ The method of calculation of NHI Tax varies between Municipalities Please refer to the page on Taxation for further information. ※ "Number One Insured" means those who are 65 years old or older. "Number Two Insured" means those between 41 and 64 years old. Payment of NHI Tax: The amount of NHI Tax varies with age. Those who are younger than 40 years old pay only the Medical Care Tax. Those who are between 41 and 64 years old must pay the Nursing-Care Insurance Tax as well as the Medical Care Tax. As a general rule, those who are 65 years old or older pay NHI Tax to their municipality and the Nursing-Care Insurance Tax is deducted from their pension. For application and further information, please contact:
National Health Insurance & Medical Care Section of The Resident's Affair Division at the Kutchan Town Office (Tel. 0136-22-1121 ext. 104, 105, 106) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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