Enrolling in National Health Insurance

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Page Number 2000106  Updated on April 14, 2025

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Japan's health insurance was created to lighten the economic burden on those that become ill or injured by having a system based on mutual support that everyone is enrolled in and whose premiums help those who need it.

The system you enroll in will differ depending on your employment

Farmers, entrepeneurs, etc. need to enroll in National Health Insurance, and those working at companies, factories, etc. need to apply for health insurance "健康保険" through their employer.

Contact
National Health Insurance and Pension Plan Division (Gifu City Hall, 2F / Tel. 058-214-4315)

National Health Insurance

Those required to enroll

Those who 1. and 2. both apply to must enroll in National Health Insurance.

  1. Those that currently have a residence certificate registered with Gifu City or plan to do so soon
  2. Those that have a valid residence status and expect to live in Japan for over three months

*Those to whom any of the following apply to cannot enroll.

  • Those that don't have a valid residence status and are staying in Japan illegally
  • Those that have a short-term stay visa
  • Those with a diplomat visa
  • Those with a specified activities visa such as “Receiving medical treatment" or "Looking after someone receiving medical treatment"
  • Those with a specified activies visa in which said activities are tourism, recuperation, someone 18 or older involved in a similar activity or an accompanying spouse.
  • Those whose residence period is three months or less
    Those who have a residence period of less than three months such as those with an entertainment visa, technical intern trainee visa, family dependent visa, official visa, etc. that are later permitted to stay longer than three months are required to enroll.
  • Those from a country that has a social security agreement with Japan and has a certificate indicating their enrollment in social insurance(s) (Certificate of Coverage)
  • Those enrolled in health insurance through their employer and their dependents
  • Those aged 75 or older
    (People in this age group must enroll in medical insurance for those 75 or older)
  • Those receiving public assistance

Processes to enroll/unenroll, etc.

Please go to Gifu City Hall or one of its branch offices within 14 days of an event that require it (moving in to the city, unenrolling with your company, etc.)

Situations in Which You Are Required to Submit a Notification

Enrolling in National Health Insurance
Reason Required Documents
If have moved into Gifu City from another municipality Certificate of Moving Out (転出証明書)
Unenrolling from health insurance enrolled in through your employer Certificate of Health Insurance Coverage Loss
You are no longer a dependent of someone enrolled in health insurance through their employer Certificate of Health Insurance Coverage Loss
If you have a child Maternal and Child Health Handbook
When you stop receiving public assistance Decision to Withdrawal from Public Assitance Notice
Unenrolling from National Health Insurance
Reason Required Documents
When moving to a different municipality One of the following: health insurance card, eligibility confirmation document, or notification of eligibility information.
If enrolling in health insurance through your employer
If you are a dependent that has enrolled in health insurance through someone else's employer

Something proving the dependent has enrolled in health insurance through your employer, such as a certificate.

(Documents that show the names of all enrolled members, such as workplace eligibility confirmation or eligibility information notices provided by an employer)

When someone enrolled in National Health Insurance has passed away The health insurance card of the person that passed away or eligibility confirmation document and death certificate
If you have started to receive public assistance Health insurance card or eligibility confirmation document, Decision to Enroll in Public Assistance Acceptance Notice
Other
Reason Required Documents
If you move to a different address within Gifu City Health insurance card or eligibility confirmation document
If the head of the household has changed or your name has changed Health insurance card or eligibility confirmation document
If households separate or join together One of the following: health insurance card, eligibility confirmation document, or notification of eligibility information.
If living at a different address to go to school One of the following: health insurance card, eligibility confirmation document, or notification of eligibility information and a (school) enrollment certificate
If you have lost your health insurance card or it gets damaged -

*When submitting a notification, you will also need to bring a document confirming your identity (residence card, etc.)

*Anyone completing a process on your behalf from a different household will need to get power of attorney from you to do so.

*Document proving your Individual Number

Health insurance cards, etc.,

Health insurance cards serve as a medical examination ticket when receiving treatment at hospitals and other medical facilities. After December 2, 2024, health insurance cards will no longer be issued. Instead, an eligibility confirmation document or an eligibility information notice will be issued. If you lose or damage these documents, please follow the procedures for reissuance.

Individual Number Insurance Card

You can use your Individual Number Card to visit a hospital if you have completed the health insurance registration for it.

Eligibility Information Notice

This will be issued to those who have registered their Individual Number Insurance card. It contains information registered on your Individual Number Card's health insurance function. It cannot be used alone for hospital visits.

Eligibility Confirmation Document

We issue eligibility confirmation documents to those who do not have an Individual Number Insurance Card. You can use the eligibility confirmation document to receive medical care at hospitals.

※ Only the enrolled member can use an Individual Number Insurance Card or eligibility confirmation document.

  • You will face legal punishment if you lend your card to anyone else.
  • You cannot use a health insurance card that you rewrote part of, copies of your health insurance card, or cards that do not have Gifu City's official seal affixed to them.

How Insurance Premiums are Determined

Health insurance premiums are determined by the number of people in a household (family) as well as their incomes.
They will start to be calculated per month starting from the month that enrollment begins (not based on the month you applied in).
If you unenroll in the middle of a payment period, you will have to pay for every month of enrollment that you have not paid for yet up until the month before you decide to unenroll.

*If you plan to unenroll, please complete the processes to do so in advance at the National Health Insurance and Pension Plan Division.

How to Pay Insurance Premiums

National Health Insurance premiums in Gifu City cover a one year period (April - March) in which 10 monthly payments are split between June and March. Those enrolled will be sent a payment notice detailing these premiums. 

Please pay each payment by the end of the month.

You can learn more on how to make payments here.

*For information/consultation on payment of national health insurance premiums, please visit the counter located at the Taxation Division.

Reduction in National Health Insurance Premiums for Those That Become Unemployed Due to Circumstances Outside of Their Control, Such as Being Fired, Business Going Bankrupt, Etc.

There are cases where the unemployed person's income that is used to determine their National Health Insurance premiums is 30% of what they were making while employed.

Documents necessary to submit a notification

  • Eligible unemployment benefit recipient certificate
  • A document proving your Individual Number

National Health Insurance Premium Payment Consultations on Holidays and Weekday Evenings

  • Days and times available
    • Every Sunday 10:00am - 3:00pm
      (excluding the New Year's period: 12/29-1/3)
    • Every Thursday (evenings) 5:30pm - 8:00pm
      (excluding public holidays and the New Year's period: 12/29-1/3)
  • Location
    Tax Collection Division
  • Documents to bring
    One of the following: Insurance premium payment notice, health insurance card, eligibility confirmation document, or notification of eligibility information

Medical Expense Coverage

If become ill or injured

If you bring one of the following: Individual Number Insurance Card, National Health Insurance Card, Eligibility Confirmation Document with you to a hospital or clinic that accepts National Health Insurance, you can be treated and only have to pay 20-30% of the medical expenses incurred.

  • Those yet to enter elementary school
    Copayment % : 20%
  • Those that have entered elementary school - age 69
    Copayment % : 30%
  • Those 70-74 years old
    Copayment % : 20% (30% if income subject to residence tax is ¥1.45m or more)

If you get treatment and were unable to bring your health insurance card due to circumstances outside of your control, such as emergencies

If you receive treatment at a medical institution, a portion of your medical expenses will be covered.

  • Example of an emergency/circumstance outside of your control.
    When on vacation (including when overseas), etc.
  • Going abroad to receive medical care is not a valid reason.
  • Fees incurred for medical fees that are not covered by National Health Insurance in Japan will not be covered.

Partial reimbursement for corsets and other support goods

The cost of support goods such as corsets that a medical institution has deemed necessary for your treatment can be partially reimbursed to you.

Things needed to apply

  • Itemized medical expense receipt or certificate from a doctor stating the necessity of a support good
  • Receipt(s) (including itemized list(s))
  • Personal seal
  • Proof of bank account details for transfer (e.g., bankbook, cash card)
  • Document proving your Individual Number

Lump-sum childbirth allowance

If a woman enrolled in National Health Insurance gives birth, the head of the household will receive a child birth lump-sum allowance.

Payment method

  1. If using the direct payment system
    The city will pay the medical institution that the birth took place at for the costs to give birth.
    • You will need to submit an agreement form (合意書) to the medical institution.
    • You can apply to receive the difference between it and the lump-sum child birth allowance in cases that expenses to give birth were lower.
  2. If not using the direct payment system
    The head of the household can apply for the lump-sum childbirth allowance after the child is born.
    Please attach all necessary documents to the childbirth lump-sum allowance application and submit it.

Funeral expense allowance

When a person that was enrolled in National Health Insurance passes away, ¥50,000 can be paid to the individual that arranges a funeral for them.

Things necessary to apply

  • Death certificate
  • Evidence to prove that the funeral was held
    (thank you message to those that attended, etc.)
  • Personal seal of the person that had the funeral conducted
  • Proof of bank account details for transfer(e.g., bankbook, cash card)
  • Document proving your Individual Number

High-cost Medical Expense Reimbursement

There is an upper limit to the amount a patient can pay for medical expenses covered by their health insurance that is determined by the income of their household.
Amounts that exceed monthly maximums will be reimbursed.
If you qualify for High-cost Medical Expense Reimbursement, a 'High-cost Medical Expense Reimbursementt Application Form' will be mailed to the relevant household approximately three months or later after the month of treatment.

Things necessary to apply

  • High-cost medical expense reimbursement application
  • Personal seal
  • Receipt from a medical institution (copies are acceptable)
  • Proof of bank account details for transfer (e.g., bankbook, cash card)
  • Document proving your Individual Number

Base period

One month, starting from the 1st until the last day of the month.

Calculating expenses patients have incurred

The expenses incurred at each medical facility will be added up for each family member.
Hospitalizations/outpatient visits, dentist visits, etc. will all be calculated separately.
Meal fees, bed surcharges, and other expenses not covered by insurance are not applicable.

Eligibility Certificate for Ceiling-Amount and Reduction of the Standard Amount of Patient Liability

If you incur medical costs at one medical institution that exceed the maximum amount you have to cover, you can show them your National Health Insurance Card or Eligibility Confirmation Document along with your Eligibility Certificate to the medical institution so you only have to pay the maximum amount (for medical expenses). 

  • For those up to age 69
    You can apply to receive the eligibility certificate.
    Households that have unpaid insurance premiums are ineligible.
  • For those 70-74
    Some people will not require the above eligibility certificate, so contact the National Health Insurance and Pension Plan Division's Payment Team (Kyufu-gakari) at 058-214-2083 to confirm if you do or not.
  • Those living in a household not subject to pay residence tax can bring their eligibility certificate to a medical institution and have their meal costs reduced.

Partial Copayment Reduction or Exemption

When your income falls below a certain level due to special circumstances such as natural disasters or the temporary or permanent of your business/employer and it becomes hard for you to pay copayments to medical institutions, you may be able to receive a reduction, exemption, or postponement of payment for a certain period of time.

Things

Please provide documentation that verifies your special circumstances or income status. (Such as a disaster victim certificate or bankbook.)

Specified Health Checkup

This type of checkup is meant to detect lifestyle diseases that arise from metabolic syndrome (visceral fat syndrome), such as diabetes, high blood pressure, etc. and prevent the severe symptoms that can result from them.

Those eligible

Those aged 40-74 that are enrolled in National Health Insurance as of the day of their checkup

*Those eligible will be mailed a medical examination card (around mid-June)

Eligible period

From the day that you receive your examination form (特定健康診査受診券) until the end of October.