Enrolling in National Health Insurance
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.
- Those that currently have a residence certificate registered with Gifu City or plan to do so soon
- 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
| 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 |
| Reason | Required Documents |
|---|---|
| When moving to a different municipality | Health insurance card |
| 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 (health insurance cards for all enrolled in health insurance provided by an employer). |
| When someone enrolled in National Health Insurance has passed away | The health insurance card of the person that passed away and death certificate
|
| If you have started to receive public assistance | Health insurance card, Decision to Enroll in Public Assistance Acceptance Notice |
| Reason | Required Documents |
|---|---|
| If you move to a different address within Gifu City | Health insurance card |
| If the head of the household has changed or your name has changed | Health insurance card |
| If households separate or join together | Health insurance card |
| If living at a different address to go to school | Health insurance card, (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
Each individual enrolled in health insurance will receive a health insurance card proving that they are enrolled in health insurance. Please take good care of it.
- Your health insurance card will be sent to your address around one week after submitting your application.
- Health insurance cards also serve as a patient identity card when being treated at a hospital or clinic.
- If you lose your card, it gets ripped, etc., please complete processes to receive a new one.
- 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.
- A health insurance card can only be used by the person whose name it is in.
- You will face legal punishment if you lend your card to anyone else.
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)
- Every Sunday 10:00am - 3:00pm
- Location
Tax Collection Division - Documents to bring
Insurance premium payment notice or health insurance card (or certificate for those owing significant payments)
Medical Expense Coverage
If become ill or injured
If you bring your health insurance card 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
- Health insurance card
- Bank book
- 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
- 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.
- 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
- The health insurance card of the person that passed away
- 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
- Bankbook
- 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 have exceeded the monthly limit, an application form for you to be reimbursed that amount will be sent to your household approximately 3 months after the month of the received high-cost medical treatment.
Things necessary to apply
- High-cost medical expense reimbursement application
- Personal seal
- Head of the household's health insurance card
- Receipt from a medical institution (copies are acceptable)
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 health insurance card and above eligiblity certificate 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 keep your health insurance card handy and 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
- Health insurance card, personal seal
- Any documents that can verify your circumstances
(Disasters, bankrupcy certificate, medical certificate, etc.)
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.
