Japan Today

Understanding the Japanese health insurance system Part 1/2: How much does it cost?

By Alfie Blincowe

Health insurance is an annoying little fact of life in Japan. whether you love the system or hate it there is no escaping it. Everyone in Japan and over the age of 20 has to have health insurance.

This is mandatory and not to enroll in the national health plan is illegal. If you want to visit a doctor or a hospital during your time here and you don’t have your health insurance card you will be turned away or charged full price for the services and medication received at the time of your visit.

The system can be confusing, especially for those who have just arrived in the country and have full-time employment. In that regard, health insurance is wrapped up with pensions and employment insurance as part of shakai hoken (社会保険), or social insurance benefits, and they are all paid together. To comprehend the system as a whole, one big component you will need to grasp is the pension plan. Luckily, GaijinPot has a three-part guide to understanding the Japanese pension system.

In my home country of the U.K., hospitals work differently, so it took me a while to figure out exactly what I was supposed to pay (and how to do that) and what benefits I was entitled to receive or access once I joined the system. The result is what you’re reading — and hopefully bookmarking and sharing with others who may have similar questions — now.

In this two-part guide to understanding the Japanese health insurance system, we’ll try to answer any questions Japanese residents — new or old — might have about Japanese national health care.

What types of coverage are there?

First of all, you need to figure out what type of health insurance you are — or should be — enrolled in. Legally, everybody must sign up, but often Japanese employers will sort this out for people — in which case, it shouldn’t be too stressful. It’s always good to double check you’re on the right plan, however, as there are minor differences between them.

Click here to read more.

© GaijinPot

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Seems like a rather simplified view which misses out on some big differences.

Kokumin Kenko Hoken will cover most peoples basic needs. This insurance is probably fine for people coming to Japan for a very limited stay.

However, SHAKAI Hoken, the one that people are rightfully allowed to have if employed for over 30 hours per week, will allow paid child-raising leave (after 2 years of payment) and assistance for disabilities as well as other benefits. With shakai hoken about 80% of my bill is covered, but doesn't cover preventative care such as health checks or birth control pills. Shakai Hoken also includes your pension payments, which you should also be paying into. The rate is decided by looking at your salary for the months or March - May in which you work over 20 days (I think...).

I think the author should dig deeper into the differences and address them in his next article.

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However, SHAKAI Hoken, the one that people are rightfully allowed to have if employed for over 30 hours per week

It's actually for anyone employed equal or more than 3/4 the hours of a full-time employee. For most companies, their full time employees will be considered 40 hours, 3/4 of which is the 30 hour number you give. But in companies where full time is more or less than 8 hours (I know, very few), the number of hours required to work to meet the 3/4 point where the employee is eligible for shakai hoken will vary.

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Health insurance is a reassuring little fact of life in Japan.

Fixed that for you. What's annoying about not having to worry about medical bills?

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