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Visa guideline on health insurance deleted

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The Immigration Bureau guideline linking social insurance to visa renewal -- Guideline No. 8 -- has been officially deleted as of Wednesday. The newly revised guidelines (showing seven instead of the present eight) are now posted on the Ministry of Justice's website, according to a statement by Ronald Kessler, chairman of the Free Choice Foundation, an organization set up by members of the foreign community.

While the Immigration Bureau will continue to require non-permanent residents to present an insurance card at the visa application window, not doing so will cause no negative effect whatsoever upon an individual's visa renewal. (The guideline never applied to permanent residents; as previously, they are not required to present an insurance card at all.)

Although Immigration will encourage enrollment in Japan's social system by distributing brochures, individual offices and officers are "forbidden" to pressure anyone to join. In fact, the new guidelines state clearly that "enrollment in the social system will in no way be tied to visa renewal." Additionally, the Ministry of Justice will set up a new hotline to field complaints from visa applicants who feel that they were in any way pressured or coerced to enroll.

For further information please visit the Free Choice website at http://www.freechoice.jp/

To download the new guidelines, visit http://www.moj.go.jp/NYUKAN/nyukan70.pdf

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limbo -

Good luck with the surgery. The very thought of people 'doing things' to your eyes can be a bit (a lot?) scary, but in my experience at least, there was no pain and very little discomfort, and that only on the day of the procedure. I hope everything goes well and you get to view the world in focus, without the bother of a lens between you and it!

Moderator: Back on topic please. The topic is health insurance.

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limboinjapan

Bear in mind it depends a lot on how the eyes react after. Your sight will be improved for zero glasses in the days after surgery. But a cousin had to revert to glasses again after a period of no glasses after the eyes healed more afterwards. Loads better than his previous prescription, but was disappointed that it wasn't 100%. Ask about that possibility in your case.

I certainly hope it goes well

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limbo: congrats and hope surgery goes well.

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cleo; That reminds me! Certain medical procedure deemed to better life and cost saving to the National health system are payed in full!

It takes a bit of paper work but they can be free!

I will be going in this summer to have my eye done, I am limited to special lenses they do not make soft or hard contacts for my level of eyesight and lasic is not an option, so my ophthalmologist suggested surgery and proceeded to request from the National health for approval.

It took a few moths but they approved it and it will cost me nothing and this summer I will no long need glasses for the first time in 43 years! This would have never been approved back home, and I doubt that many international plans would pay it seeing it is purely elective and the only benefits are that I will no long need glasses and the government has one less person needing glasses!

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limbo -

It gets better! So I can have my national health insurance, an extra policy with the Coop to cover the 30% for hospitalisation and still bank the difference for that annual holiday. Actually my life insurance policy has a medical clause that covers hospitalisation with slightly better payouts than the Coop, and even paid out for eye surgery (lasic) that didn't involve any hospital stay.

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cleo; Thank you for the clarification, it have been a long time since I bothered checking out any increases, but as I pointed out you can get a supplementary insurance for as low as 1,000 yen a month that will cover any extra charges even if you are over 60! The 1,000 Yen ones would only cover hospitalization, surgery basically in-patient cost!

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That 30% & room chgs cant quickly get out of hand if you dont have the extra coverage.

According to the kokumin hoken HP, the maximum charge for a person with an average income is 80,100 yen per month for the first three months, 44,400 yen per month thereafter. If you're a 'high earner' (taxable income of 6 million yen after deductions), those figures are 150,000 yen and 83,400 yen. If your income is low enough that you pay no resident taxes, they're 35,400 and 24,600.

http://www.kokuho.jp/iryou-kougaku.htm

When I looked at the private insurance, my premiums would be somewhere in the region of 56,000 yen per month - 680,000 yen per year. If I gamble that I'm not going to need months of hospitalisation in the next 12 months, I could put the difference between the private insurance premiums and the national insurance premiums in the bank and in the event that I don't need months of hospitalisation, celebrate by treating myself to a break in Okinawa.

(Moddie, when there's a '&' in a pst, nothing after the & shows up in the preview. Can your IT people fix that? Please?)

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BTW unless thing have changed the postal and other Japanese supplementary health insurances premiums are tax deductible (in most cases) but not the international ones!

I used to think that as well (I am on Tomin Kyousai) but that is not true. There is a life insurance part of the Kyousai (Seikyou) insurance that is deductible from you income which is why they send you slips of paper every year in October to fill out for your year end tax filing. But again, that is only the life insurance portion of your fees, not the bit that goes towards the medical coverage. Oh, but the bits you are paying for your child under Kyosai should be deductible. Just not your bit.

http://tomin.jp/about/qa/02.html#ans3_3

http://coopkyosai.coop/column/lpa_071029.shtml

http://www.jp-life.japanpost.jp/tax/tax_kojo.html

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GW: I've been hospitalized twice, my son 7 times my late fiance lost count over the year and a half she was treated!

We used and still use a major University hospital there are no extra charges if you take a ward (4 to 6 people) the 30% is limited to 36,000 yen per month or 60,000 per month depending on you income in many cases you can apply for an exemption if in financial problems and in all the cases NO hospital can refuse to treat you even if you can't pay!

Sorry I need to make a correction my late fiance and one child had/have the postal and I and my other child have Tokyo coop (seikio) but they both pay around the same a fixed amount for each type of medical procedure plus an amount for semi-private room (if you take it or not) and an amount varying between 15,000 to 20,000 yen a day (depending on child or adult)in living expenses!

And as it stands now in my ward children under 15 are covered 100% it used to be under 6 so my sons first operation was not 100% paid, so 17 days hospitalization, surgery, medications and followup cost me at the time 30,000 yen that year my total out of the pocket expenses (due to a chronic condition that I have) exceeded 100,000 yen so it was all tax deductible!

BTW unless thing have changed the postal and other Japanese supplementary health insurances premiums are tax deductible (in most cases) but not the international ones!

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limbo,

that 30% you mention can rack up quickly if treatment/care is expensive thats what I & many other buy extra ins for, that & yr room chgs natl ins only cover a bit, cant remember the details & thats what yr supplementary postal ins covers by the sounds of it.

That 30% & room chgs cant quickly get out of hand if you dont have the extra coverage.

The thing I hate is its so hard to really nail how it all works as everyone has vastly different experiences & costs.

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GW; Yes you are right that the regular national insurance doesn't cover your income if you are hospitalized but as for cancer, I have heard this one before and I still have not quite figured out what people mean by it!

I lost my fiance 2 years ago to cancer she was Japanese and on the national health plan everything was covered (even the latest meds) except the 30% and then that was limited to 40,000 yen a month!(and it can be waved in many circumstances)

We did(and my children and I still) have a postal insurance that covers semi-private room (if you want you can take cash instead) a daily income and other expenses that cost 3,000 yen for an adult and 1000 yen for a child (per month) life insurance included!

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Noborito, give me some time to get a post up at my site.

If you an American, you (or your employer) must certify that you are covered under both American pension and social security in order to avoid the Japanese system.

Furthermore, if you do get this certification (evidenced by form "USA/J-6"--USA comes first), you agree not to use the Japanese medical system at all.

That is the rule. What the Choicers front page is saying is plain wrong.

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chuckers,

The $$ I was talking about was just my premiums so to speak, fortunately I dont go to the doc much so probably dont rack up even Y10-20,000 a year from doc visits so nothing to deduct, but I can of course deduct my premiums the next year as Cleo says but I still keep getting hit for more it seems each year, and you still need to buy supplemtary private ins for cancer & that kind of thing because the basic ins doesnt cover much of yr rent so to speak if yr hospitalized

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if we as non-Japanese we ever wish to be accepted and receive the same protections in the work place as Japanese then we need to join and accept the Japanese system and force employer to accept and treat us equally by providing the same benefits as the Japanese get!

You're absolutely right; people cannot seriously complain about discrimination and demand special treatment in the same breath.

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noborito: Didn't mean to seem as though I was calling you a liar, sorry if you took any offense! I'm guessing you've been on the plan for 13 years and or you get it through your work (really I have no idea) but when I input the information into the website you posted it give very different results!

But my real point here is that if we as non-Japanese we ever wish to be accepted and receive the same protections in the work place as Japanese then we need to join and accept the Japanese system and force employer to accept and treat us equally by providing the same benefits as the Japanese get!

By making the health care part of the requirements to obtain a visa employer sponsoring or hiring you will need to provide you with it.

This translates to an actual full time position with all the securities that come with it!

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(and if I convert USD to today's rate it would be 8,054 yen. I was way off. It's even cheaper than I thought.) wrong coversion... oops was using Singapore dollar. USD to yen conversion would be 11,282 yen. a bit cheaper than I thought.

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and if I convert USD to today's rate it would be 8,054 yen. I was way off. It's even cheaper than I thought.

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Hoofin... your comment is non comprehendable.

As for limboinjapan, If I paid yearlly it would be even cheaper. I am copying the quote from Global health care. I have used them for 13 years. International Schools Plan Gold: Payment 1. 03 Jul. 2009 - USD 381.75 Payment 2. 03 Oct. 2009 - USD 381.75 Payment 3. 03 Jan. 2010 - USD 381.75 Payment 4. 03 Apr. 2010 - USD 381.75 So.... 381.75 * 4 = 1527.00 USD or 127.25 USD a month. 100% coverage included (plus 10%) Dude if you don't believe who really cares. I have no reason to lie. I don't work for them. I only have used them for years and years. Why would I signup for Japanese crap when I get 100% coverage at half the price.

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Noborito, if you are an American, you would also have to certify (an obtain a special certificate) that you will not use the Japanese hospitals or doctors in the system at all. More on my blog today and later this week.

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Too bad. The government should FORCE all FOREIGN residents to pay into the national health insurance system. Buying insurance from a foreign company deprives the gov. of money that it needs to build and maintain hospitals and pay medical professionals.

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Cleo; We don't always agree but I think this time we are both thinking along the same lines.

My problem here is that so many of the people who do not want to pay into the Japanese health system are often the same people who say "when in Rome" They came here knowing the laws but when it is not convenient try to opt out!

For the Americans I get why they don't understand, they have one of the most confusing medical insurance systems of the developed world so they are used to going it on their own!

The ones I really don't get a the Brits, Canadians and most of the other developed economies that if they were back home would be on their countries mandatory system and would be the first to complain if some foreigner came to their country and tried to "opt out"!

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I just had a look at the site limbo and noborito are talking about, put in my details and got a quote that was more than double the national health insurance.

So I think I'll stay where I am.

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Whether the national health insurance or a private insurance scheme is cheaper/better value etc depends a lot on individual circumstances. The national health is calculated according to your taxable income, so if you're young, single, a high(ish) earner with no dependents and in excellent health, the premiums can seem pretty steep and the private schemes may look a lot more inviting. If you're a householder with all kinds of deductions for dependents, kids who are constantly at the doctor's for kiddy ailments, knocks and bruises etc., the national health starts to look better and better. If you have a chronic condition or a child with a congenital condition, the national health looks better and better. (The premiums are also tax-deductable, not only medical costs over 100,000 yen)

The thing about the national health is that it works on the premise that everyone pays in their fair share, and those that need it take out what they need when they need it. If only those that need it are paying in, it raises the premiums for everyone.

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noborito: like I wrote before your 12,700 yen a month just doesn't compute.

Again I went to the site you provided and entered in your age this time and your profession and the plan that has the coverage you claimed to have and the number no mater how you try do not come out to 12,700 yen they come to world coverage incl. USA $ 456.81 excl. USA 214.66, I'm not calling you a liar but the numbers just don't add up!

Also you should check the out-patient coverage they have much lower limits then your $1.700.000 more like $8.500 for contemporary treatment and $1.000 for Physiotherapy (ripped my shoulder in a freak accident at home a few years back the 10 month of Physio would have been way more then that $1.000)

I presently pay 15.000 Yen a month for myself (70% paid) and 2 children (100% paid) with a maximum of 40,000 Yen per month out of pocket and then if your out of pocket exceeds 100,000 Yen per year the amount is tax deductible!

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Japanese health care is not a utopian dream of perfect balance but a more than adequate expression of a society that cares for its people; no matter your creed or position. All people who pay their taxes and contribute to society should have their health care paid for by employeers, this ruling further romoves non-Japanese from a society to which they do contribute postively. If you're from country where it's not a right to have access to free / subsidsized health care you just will not understand. Watch SICKO. Learn. The national health inusrance of Japan is a good thing. Especially when you're a working parent with all the responsibilities that entails.

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@GW

This yr it cost me almost 3/4 of a mil, what a waste of $$ aaghh.

You are aware that you can claim those against your Japanese taxes for a refund on the amount over JPY100,000 per year, aren't you?

You do need to keep your receipts, of course, but anyone expecting huge medical bills should be doing that anyway. Use of public transport costs (and taxi if an emergency) can also be included.

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limboinjapan, no teachers plan. I am 39 and a university professor.

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Hoofin, It is correct. Read their websites and download their brochure. Copied and pasted the amounts. Japan insurance can't beat it.

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Guideline 8 has nothing to do with free choices. It was an administrative rule to consider your duty to enroll in Japanese health and pension programs as one of the factors in a visa renewal.

Now, they simply won't consider it. Instead, if you haven't enrolled, they'll give you the information on how to, (and probably pass your name over to Labor and Health, the real enforcer, to see what your circumstances are.) If you have enrolled, then you can submit your card and blue nenkin book.

I think the guidelines for PR status are different than the seven given for a visa renewal. There is more to PR status.

Since Ron Kessler's "group" never bothered to contact Labor and Health about this gap-insurance proposal, I think anyone who hasn't been paying the right premiums could still potentially be on the hook.

Check with Labor and Health as to whether, as a foreigner, you can wing it with the health insurances, and good luck with that.

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sonikichi24; you miss the point free choice for the high paid expat is all that has been achieved by Ronald Kessler, the facts are that this rule would have eliminated another loophole that employer use to not provide health insurance to the low paid foreigners!

Go to http://www.freechoice.jp/ and read the comments nearly all those who supported Ronald Kessler are well off expats or short term teachers, clearly not the majority of the foreigners in Japan! Basically big business and the rich westerner wins again!

Come up to North East Tokyo and have a chat with the Filipino, Thai and South American "nisei" here who work full time at low pay but are call "contract" workers even after as long as 10 year at the same place, have to pay their insurance without co-payment for their families out of a salary of 140,000 to 180,000 yen a month! See what they will tell you about "free choice"!

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While everyone has an opinion, the issue was about your individual needs, your choice. Whether you opt for the national insurance or a private insurance plan, Guideline 8 would have taken that Free Choice away from you.

Ronald Kessler, thank you. You've done a great service to the entire foreign community.

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That was quick.

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limboinjapan, in deed. point taken. I was thinking that anyway. But in any case, today's announcement was great.

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cleo; He starts Junior high next month so getting the pacemaker in between his graduation ceremony and entrance ceremony will cost nothing in a large University hospital that has made all sorts of schedule changes to accommodate us so he would not miss either ceremony he takes 3 daily meds that have been changed several times no cost no per-approval and when I was out of work and couldn't make my health insurance payments, just went to the ward office and they said:

"no problem let us know when you get a new job, but it would be nice if you could make a token payment once in a while of 2000~3000 yen till then, your coverage will not be cut off".

Try that with one of those international ones!

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limboinjapan -

2 surgeries 7 hospitalizations and will now have a temporary pacemaker installed

That's some pretty heavy bodywork for a little lad. I hope he's better soon and none the worse for his experiences.

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Not sure why everyone is celebrating. Obviously the government buckled under pressure from companies that didn't want to have to pay benefits to foreign workers.

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Yourock: If you are planning on staying her as a PR and having a family (assuming that you don't already) then you should check things out carefully these international health plans get pretty expensive and start to exclude many things as you get older!

As for Ronald Kessler he is a shot sighted person that neglected to see the whole situation regarding job stability and benefits to the majority of foreigners here! The "western" executive is the minority and the exception, the majority of those who would have been affected by this rule would have been the ones that are now exploited as full time workers but referred to by their employers as "contracted", no insurance, no vacation, no security and low pay!

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Noborito: just got a quote for coverage on from where you get your coverage and for "standard" would cost for myself and 2 children $257.46 limited to $850,000 NO out-patient coverage or dental! The monthly for your plan "comprehensive" would cost me $406.36 and would still not cover what I get on the national plan for half that cost! If I were single your plan would still cost me $287.93 to get the price you are paying you must be under 25 years old!

And you should read the fine print there are many limits and exception for out patient care, chronic care, transplants, terminal illness, etc..

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Thank you Ronald Kessler for doing an amazing job. I have been using Global Healthcare for about 8 years after national health care premiums started to become too expensive. I'm British btw. I was worried about this issue as I'm going to apply for PR later this year. I went to the immigration office in Kitakyushu recently, and when I mentioned about having to have national health care, and NOT private insurance as I have now, they reacted vaguely and said that I should just apply. Now I understand why. They knew what news was coming.

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Noborito says:

overall policy up to 1,700,000 US$ per year. Even pays for my remains, if I were to die here, to be shipped home.

There is no way an insurance selling for less than $150 a month is going to give you a $1,700,000 a year coverage on health care.

"Repatriation of remains" insurance is just overpriced life insurance. The keisatsu will only release your remains to an embassy or family member. They are going to arrange to ship you home, then. Your estate can cover the bill for much less than the gap-insurance markup.

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Yay!

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BTW in most of Japan all medical costs for children under 6 years of age (in my ward here in Tokyo under 15)are 100% covered. That came in handy when my son had 2 surgeries 7 hospitalizations and will now have a temporary pacemaker installed this month! Under most of the "international" plans he would have been excluded on the day he was born!

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The people who were most vocal against this rule were expats who didn't care or don't understand that most foreigners her do not get the "package" they have.

This rule would have forced many businesses that hire foreigner to pay their part for health insurance or risk loosing worker for lack of visa renewal!

Many large companies and the "aikaiwa" schools first push the removal of the minimum salary of 240,000 yen per month for visa sponsorship now we have even less protection!

Previously you were looking at a minimum of 250,000 yen with full health for a full time English teacher and 450,000 yen for your basic IT worker. Now 180,000 yen per month is not uncommon for full time teaching no heath or anything else and 250,000 in IT!

Other than expat plans most of these so called "international" plans do not cover dental (other than emergency) or long term care (they have a maximum payment limit)they do not cover many things if you have children in the public school system or vaccinations, so they are fine for your single short term foreigner who plans on leaving in a few years as for the expats, well they get the "package" including health care, international schools and company subsidized living, so of course they are against would be against this!

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Hoofin, Never been turned away. Pay with credit card and before the bill is due the payment is made. Global Health Care, if you talk to them, will make sure you are covered. Even use it at small local clinics. Pay 100% with a credit card and then get reimbursed within 10 days. I even get DENTAL. (co-pay of 25% which is still better than the Japan 30%) Dental 1275.00USD a year, and heath In-Patient and Daycare Treatment paid in full, overall policy up to 1,700,000 US$ per year. Even pays for my remains, if I were to die here, to be shipped home. interglobalpmi.com

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As a retired military member, I have 100% coverage at the bases, 80-90% reimbursement if I go local. So I'm happy, but will look into the coercement factor, as my city hall told me I HAD to join...

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Try having a "pre-existing condition." Japanese insurance starts looking reallllly good. I had a very high doctor's bill last month and can't even imagine having had to pay the full 100%. It wouldn't have even been covered by an overseas plan (pre-existing) but even if it had, the waiting period to get the money back would have killed me.

That Global stuff might look good when you think you can't possibly get hit by a car. But if you do, you'll be paying quite a lot out of pocket. It's really just worth it to get the Japanese insurance. Just in case. (But I'm American, so my perspective seems to be really skewed, seeing as insurance is horribly expensive and crappy back home.)

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individual offices and officers are “forbidden” to pressure anyone to join

And I'm wondering if this is in the (now) Seven guidelines, or is embellishment from the article's clear source.

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Visa guideline on health insurance deleted [...] The Immigration Bureau guideline linking social insurance to visa renewal.

Is this abolished rule regarding health insurance as in the headline or social insurance as stated in the text body? Or are both the same in Japan?

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Noborito, what is the limit on your policy, and what is your assurance that you won't be asked for an estimated payment of a bill in full if you show up at a hospital here? (Or, even, be turned away . . . )

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Noborito, yep I have a similar deal, maybe a tad cheaper - but WAY, WAY cheaper than the government one. I have had ZERO problems with them in 5 years, I've made quite a few (big) claims and always reveived good service and 100% refund. I feel secure with them - so why switch, as you say, unless they can better our private insurance?

I think the Japanese health insurance is wonderful. Most people here would rather just keep the money they should be paying in for drinking probably.

Dunno about that, buddy. I pay for gym membership with the big savings I make in having private insurance! And, yeah, a little drinking never goes astray - 2 glasses of red every night is great for the old heart!

Free choice - you better believe it!

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I pay 12,700 yen a month with Global Health Care. 100% coverage including Medicine. If a close family member dies I get a paid trip home for the funeral and for an extra 14,000 yen a Year, 8,000,000 in life insurance to cover me if I die here and need to get repatriated. Top that Japanese health insurance and I will switch to your Japanese scheme.

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If you wish to gain from society, you have to put in. No contract is free, your contract with society needs to be paid or you will not benefit, get sick or badly injured and don't be on insurance, see how much that costs you in Japan. I get a free yearly health check- up, only have to pay 30% of any medical / dental costs, and have peace of mind that my family has the same. What many non-Japanese here see as a 'blessing' actually helps to reinforce the reality that you're an underclass, not only will you not be provided mandatory health insurance, which you should be by law, this rule now stipulates that any employer doesn't even have to worry about paying that money --even if they did. Yeah, really smart cheering on a tearing away of more protection, recognition, --the little that is provided-- as equal members of this society.

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I think the Japanese health insurance is wonderful. Most people here would rather just keep the money they should be paying in for drinking probably.

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I feel sorry for all those foreigners who had to backpay and get on the system before this good news came into effect. How cheated they must have felt while others got off scotch free.

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The Immigration department indicated late last summer that they would not be enforcing Guideline 8. But Guideline Eight isn't the real law anyhow. And Immigration does not enforce insurance and labor codes.

Now immigration will simply ask you for the card. And if you don't have it, your name will just get forwarded to your local ward office insurance desk. To check up on why you don't have it.

As I've been saying, if they kick you out of the country, there goes the insurance payments.

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Actually with 3 kids in the family, it seems to me the amount the health insurance has to pay balances what I have to put in.

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Japanese insurance is wonderful. I work for myself and have a wife and two children. Similar insurance in California would cost about $1,300 a month; I get it for half of that. It is known and welcomed anywhere; the deductible is low; and as for GW, I had my meniscus operated on a few years ago which entailed a four-day stay (they wanted me to stay longer, but the operation was so good, I was raring to go), and my deductible was about $700. I know most of you posters are single or have no children, but if you were in my position, you would probably feel the same. Despite its problems, I think the Japanese system would be great for America.

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Man if I wasnt married to a lovely Japanese lady I wud have dumped this insurance which DOESNT even cover if you get seriously ill & need hospital stays, the mrs wont trust purely private insurance, aagghh!

This yr it cost me almost 3/4 of a mil, what a waste of $$ aaghh.

For those that can ditch it do it!!!

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The guideline never applied to permanent residents; as previously, they are not required to present an insurance card at all.

Wouldn't that be on account of them not being required to renew their visa, on account of them being, like, permanent?

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timeon, that would be because the guideline wasn't due to be introduced until this April.

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Super news! Yes, there are some humanitarians with some common sense at immigration!

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"Additionally, the Ministry of Justice will set up a new hotline to field complaints from visa applicants who feel that they were in any way pressured or coerced to enroll."

Said hotline will probably be a single person, hired for one day a week to work two hours.

Regardless, it's a mild step forward. Won't last, but for now it sounds good. Thanks for all your hard work, Ron.

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May be immigration department should provide both Visa & Health Insurance !

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wow, I didn't even know they ask this. I renewed my visa 5-6 times, but I never had to show the insurance

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Great! So will they now do something about the Japanese not paying health care and pension? I mean, if foreigners have to produce a card showing they pay some sort of health care, shouldn't the local??

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AWESOME NEWS!

individual offices and officers are “forbidden” to pressure anyone to join.

I look forward to renewing my visa now, and seeing if any of the geeks there try and mention/persuade me to join their "fabulous" National Health Scam...erm, scheme. Kudos to Ron Kessler, this guy worked hard to achieve this. Give it up for Ron!

Now - is this the FIRST piece of good news the new government has delivered?!?

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great news !!!!!!!!

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When non-permanent residents are excused from the backpayment of years worth of premiums, I dare say people will be more than happy to join up.

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wow almost human of them

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