A hospital visit in a foreign country can be terrifying enough without having to worry about payments or insurance. While the insurance system in Japan isn’t terribly complicated, it may not be entirely intuitive either. Having a basic understanding of the system may help you avoid unpleasant surprises and unnecessary stress.
Technically, there are many different types of insurance situations that are possible in Japan, but for the sake of simplicity, they have been reduced to four different categories here.
Japanese Health Insurance
This is the type of insurance that employees get. There are actually several different types of employee insurance managed by different organizations, but the overall process is the same. The employer is required to take care of all the paperwork and to pay the monthly premiums.
Japanese National Health Insurance
This type of insurance is for individuals who are not eligible for the employee insurance. It is managed by the local government. Unlike the previous insurance, individuals must apply for the insurance themselves and pay the monthly premiums. These premiums are based on each individual’s age and income.
Japanese Advanced Elderly Medical Service System
This system is for people who are at least 75 years old, or are at least 65 with a qualifying disability. This system is also managed by the local government. Premiums are based on the elderly person’s income with a standardized fee added. Low income individuals can apply for a reduction of the standardized fee. Premiums are paid through account transfers or taken from pension benefits.
While private insurance is almost never directly accepted by hospitals in Japan, this is the only option for tourists and other foreign guests who are not staying in Japan long enough to register with the local government. Please be aware that this type works differently than the previous types.
Typically, you can only use private insurance for claims after a visit. Some private insurers have special hospitals that they work with and will give you a list of participating doctors or facilities. Otherwise, you will need to pay 100% of your bill by yourself.
Don’t let that percentage scare you too much. All prices for procedures and medicines are reviewed by the Ministry of Health, Labour and Welfare and the Central Social Insurance Council in order to ensure that the prices remain reasonable.
Why Should I Enroll in Japanese Insurance?
Well, if you are in Japan with a long term visa, you are required by law to enroll in either the National Health Insurance or the Health Insurance. While this has not been strictly enforced over the years, some foreign individuals have had difficulties when caught after years of avoidance. You may even be required to pay for the previous years.
That being said, all forms of Japanese insurance limit the amount you have to pay upfront. Insured individuals only have to pay 10-30% of their bill. The percentage is determined by their age and income. Their monthly premiums go towards their insurer paying the remaining part of the bill. Individuals can also apply to have a limit set on the amount of medical bills they pay per month. If they pay over that limit, the money will be refunded.
However, Japanese insurance doesn’t cover everything. It is always good to check whether a procedure or a certain medicine is covered or not. Some residents in Japan choose to have both Japanese and private insurance for this purpose.
If you want a more in-depth look at the health care and insurance systems, you may want to check out the Ministry of Health, Labour and Welfare’s English pamphlets here.