Understanding Japanese Home Insurance Claims: A Guide – One of the great things about moving to a foreign country is that it’s always full of new surprises – but not all surprises are good. For expats who have come from the United States, you’re probably aware of the ever-increasing costs that can pile up with even a quick visit to the emergency room.
Then there is the story a while back of an Australian couple who were billed a million dollar hospital bill in Canada. Bottom line: Every country has its own insurance system, and learning about it before you travel can save you unnecessary costs and stress.
Understanding Japanese Home Insurance Claims: A Guide
While going to a hospital in Japan – where most healthcare workers only speak Japanese – it may seem scary, it doesn’t have to be. And fortunately, expats in Japan are unlikely to face crushing debt that induces medical costs.
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So what insurance plans are available? And how much are premiums? Here’s how you can better prepare for when the unexpected happens while living in Japan.
There are two types of health insurance available to those living in Japan. All people living in the country – both citizens and expats on long-term visas – are required by law to enroll in either an Employee Health Insurance (kenkô hoken) or the country’s National Health Insurance (kokumin kenko hoken). However, by agreement with certain countries, this registration can be waived. The determining factors in which insurance you will sign up for are 1) whether or not you work for a Japanese employer and 2) whether or not the Japanese employer offers this health insurance benefit.
Employee Health Insurance (EHI), as the name suggests, is employment-based health insurance; i.e. your employer pays half of your EHI premium. The other half is simply deducted from your monthly salary. The insurance covers 70% of your medical bills (and any dependent family members).
The premium for this insurance depends on your income. For example, the premium for a 30-year-old unmarried Tokyoite earning an average monthly salary of JPY 310,000 will be around JPY 15,000 (the company paying the remaining JPY 15,000). To sign up for this type of insurance, all you have to do is become an employee; the human resources department of the Japanese company will take care of the documents, and soon you will be issued an insurance card.
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National Health Insurance (NHS), on the other hand, is for those who are under 75 and unemployed, self-employed (including self-employed) or retired, as well as their dependent family members.
Like EHI, NHI covers 70% of your hospital bills. To apply, you must visit the Residential Affairs Division at your local City Office or District Office. The premium is based on your age and previous year’s income.
For those who are over 75 or over 65 with a registered disability, the Long-Term Care System (chôju iryô seido) applies.
Administered by local government, premium charges and insurance coverage depend on the insured’s income. For people with low incomes, insurance can cover up to 90 percent of all medical bills, while for others the standard 70 percent applies.
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While private insurance is rarely accepted directly by Japanese hospitals, it is also the only insurance option for short-term residents. Paying medical bills in full up front and filing a claim may not sound appealing to most, but it will be worth it when the reimbursement is issued.
Foreign travelers and short-term residents visiting for a month or two will not be eligible to apply for EHI or NHI, but can still purchase insurance plans from private companies. Some companies, such as Viva Vida Medical Life, offer short-term insurance plans (eg 1, 2, 3 and 6 months) during your stay in Japan that cover 100% of medical fees for any illness, injury or hospitalization. totaling up to 1.6 million JPY.
For travelers staying longer than 6 months, companies like HealthOne offer a 1 year plan in addition to their 3 and 6 month plans. All plans cover up to JPY 2 million of hospital and clinic costs.
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While health insurance is mandatory in Japan (note: by agreement with certain countries this enrollment can be waived), it is also quite easy to obtain affordably (which is not always the case in other developed countries). This is largely due to the fact that all medical fees (including fees for surgical procedures and medical prescriptions) are reviewed and regulated by the Ministry of Health, Labor and Welfare as well as the Central Social Insurance Board. There are exceptions, however, such as getting a dental crown or vaccinations (for example, the flu shot), as these are not covered by insurance. For more information, you can download the Ministry of Health, Labor and Welfare brochures in English here. Japan’s health and welfare system is one of the best in the world. All Japanese citizens and foreign residents living in Japan are entitled to reasonably priced healthcare with low monthly premiums, and it is important to take advantage of this service, including a health checkup every year. Read on to find out how to get yourself checked and the tests that are provided.
Anyone currently insured in Japan (which by law should cover 99 percent of people living in Japan) can make an appointment for an annual health checkup. If you are a full-time employee and receive kenkou hoken（健康保院）, your company will cover this and usually issue a reminder. Some larger companies even have the health check on a designated day, sending all employees to the same clinic or giving half a day off to schedule the appointment.
If you are self-employed or unemployed, you will need to make your own appointment through the national health insurance program kokumin kenkou hoken（国兰健康保院）. You may be entitled to a health check subsidy depending on the city you live in, as well as free testing depending on your age. If you’re not sure which insurance program you fit into or want more details, our guide of National Health Insurance in Japan can help you understand your rights under this system.
As for children, they do their annual check-up through the public school system, although private schools may have different procedures.
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The standard health check-up is called Ippan Kenko Shindan or Ippan Kenshin (general health diagnosis・general health diagnosis) and includes basic measurements of height and weight, as well as blood tests for anemia, lipids, and glucose, as well as liver disease. In addition, doctors often take a stool sample (especially for those with certain medical conditions) and a chest X-ray. If you appear healthy or are under a certain age, some doctors will eliminate or cancel one or more of these tests to save you time.
If the doctor discovers that you have certain unhealthy habits, such as excessive smoking, obesity or excessive alcohol consumption, you may be asked to come in at an additional time for counseling, where they will give you plans to quit smoking, exercise or, respectively, quitting smoking. If you want any of this information, you can request it even without a doctor’s referral.
First, you may need to make a reservation at an approved medical facility, depending on your company. Be sure to check with your employer about their procedure, as companies that offer health checks through kenkou hoken may have a specific list of facilities you are allowed to go to.
If you are self-employed or otherwise take care of your own insurance, you can usually do your Ippan Kenshin wherever you want. Call your GP and ask for Ippan Kenshin.
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In any case, you will be asked if you want to receive a certain amount of optional tests. You will then receive a time and date for your appointment. Note that this must be done several weeks in advance as you will receive a packet in the mail that you must fill out and bring with you. There are many questions that can be difficult to understand without above-average Japanese ability, so try to ask for an English package if you can – your doctor can usually provide one.
In addition, you will need to provide both a urine sample and a stool sample. The stool sample is much more complicated than most western-style samples, so be sure to read the instructions carefully. The urine sample should be taken on the morning of the examination immediately after waking up.
You cannot eat any food after 21:00. (usually sometimes it’s 10pm) the night before, no water after 10pm. that night
This is essential, as failure to follow these rules will render your tests unusable. You should also refrain from smoking cigarettes in your morning
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