Insurance & Reimbursement

There are two general types of health insurance in Japan:

• National Health Insurance – copayment for policyholders is 30%

• all residents of Japan who are planning to stay in the country for one year are enjoined to enroll in NHI.  This includes part-time workers and the self-employed.  Their dependents also enjoy equal coverage
• the amount of payment depends on local resident tax, assets, the number of people benefiting from coverage and the number of people living in a particular area that have enrolled in the system.
• Not considering income and assets, the highest amount payable yearly is 530,000 yen that can rise to 610,000 yen depending on the number of people aged 40 in a policyholder’s household.
• The payment is not deducted from wages but must be paid in installments at a health insurance office or post office.
• Medical costs due to accident caused by a third party are not covered since Japanese customs expect the third party to pay

• Employees Health Insurance – copayment for policyholders is 10%

• for company employees and their dependents stretching to the third generation, provided they rely on the policyholder for more than half of their livelihoods and have an annual income of less than half of the policyholder’s or up to 1,200,000 yen per annum.
• Employer and employee each pay half the premium, depending on a percentage of income

Japan implements standardized fees for medical services.  Physical examinations and over-the-counter (OTC) drugs are not covered under the health insurance as well as normal childbirth, abortion for economic reasons, vaccinations, alternative medicine, orthodontics and cosmetic surgery.  Drugs listed in the NHI (National Health Insurance) drug price list are the only ones allowed for reimbursement.