National Health InsuranceIf you have an Alien Registration Card, you are by definition required to subscribe to the health insurance program provided by the city government. This is regardless of whether you are working, researching or studying. To subscribe, you need to head to the "National Health Insurance & Pension Division" in City Hall. The premiums are relatively low compared to the amount of insurance cover provided.
For medical and nursing costs the rates are calculated from a formula including:
1. Income Base: Amount of Citizen Tax you pay based on your income
2. Property Base: Amount of Fixed Property Tax (land / house) you pay
3. Equality Base: Calculation per insured person
4. Even Base: Calculation per household
The premium is reduced if your taxable income (in Japan) for the previous year falls beneath the threshold. This is good news if you have just arrived (although the "National Health Insurance & Pension Division" will make an effort to investigate your income level prior to your arrival) or if you are beginning the second year of ekeing out an existance on a research stipend, scholarship or your savings. To apply for the reduction in premium, head to City Hall.
If you are aged 40 to 64, then since April 2000 you are required to contribute to the Nursing Care Insurance Program, the rate is slightly different if you are aged 65 or more. This is a new program and is still finding its way - bottom line is that you will pay a little more than the young. For the full details, contact the Nursing Care insurance Division in city hall.
s of 2004, the insurance plan will cover 70% of the total cost of medical treatment for injuries or illnesses (in other words you will need to pay 30% of the cost incurred). Please also note that at the time of printing, most hospitals, clinics etc won't accept credit cards. (If you don't have sufficient cash on you at the time, you won't be turned away though, you will just receive a bill).
If you receive large medical bills due to a serious illness or injury, the system is designed to cap the overall cost and keep it within an affordable level. Basically you need to keep the receipts of your payments (the 30% of the total bill that you contribute). If the medical fees exceed 63,600 yen per month, then the full additional cost of medical treatment above that threshold will be paid for by the Insurance program. If you are on reduced premiums, or exempt (due to low income) from paying the citizen's tax, then the threshold is only 35,400 yen per month. Please note that the receipts should originate from only one hospital (as a general rule, the system does take into account specialist care) and for the same treatment.
Another feature of the Insurance is that if you have difficulty paying a large medical bill (for example due to cash flow reasons) you are able to apply for a loan of up to 90 percent of the amount due.
If you are exempted from paying the citizen's tax, you can receive subsidized meals while in hospital. You need to apply for it, though it should be noted that the food isn't really the best.
If you or your spouse has a child while in Okazaki, then 300,000 yen (per child) is paid to the head of the household to help cover some of the costs.