There are various medical insurance plans available in Japan according to job categories, operating authorities, and targeted ages.
|Insurance plan||Insured person||Insurer|
|Medical insurance||Health insurance||Employees of applicable business establishments (workers of private business corporations)||Japan Health Insurance Association, health insurance association|
|Part-time/seasonal workers of applicable business establishments (excluding those who are employed for over a certain period)||Japan Health Insurance Association|
|Seamen's insurance||Sailors employed by ship owners||Japan Health Insurance Association|
|Mutual aid association insurance (short-term payment)||National public employees, local public employees, faculties of private schools||Mutual aid associations|
|National health insurance||General citizens other than employees insured by the above health insurance/seamen's insurance/ mutual aid association insurance||Municipal authorities (ward / city / town / village)|
|National health insurance||Citizens under 65 years of age who were enrolled in employees' pension plans for a certain period and are receiving old age or retirement pension payments||Municipal authorities (ward / city / town / village)|
|Healthcare program for the advanced elderly||Citizens who are 75 years of age or older; citizens who are between 65 and 74 years of age and whose disability level has been officially assessed and recognized||Extended association (handled by municipal governments)|
Medical insurance is managed by the local government and other public organizations. By paying a required premium, you are covered for necessary medical costs in case of illness or injury. Insurance holders are issued a certificate of insurance, which is required to be presented at medical treatment facilities. Without the certificate, patients are responsible for all the costs for the treatment they will receive. Depending on the type of employment, medical insurance is mainly divided between occupational health insurance (shokuiki hoken) and national health insurance (kokumin kenko hoken). After turning 75 years of age, your insurance will be switched from its previous form to the latter-stage elderly healthcare system (koki koreisha iryo seido).
National health insuranceNational health insurance is designed for the general public (including non-Japanese nationals who plan to stay in the country for three months or longer with valid residential status) other than those who are employed and covered by any other health insurance, seamen's insurance or mutual aid association plans.
Long-term care insurance system
Long-term care insurance is an insurance system designed to provide necessary services to support the independent lives of citizens who require living assistance due to aging-related diseases. The system is applied to citizens 65 years of age or older (Category 1) and those 40 to 64 years of age who are covered by a medical insurance (Category 2).
Beneficiaries of the long-term care insurance may receive appropriate services when necessary to support their daily living, such as bathing, eating, and other personal assistance. Category 2 is limited to cases caused by cerebral stroke, presenile dementia, or other aging-related factors. The application procedures for the insurance benefits are as follows:
- Submit the application to a local municipal office.
- The degree of need for long-term care is determined.
- Make a care plan with a long-term care service provider.
- Determine the services to be received.
- Receive the services.
- Pay the responsible amount.
The amount paid for services rendered is either 10% or 20%. The amount that one pays differs based on income and household composition, so confirm on the "long-term care insurance percentage certificate" issued to persons having been certified eligible for long-term care (support).
Types of long-term care servicesThe following services are among those available to be received as benefits.
<Facility-based care services>
- Special nursing homes and other designated facilities
<Homecare services, other forms of services>
- Home-visit care ("home help" service)
- Bathing assistance at home
- Home-visit rehabilitation service
- Daycare service at care facilities
- Short stay service at care facilities
There are many other long-term care services available. Choose the services that meet the beneficiary's needs when making a care plan. Some local authorities may offer services unique to their communities.
Enrollment/Payment of premiums
In principle, anyone who is 65 years of age or older or who is between 40 and 64 years old and is covered by a medical insurance is automatically enrolled in the long-term care insurance. For those who are between 40 and 64 years of age, the premiums for the long-term care insurance are paid by being automatically added to the premiums for their medical insurance. For those who are 65 years of age or older, the premiums are automatically deducted from the amount of their monthly pension benefit if it is 15,000 yen or more. If the monthly pension benefit is less than 15,000 yen, the premiums are paid at the counter of local municipal offices or at financial institutions. The amount of premiums varies according to each local authority.