Chapter

7

Insurance/Pension

1National Health Insurance Program

The Japanese medical insurance system, a mutual-aid system for which everyone pays
premiums, is designed to provide affordable medical care to all those who are ill or injured.
All residents in Japan including foreign nationals are obligate to join the National Health
Insurance program.

① Eligibility

Persons who fall under the conditions listed below are required to enroll in the National
Health Insurance program.
◦ persons living in Ota City who have a registered residence◦ residents who are not enrolled in any other public medical insurance
programs◦ residents who are not receiving public financial assistance◦ residents who do not qualify for the Medical Insurance Program for
Elderly Senior Citizens② Application for National Health Insurance【Inquiries】National Health Insurance Qualification Section, National Health Insuranceand National Pension Division ☎ 03-5744-1210
For eligible persons, please complete the necessary procedures to enroll in the National
Health Insurance program within 14 days of becoming eligible at National Health
Insurance Qualification Section or your local branch office. (P17)
Required documents include the My Number of all applicants and the head ofhousehold, as well as identification for the party performing the application. Pleasecontact us for details.
* The head of household is obliged to complete the enrollment procedures for his/her
entire household. The insurance premiums are charged from the month in which youbecome eligible for the program and not from the month of your enrollment. Please
note that if your enrollment procedure is delayed,
you will have to pay insurance premiums
retroactively and bear the full expenses for your
medical care during that period except undercertain unavoidable circumstances such asemergency.

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List of procedures
Procedures

Occasions
When you complete resident registration in Ota City
When you withdraw from your employer’s health insurance program

Enrollment
When your child is born
When you become ineligible to receive public financial assistance
When you move out of Ota City or leave Japan
When you enroll in an employer’s health insurance program
Withdrawal
When the insured person dies
When you begin receiving public financial assistance
When your name or alias stated on your National HealthInsurance Certificate change

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When the head of your household changes
When your household information has changed due to separation or merging
OthersWhen you move within Ota CityChanges to status or period of residence
When you need to have the National Health Insurance certificate reissued due toloss or other reasons
When leaving Ota City for training and the insurance certificate is needed③ National Health Insurance benefits【Inquiries】National Health Insurance Benefit Section, National Health Insuranceand National Pension Division ☎ 03-5744-1211
Medical payments may be waived or refunded in the following cases:◦When you receive medical treatment at a hospital or clinic, or are hospitalized due
to illness or injury by presenting your National Health Insurance certificate, you canreceive medical treatment by paying a portion of the medical expenses covered byinsurance.
◦When care is received without providing the insurance certificate to the medicalfacility for reason of emergency such as acute illness◦W hen receiving medical examination while traveling abroad (except when thepurpose of travel is medical treatment)51

◦ When purchasing an orthosis such as a corset◦ When it is determined necessary by a physician to receive massage, acupuncture orother traditional methods of treatment◦ When visiting an osteopathic or orthopedic clinic◦ When serious injury requires rapid transportation of a patient (transportation fees)◦ 
When medical fees paid at the service counter of the medical facility exceed aspecified limit◦ When issued an “Eligibility Certificate for Ceiling-Amount Application” or an “Eligibility

Certificate for Ceiling-Amount Application and Reduction of the Standard Amount ofPatient Liability”◦ Food expenses for the period of hospitalization◦
If you are eligible for high-cost medical care reimbursement and are having trouble
paying your medical expenses during the period before you are reimbursed◦ Fees related to expensive long-term care◦When receiving treatment for HIV infection related to chronic renal failure/blood
coagulant preparations required by hemophilia or artificial dialysis.
◦ Lump Sum Birth Allowance◦ When the insured person dies (funeral expenses)◦ Subsidy for treatment of tuberculosis or subsidy for psychiatric care
◦ Traffic accidents or injury◦ When payment of medical fees is not possible due to natural disaster or similar cause* When medical fees are expensive, showing a certificate of accepted limit to the medicalfacility will limit the amount paid at the service counter (per month; per facility; separatelyfor outpatient, hospitalization, medical and dental). Apply in advance.
* Medical fees for orthosis, expensive care fees, lump sum birth allowances, funeral fees,etc. are provided by application.
* Please note that in some cases, the National Health Insurance program does not cover
injuries/illness, such as those incurred in traffic accidents or during work. Please ask formore information.

④ National Health Insurance premiums【Inquiries】National Health Insurance Qualification Section, National Health Insuranceand National Pension Division ☎ 03-5744-1210
Persons who are members of the National Health Insurance program have both “rights”
to receive benefits and “responsibilities” to pay premiums.
The premium payments are a crucial source of funding for the national health insurance
system. Please be sure to make premium payments in time.
The annual premiums are the sum of the medical portion, older-senior citizen support
portion and nursing care insurance portion (required for only insured persons aged
between 40 to 64 years old). Each portion is determined by adding together an incomebased amount (income tax) and per-capita amount (flat-rate tax). To ensure that thepremiums are calculated correctly, filing an income tax report for the entire household
is necessary. The insurance premiums are calculated on per-household basis, and52

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Insurance/Pension

the head of the household is obligated to make premium payments for his/her entire
household. The premium statements are sent out to the head of each household.

⑤ Premium payment methods【Inquiries】National Health Insurance Premium Collection Section, National Health
Insurance and National Pension Division ☎ 03-5744-1209
Health insurance premiums are paid for the whole household by the head of the household.
There are two payment methods available.
◦ Automatic debit transfer
With this service, your premium is withdrawn automatically from your bank accountwithin the payment deadline.
Applications:① Bring your automatic debit transfer request form, bank book and seal to thefinancial institution that you have a savings account with.
② Bring your bank book and seal to the National Health Insurance and National
Pension Division.
◦ Payments made with the premium payment slips
Using the payment form sent from the City Office, make your payment before thedeadline via a financial institution (bank, savings trust, credit union, agriculturalcooperative, postal bank), convenience store, Mobile Regi, Mobile Credit, cashless
payment, branch office (P.17) or City Office.

7For more information about the National Health Insurance, please referto the following:Ota City National Health Insurance Guidebook Languages: Japanese, English
Available at: National Health Insurance and National Pension Division andBranch Offices
Issued by: National Health Insurance and National Pension Division, Residents
Affairs Department, Ota City Office⑥ Medical care for people 70 or older and younger than 75(Senior Members’ Certificate)【Inquiries】National Health Insurance Qualification Section, National Health Insuranceand National Pension Division ☎ 03-5744-1210
A National Health Insurance Elderly Recipient Certificate is issued to individuals aged
70-74. This medical certificate must be presented with the National Health Insurance
Certificate from the first day of the month following your 70th birthday (or the first day ofthe month of your 70th birthday if it falls on the first day of the month) to the day before
your 75th birthday. The deductible rates of the holders of the Elderly Recipient Certificate
are set depending on their incomes.
Please present both the National Health Insurance Elderly Recipient Certificate and theNational Health Insurance Certificate when you go to a hospital or clinic for medical treatment.

532Pension system(1) Pension System of Japan (National Pension Plan)
This is a pension plan managed by the national government to support the lives of theaged, disabled and bereaved. Anyone between 20 and 59 years of age who lives (holdsresidence registration) in Japan is obliged by law to enroll in the National Pension Plan.
There are three kinds of insured person.
◦ Type 1 Insured: Self-employed, part time worker, student, unemployed, etc.
◦ Type 2 Insured: Insured under employee pension◦ Type 3 Insured: Spouses dependent on a Type 2 person① Enrollment procedure【Inquiries】National Pension Section, National Health Insurance andNational Pension Division ☎ 03-5744-1214
National Pension Section, Ota Branch Office,Japan Pension Service ☎ 03-3733-4141
Enrollment procedures can be completed at the government office of the municipality inwhich you are registered as a resident (Ota City) or at a Japan Pension Service Branch
Office. Employees of Japanese companies are required to enroll in the Employees’Pension Insurance Plan as well as the National Pension Plan.
The enrollment procedures for both the Employees’ Pension Insurance Plan and theNational Pension Plan for company employees are carried out at their workplace.
If you are a company employee, you do not have to complete the enrollment
procedures on your own.
In event of the following

NotifyWhen arriving in Japan and applying
for resident registration

National Pension Section, National Health Insuranceand National Pension Division, Japan Pension Service
Ota City Pension Office

When leaving your company

National Pension Section, National Health Insuranceand National Pension Division Branch Office (P17),
Japan Pension Service Ota City Pension Office

When becoming a dependent spouse
Spouse’s workplace(of person with employee insurance)

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When losing status as dependent
spouse (of person with employeeinsurance)

National Pension Section, National Health Insuranceand National Pension Division Branch Office (P17),
Japan Pension Service Ota City Pension Office

When spouse changes place ofemployment

Spouse’s workplace

Chapter 7
In event of the following

Insurance/Pension

NotifyType 1 Insured: National Pension Section, National
Health Insurance and National Pension Division
Branch Office (P17), Japan Pension Service Ota
When the pension handbook or Basic
City Pension OfficePension Number Notice has been lostType 2 Insured: Workplace
Type 3 Insured: Spouse’s workplace, JapanPension Service Ota City Pension Office
For information about premium
payments

Japan Pension Service Ota City Pension Office

To apply for exemption of insurance
premiums

National Pension Section, National Health
Insurance and National Pension Division, Japan
Pension Service Ota City Pension Office

To apply for student payment
exception for insurance premiums

National Pension Section, National Health
Insurance and National Pension Division, Japan
Pension Service

To apply for an exemption for theperiod before and after childbirth

National Pension Section, National Health
Insurance and National Pension Division, Japan
Pension Service Ota City Pension Office

7National Pension Section, National HealthTo perform enrollment procedures forInsurance and National Pension Division, Japan
old age pension
Pension Service Ota City Pension Office* Please inquire for details regarding required documents.

② Basic pension benefits【Inquiries】National Pension Division, Japan Pension Service Ota City
Pension Office ☎ 03-3733-4141
National Pension Section, National Health Insurance andNational Pension Division ☎ 03-5744-1214
Persons who paid the national pension premiums for at least 10 years begin toreceive the basic elderly pension when they are 65 years of age. In addition, they
are entitled to receive the pensions listed below if they become disabled or if they
are foreign residents who leave Japan before completing the qualifying coverage
periods.
（The following are examples）◦ Basic disability pension
Persons who become disabled through illness or injury while they are enrolled in the
National Pension Plan are entitled to receive this pension as long as they have been
paying the premiums.
◦ Basic bereaved family pension
The spouse and children of a deceased National Pension Plan member are entitled
to receive this pension as long as the member had been paying the premiums.

55◦ Lump-sum withdrawal payment
To receive a basic elderly pension, basic disability pension or basic bereaved family
pension, you must pay the premiums for a designated period. There is a lump-sum
withdrawal benefit program for short-term foreign residents who return to their homecountry before becoming eligible to receive payments. The lump-sum benefit is paid
upon request within two years of leaving Japan if the resident has paid the premiums
for at least six months.

③ National Pension premiums【Inquiries】Japan Pension Service Ota City Pension Office
National Pension Division ☎ 03-3733-4141
Amounts change each fiscal year (April to March)* Under the Employees’ Pension Insurance program, the employer deducts half theamount of the employee’s income-based premium payments out of his/her salaryand makes the payment on his/her behalf. (The employer is responsible for thepayment of the remaining half premium.)④ Premium payment methods【Inquiries】Japan Pension Service Ota City Pension OfficeNational Pension Division ☎ 03-3733-4141
After you complete enrollment procedures at your municipal office (Ota City Office)or Japan Pension Service (JPS) Branch Office, your local JPS Branch Office will
send you a Basic Pension Number Notice and premium payment slips. Please use
the payment slips to pay the premiums by the payment deadline at a nearby financial
institution (bank, credit union, credit association/agricultural cooperative), post office(Japan Post Bank), convenience store, or by using a smartphone app.
Payments can also be made via automatic debit transfer or credit card. Pension
premium payments are not accepted at the Ota City Office or branch offices (P. 17).
Please complete the procedures at the Japan Pension Service Ota Branch Office.

⑤ Exemption of premium payments【Inquiries】National Pension Section, National Health Insurance
andNational Pension Division ☎ 03-5744-1214
Japan Pension Service Ota City Pension Office
National Pension Division ☎ 03-3733-4141
If the income of the applicant, spouse, or head of household for the previous year islower than the designated standard, or if it is difficult to pay the pension premiums due
to unemployment, etc., you may apply for the premium payment exemption program.
Upon approval, a full or partial exemption will be applied to the premium payments.
There are other exemptions available, such as the Special Payment System ofStudents, Premium Payment Postponement System, and the Exemption System for
the Period before and after Childbirth.

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Insurance/Pension(2) Totalization of Pension Coverage Period【Inquiries】Japan Pension Service Ota City Pension Office
National Pension Division ☎ 03-3733-4141
Japan Pension Service
You may be qualified for totalization benefits under the Japanese system as well as the foreignsystem if you have a qualifying coverage period under the pension systems of countries withwhich Japan has totalization agreements, subject to each qualification condition.
Please note that once you receive your lump-sum withdrawal payments, your total
coverage periods will no longer be valid to apply for other Japanese benefits. For more
information, please check Japan Pension Service’s official website.

3

Medical Insurance Program for Older Senior Citizens

Residents who are 75 years of age and older are eligible and required to enroll in the
Medical Insurance Program for Older Senior Citizens, and they are not eligible for theNational Health Insurance program. Residents who are between 65 and 74 years of age
with a designated level of disability can also enroll in the system on a voluntary basis after
withdrawal from the National Health Insurance program. Please inquire with the Medical
Insurance for Older Senior Citizens program eligibility officer.
For more information on eligibility and benefits available for foreign residents,
please inquire with the following division.

7【Inquiries】Medical Insurance for Older Senior Citizens Section,
National Health Insurance and National Pension Division① Eligibility and premium calculation: ☎ 03-5744-1608② Benefits: ☎ 03-5744-1254

・When medical fees are expensive
・Food expenses while hospitalized
・When expensive treatment continues for an extended period, etc.

③ Payment methods: ☎ 03-5744-1647

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