Ota City Hall
National Health Insurance DivisionWho Enrolls in National Health Insurance?
The national health insurance is a system that insures enrollers from sickness andinjury with taxes (national health insurance tax) paid by the insured.
With the exception of those enrolled in their employer’s insurance, medical insurance
for older senior citizens, or for those receiving welfare, everyone must enroll in national
health insurance.

●Those that must enroll in national health insurance
Those that have their own business, etc. and are self-employed
Those involved in the agricultural (farming) and fishing industry
Those working part-time that are not insured in their employer’s insurance
Those that quit their job and are not covered by health insurance (includes family)

Foreigners who have a resident record (those with a residence
status of more than 3 months, etc.)●Enrollment is conducted per household
Each person is covered individually, but enrollment will be conducted per household.
In other words, the national health insurance tax will be levied to each household (notto each individual).

Keep your Health Insurance Card Safe!
Your insurance card (National Health Insurance Card) is a certificate that shows you
are enrolled in national health insurance. Do not lose or tear your health insurance card,and please handle it with care.

●How to use your health insurance card
◆Make sure you show your card when visiting a medical facility.
◆Copies will not be accepted.
◆Cards past their expiration date cannot be used.
◆The actual card holder may only utilize the health insurance card. (Those that use it
inappropriately will be subject to punishment by law.)◆When moving to another city/abroad or switching health insurances, please return
your health insurance card to city hall immediately and start the procedures for
submitting a National Health Insurance Withdrawal Notification.

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When Enrolling/Withdrawing from National Health Insurance
Please submit a notification within 14 days after enrolling/withdrawing from national
health insurance.

●When to enroll in national health insurance:◆When moving in from another municipality◆When leaving your employer’s health insurance (day after quitting your job)
◆When your child is born
◆When you stop receiving welfare

Warning!

If enrollment procedures are late…

Individuals are responsible for paying national health insurance taxes from the monththey become eligible for national health insurance coverage (when moving in fromanother city, quitting your job, etc.). As a result, if your enrollment procedures are late
you will be retroactively charged for from the month you gained eligibility. (Subject to becharged up to three years back.)●When to withdraw from national health insurance:◆When moving to another city or abroad (※Make sure to visit the Resident
Affairs Division when moving out of Ota for moving-out procedures)◆When enrolling in your employer’s insurance, etc.
◆When death occurs◆If you start receiving welfare

Warning!

If withdrawal procedures are late…

A notification is required if you are withdrawing from national health insurance. If
withdrawal procedures are late, you will be taxed for national health insurance
premiums even if you are enrolled in another health insurance plan. Moreover, if you
were to use your national health insurance card, you would be responsible for paying
the portion that was covered and pay the medical fees for that health checkup.

National Health Insurance TaxesMedical fees for injury/sickness, childbirth, funeral expenses, etc. are paid with publicfunds from national health insurance taxes and taxes at the national, prefectural, andmunicipal level. National health insurance taxes are an important financial source forsupporting this insurance system. Please make your payments within the designateddeadlines.

●Head of household is responsible for paying taxes
Regardless of whether the head of household is enrolled in national health insurance
themselves, they are still responsible for tax payments if someone in the household isenrolled.

-2-If you have Default Non-Payments of National Health Insurance Taxes
Please keep in mind, if you have default non-payments (excludes disaster and otherspecial circumstances), the following measures may be taken.
If the payment deadline passes…
A dunning letter will be sent.

Dunning Letter

You may be subject to pay fees, etc. for delays in payment.

If the deadline continues to pass without payment…
Provisional Health You may be issued a provisional health insurance card that has a
Insurance Card

shorter expiration date.

If one year passes from the deadline…
You will return your provisional health insurance card and beissued a qualification certificate (health insurance qualification
Qualification

certificate). This shows you are insured and under national health

Certificate

insurance.
You will be responsible for paying all medical fees for a while until
taxes are paid.
If a year-and-a-half passes from the deadline…

BenefitPart or all of your national health insurance benefit may be

Suspension

suspended.

If non-payments continue…
Default non-payments may be deducted from your suspended benefits. Your financial
assets may also be subject for seizure. Moreover, your nursing insurance benefits may
be limited as well.
In order to receive your health insurance card
●Pay all national health insurance taxes in arrears●There must be a marked decrease in taxes in arrears

Please come in for a consultation if you are having difficulties paying taxes.
Consultation Counter: Ota City Hall Tax Payment Division☎ 0276-47-1820/0276-47-1935 Tax Collection Measure Division ☎ 0276-47-1946

We recommend using a direct deposit system to pay your national healthinsurance taxes! Please bring your bank book and its registered inkan-seal.

-3-When you Become Ill or Injured
With national health insurance, enrollers can receive treatment without worry.
Coverage is listed below.

Medical Treatment Coverage and Burden of Costs
Please show your health insurance card when coming in for an injury or sickness.
This insurance will cover 70% (depends on age and income) of costs.
From 0 to before

From the start ofenteringcompulsory

compulsory

education to 69

education

years old

70 to 74 year olds

80%

Treatment
Coverage(Kokuho’s Burden80%70%of Costs)

Burden of Costs(of patient)20%

30%

Income equal to current
income earners – 70%
Born on/after

Born on/before

April 2nd, 1944

April 1st, 1944

20%
10%※
Income equal to current
income earners – 30%※The patient’s burden of costs are naturally 20%, but since the country burdens theother 10% you are only responsible for 10% of costs in this case.

There are subsidies for the following cases●The following subsidies requires an application to be filled out.
※The statute of limitations for subsidy applications are 2 years in principle
Type of Subsidy
Description
RequirementsMedical
Treatment Fees

High-cost
MedicalTreatment Fees

FuneralExpenses

For occasions when you
receive treatment for sudden
illnesses, etc. without using
your health insurance card,buy clothes for treatment, etc.
Medical treatment fees
overseas (※ 1)
When medical fees become
expensive and exceed acertain amount.

Document containing checkup
information, receipt, healthinsurance card, inkan-seal ofhead of household, anddocument, etc. that shows yourbank account number for direct
deposit.
Those eligible will receive a
notice from city hall. Please bringthe items listed in the notice withyou.
When a national healthInkan-seal, document, etc. that
insurance enroller is deceased, shows bank account number for
50,000 yen is subsidized to the direct deposit, receipt or letter of
person preparing the funeral.
thanks to mourners (from host)from the person who coordinatedthe funeral.

-4-When someone hospitalized in
critical condition needs to betransferred to another hospital,
and fees are incurred.
＊Only in cases when Kokuho
deems it necessary.
When the insured person gives
birth, 404,000 yen is
subsidized to the head ofhousehold.
●An additional 16,000 yen will
be granted if given birth infacilities enrolled in the Japan
Obstetric Compensation
System for Cerebral Palsy.

Certificate from doctor, receipt,
health insurance card, inkan-sealof head of household, document,
Transport Costs
etc. that shows your bankaccount number for direct
deposit.
If childbirth costs are below
404,000 or 420,000 yen, an
application is required to be fillout. Detailed receipt of fees,Childbirth
documents pertaining to theLump-sum
usage of direct payment system,
Allowance
health insurance card, inkan-seal※2of head of household, anddocument, etc. that shows yourbank account number for direct
deposit.
※1）Overseas medical treatment fees refers to occasions when you have no choice but
to receive medical care while traveling abroad. However, you cannot apply if yourpurpose of travel was to receive medical treatment.
●Application requirements: Document containing checkup information (translated intoJapanese), receipt (translated into Japanese), health insurance card, inkan-sealof head of household, document, etc. that shows your bank account number for
direct deposit, passport and ticket stub, etc., and consent form stating the medical
facility where checkup took place may be contacted.
※2）In principle, you will apply at the medical institution’s counter, where the national
health insurance will directly make the payment (direct payment system). Thissystem allows users to directly use this money for child labor, which relieves thefinancial burden of childbirth costs.
All applications will require you to bring your Individual Number (Notification) Cardand photo I.D. (Resident Zairyu Card, etc.). Please call the National Health Insurance
Division for details.

If you are in a Traffic Accident
If you are in a traffic accident or become injured/sick due to a third party, you will beable to receive treatment through the national health insurance.
However, the wrongdoer (responsible party) is responsible for payments. In order toreceive treatment through this insurance, Kokuho will temporarily loan the money
required for treatment which will be refunded back to the national health insurance by
the responsible party. Please be sure to submit a notification to city hall.
●Points to be careful of when in a traffic accident◆Submit a notification to the police◆Submit a notification to the National Health Insurance Division in city hall.
Your health insurance card, inkan-seal, and traffic accident certificate, etc. arerequired. Please contact the National Health Insurance Division for details.
※Examples of third party actions●Traffic accidents●Bitten by someone else’s pet

person’s snowboard, skateboard, etc.

-5-●Collision/hit by another●Food poisoning●etc.

Things to Keep in Mind When Going in for a Visit
Orthopedics, treatments using needles, moxibustion, and massages have limited
coverage through national health insurance. Please be aware in the case it cannot beused, the patient will be responsible for all costs.
●For those going to orthopedic clinics
National health insurance may be used for:

National health insurance cannot be used for:・External sprains and bruises
・Contusions (pulled/torn muscles, etc.)
・Broken/dislocated bones (consent fromdoctor is needed except in cases ofemergency)

・Fatigue and shoulder stiffness from dailylife・Muscle fatigue caused by sports
・Lower back pain and shoulder stiffness
due to increased age・Nerve damage (rheumatism, chronicarthritis, etc.)
・Chronic pain from after-effects of brain
disease・If you are receiving treatment for the same
injury, etc. at a medical facility
・Injuries suffered commuting/during work
(eligible for Worker’s Compensation)●For those receiving needle and moxibustion treatment
National health insurance may be used for:

National health insurance cannot be used for:If you possess a consent form anddiagnosis issued by the doctor.
●For those receiving massages

If you are receiving treatment for the samedisease at a medical facility.

National health insurance may be used for:

National health insurance cannot be used for:

When medical massages are deemed
Massages that are aimed to simply recovernecessary due to muscle paralysis,
from fatigue, gain comfort, prevent ailments,
arthrogryposis, etc. (Consent from andetc.
diagnosis issued by a doctor is required.)Let’s Visit Medical Facilities Effectively!
Along with receiving the medical treatment you need, in order to efficiently utilize thetaxes and fees paid by the patient, please keep in mind of the following points whenvisiting a medical facility/pharmacy, etc.

●Except for emergencies, please refrain from coming in for a visit on
weekends and at night.

Let’s consider whether we can make a visit during daytime hours.

●Let’s have a primary care physician selected.
Let’s first select a primary care physician and consult any worries with them.

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●Let’s refrain from visiting multiple clinics for the same illness.
Please refrain from visiting multiple clinics for the same illness. Not only does thisincrease your medical fees, but there is also cause for concern of the bad effects on
your body due to multiple checkups and doses of medicine.

●Please be careful from receiving too much medicine.
Please consult with your doctor/pharmacist if you have any medicine left.

●Please be careful from taking multiple medicines at once.
Check your medicine handbook, etc. and let your doctor/pharmacist know of any
medicines you have already been given. Please be careful of mixing and taking
medicines.

●Let’s use generic drugs.
Generic drugs (brands) hold the same effects and benefits as the original drug, and isoften cheaper as well. Please consult with your pharmacist about using genericdrugs.

Receive your once-a-year special health checkup!
Japan has recently seen a rise in lifestyle diseases, such as diabetes and high bloodpressure. Lifestyle diseases can be prevented by improving your lifestyle. In order toprotect your health, let’s take the initiative to take these special health checkups andspecial health guidance that puts a focus on metabolic syndrome (visceral fatsyndrome) and preventing lifestyle diseases, respectively.

●What is a Special Health Checkup?
◆Who is eligible?
National health insurance enrollers aged 40 to 74.
Those currently going to a hospital are also eligible.
◆There is no fee!
◆When and where can I receive this checkup?
An envelope containing tickets for various health checkups will be sent once a year
towards the end of April. Please go to the places (medical facility/group checkups)
listed in the guide enclosed in the envelope.
◆What will be done in this checkup?
Stomach, height, and blood pressure measurements, a blood test, checkup
performed by a doctor, etc. Depending on your results, additional checkups may beadded.

-7-◆What of the checkup results?
Everyone will be notified of their checkup results and current state of health inregards to their lifestyle, etc.

●What is special health guidance?
◆ Who is subject to this?
Persons who are above the stomach measurement standard (85 cm for males, 90
cm for females) or have a BMI index of 25 or above in addition to meeting certain
blood sugar/pressure and lipid indexes are subject.
(Note) In principle, individuals taking medicine for blood sugar/pressure and lipids
are not subject.
◆There is no fee!
◆When and where can I receive this guidance?
Persons eligible will receive a notice from the National Health Insurance Division.
◆What will be discussed?
Doctors, public health nurses, nutritionists, etc. will give support and discuss how toimprove your daily lifestyle habits such as diet and exercise. Depending on yourrisk of sickness, there is “motivational support” and “positive/active support”.
(Smokers will have an increased level of guidance.)<Contact Information>● Matters Regarding the National Health Insurance Card and Benefits andSpecial Checkups, etc.
Ota City Hall National Health Insurance Division (1F Counter 16)
TEL: 0276-47-1825● Matters Regarding National Health Insurance Payments
Ota City Hall National Health Insurance Division (1F Counter 16)
TEL: 0276-47-1966● Concerning National Health Insurance Taxes and Tax Consultations
Ota City Hall Tax Payment Division (2F Counter 23)
TEL: 0276-47-1820
Ota City Hall Tax Payment Measure Division (2F Counter 24)
TEL: 0276-47-1946
Issued November 2018

太田市役所 国民健康保険課

太田市国民健康保険ご案内・英語版-8-