Health Insurance
Contact
Kasama City Hall

Main Office

Health Insurance and Pension Division (hoken nenkin ka)
Kasama/Iwama Regional Branch
Citizen Service Division (shimin madoguchi ka)

Employee Health Insurance (shakai hoken)
Employee Health Insurance is a public insurance program for employees andtheir family members to receive medical benefits or allowance when needed (e.g. incases where they are injured or become ill outside of work). Employers pay half of theinsurance premiums in this program. Please inquire about your application with youremployer.

National Health Insurance (kokumin kenkou hoken)
National Health Insurance (NHI) is a mutual assistance program, in which
every resident pays premiums to reduce the individual burden of medical expenses inthe case of sudden injury or illness.
How Foreign Residents Join NHI in Kasama City
Those who have their Resident Record in Kasama City will join the NHI in Kasama City,
with the following exceptions:•Those who enroll in Employee Health Insurance and others covered by theemployee’s insurance•

Those insured through a health insurance association•Those under health insurance for the latter-stage elderly•

Welfare recipients under the Public Assistance Act•

Foreign residents who do not have their Resident Record registered in Kasama
City.

•Unsupported and institutionalized children under the Child Welfare Act.

When Procedures are Necessary

Moving-out Certificate from previous

City

Municipality (if moving from within Japan)

Health Insurance (shakai hoken)
When a person ceases to receive
public assistance (seikatsu hogo)
When a child is born
When a Foreign National stays formore than 3 months in JapanWithdrawingfrom NHI

Seal and Residence (zairyuu) Card)

When you have moved to Kasama

When you withdraw from Employee

Joining NHIWhat to Bring (in addition to your Personal

Certificate of loss of health insurance statuswhen you quit your workplace healthinsurance (shikaku soushitsu shoumeisho)
Written notice that you have stopped
receiving public assistance (hogo haishitsuuchisho)
Health Insurance card and Mother andChild Health Handbook
Passport

When moving to another municipality

Insurance Card

When joining the Employee Health

Both your NHI card and your Employee

Insurance (shakai hoken)

Health Insurance card

If you begin receiving Public
Assistance (seikatsu hogo)
When someone dies

Insurance Card, written notice of public
assistance acceptance (hogo ketteitsuuchisho)
Insurance Card, Funeral Notice

When you leave Japan to your country Insurance Card
When you move address within
Kasama City
When your Head of Householdchanges
Other

When your household memberschange (on your Resident Record)
When you move to anothermunicipality for school
If you lose or damage your Insurance
Card

Insurance Card
Insurance Card
Insurance Card
Insurance Card, Enrollment Certificate
Identification

Policies on Premium Payments
Insurance premiums are based on the amount of residence tax and other conditions.
The insurance premiums paid by everyone are an important financial resource, which isadded to the national subsidy to provide NHI benefits for medical expenses or lump sum
birth allowances.
*Premiums should be paid by the due date.
*If you do not pay on time you may have the validity of your insurance card shortened,
be asked to return your insurance card, be required to pay all costs of medical servicesup front and apply for a refund to lessen your portion of the costs, have your payment
denied, or have your insurance benefits suspended.
Methods of Payment
1. Account Transfer Payment
Premiums can be paid by automatic transfer from a designated account. Please apply ata financial institution where you hold an account.
Required Items
Bankbook, personal seal used when opening the account, insurance card
2. Direct Payments at Financial Institutions or Convenience StoreA payment slip will be sent to the taxpayer in your family and premiums should be paidwith the slip at any financial institution or convenience store. Note that you cannot
make payments with the slip at Japan Post Bank (Post office).
Required Items
Payment slip
Benefits of National Health Insurance
1. Medical Benefits
You can receive the following treatments at a discount when you show your insurance
card at the reception desk of the hospital you visit when injured or ill. The difference
will be covered by the NHI.
•Examinations•

Treatments•

Medicine and injections•Hospitalization and nursing care•House calls or treatment from your doctor or nurse at home2. Medical Expenses•

Should there be times when you require treatment at a hospital not affiliatedwith NHI or become ill while travelling so have to pay the full cost of the medicaltreatment, you can apply to NHI for reimbursement of the cost minus yourdeductable.
•You can receive a reimbursement from NHI, minus your deductable, for the costof therapeutic devices, such as corsets, if they are deemed necessary by a doctor.

Lump Sum Birth Allowance
You can receive a lump sum birth allowance when you have a baby or a stillbirth after
16 weeks of pregnancy.
Funeral Allowance
The funeral allowance is paid to the person who conducts the funeral of an insured
person.
High-Cost Medical Expenses
If your portion of medical expenses within a one-month period becomes too great, you
can apply for and, upon acceptance, receive a refund of the portion exceeding thedesignated limit.
You can use NHI for injuries caused by other people such as traffic accidents.
Report traffic accidents to the police and NHI immediately. NHI cannot be used if you
have accepted money for medical expenses from the other party or reached an
out-of-court settlement.
High-Cost Total Expenses for Nursing Care
If one's own total payments in a year for national insurance and nursing care insurance
exceed the designated limit, one can contact national insurance and apply to have theexcess reimbursed (high-cost total expenses for nursing care).

National Health Insurance Tax Payments
About National Health Insurance Payment
The National Health Insurance system was operated by municipalities until 2017, andthe National Health Insurance tax rate was decided by estimating the insurance benefit
expenses required by each municipality. However, from the fiscal year of 2018,prefectures will also be responsible for financial management and will operate it
together with municipalities. Therefore, from now on, municipalities will pay the levy toprefectures, and the amount necessary for the insurance benefit of municipalities will

be covered from the levy. Each municipality determines the National Health Insurance
tax rate by referring to the standard premium (tax) rate indicated by the prefecture.
Nursing care (People between 40 and 64 years old pay.) is paid once to an institution
called "Social Insurance Medical Fee Payment Fund" through each medical insurer<Government-Managed health insurance, mutual aid associations, National Health
Insurance, etc.> as nursing care payment. And this nursing care payment will be a partof the financial resources to support those who need nursing care.
Kasama City imposes a National Health Insurance tax in accordance with Article 703,
Paragraph 4 of the Local Tax Law.
About the Taxpayer
The taxpayer of the National Health Insurance tax is the Head of Household.
Therefore, even if the Head of Household is not a member of the National HealthInsurance system, if a member of the National Health Insurance system is in thehousehold, a notification such as a tax notice will be sent to the Head of Household.
In this case, the Head of Household is not included in the tax amount calculation.
Calculation of National Health Insurance Tax AmountThe National Health Insurance Tax is composed of three parts:"Medical Tax" to pay medical expenses"Elderly Support Tax" to support elderly aged 75 or older"Nursing Tax" (only paid by people aged 40 to 64)
The calculation method is to calculate tax on a household basis by adding up theamount calculated by multiplying the previous year's income of each subscriber by a tax
rate (1), the amount calculated by multiplying each subscriber by a fixed amount (2),and the amount calculated by multiplying each member by a fixed amount (3).
The National Health Insurance tax is calculated and taxed on a monthly basis.
(Note)The National Health Insurance tax is imposed by dividing the annual tax amount (For12 months) by the due date (Up to eight terms in Kasama City). Please note that the tax
amount per term is not the amount for one month of the household.
National insurance taxes for fiscal 2018 are calculated at the following rates:

Classification(1) Income Rate

(2) Per Capita Rate(3) Equal Rate

Medical portion (1) + (2)Elderly Support

Nursing Care (1) + (2)+ (3)Persons (1) + (2) + (3)[From age 40 to 64]

580,000 yen tax limit

190,000 yen tax limit

160,000 yen tax limit(Gross income of(Gross income of(Gross income of¥-330,000 in the¥-330,000 in the¥-330,000 in theprevious year) x Taxprevious year) x Tax

previous year) x TaxRateRateRate

Tax rate... 7.5%

Tax rate... 2.6%

Tax rate... 2.3%

For one national healthFor one national healthFor one national healthinsurance subscriber

insurance subscriber

insurance subscriber

23,400 yen

8,200 yen

13,000 yen

For a single household

For a single household

N/A

22,800 yen

7,100 yen

*All prices are annual. Last revision 2018.

Medical Care System for Seniors aged 75 and older
People over the age of 75 (65 if the patient is bedridden or has certain disabilities) canreceive medical care from through this system. This system reduces the burden of
medical expenses for elderly people and to enables them to receive medical care withpeace of mind.
Who is

1. Those aged 75 years or older

applicable?

2. Those aged 65 years or older, and with certain disabilities.

Percent of the10% (Income earners above a certain level shall bear 30% of the cost.)

bill you pay

Please submit your senior medical card to the counter of medical
institutions, etc.

Payments

1. Payment of High-Cost Medical Expenses
If the monthly medical expenses become high, the amount exceeding
the self-pay limit will be covered. (We will notify the appropriateperson.)
2. Benefits for Medical Treatment, etc.
If a doctor finds it necessary, the cost of medical equipment such ascorsets, and treatment costs such as acupuncture, moxibustion, andmassage will be covered.
3. Payment of Funeral Expenses
When a person who has latter-stage elderly medical insurance dies,
50,000 yen will be provided to the person who holds the funeral fromIbaraki prefecture latter-stage elderly medical care wide association.

Medical Welfare Payment System (iryou fukushi hishikyuu seido)
The medical and welfare expense payment system (Marufuku) is a system to subsidize
part of the medical expenses of pregnant women, children, single parent families withsevere mental and physical disabilities with the aim of reducing the burden of medicalcare for parents and children, and severely disabled people, who are socially andeconomically burdensome.
*Expenses not covered by medical insurance cannot be subsidized.

Classification
Expectantand Nursing
Mothers

Conditions
Pregnant women who have received a Maternal and Child Health
Handbook (From the first day of the month in which the Maternal andChild Health Handbook is issued to the end of the month following thedelivery date (including abortion))Children ages 0 to 15 (Until the first March 31 after the day on whichChildhe/she reaches 15 years of age)
Hospitalization only until age 18 (Until the first March 31 after the dayon which he/she reaches 18 years of age)
Unmarried parents of a single parent with a child under 18 years of age
and their children

Single-Parent (until the first March 31 after the day on which he reached the age ofHousehold18)*Up to age 20 for families with children with disabilities and highschool students
A person who has received Level 1 or Level 2 of the Physical Disability

Severely

ID Booklet (shintai shougaisha techou), Level A or higher of theDisabled

Rehabilitation Certificate, Level 1 of the Disability Pension, or Level 1of the Mental Disability Certificate.

Marufuku Member Payment AmountClassification

Payment Amount (per medical institution)

 Expectant and Nursing

Outpatient service: Up to 600 yen per day, up to 1 month

Mothersand 2 days

 Child

Hospitalization: Up to 300 yen per day, up to 10 days per Single-Parent Householdmonth
There is no out-of-hospital prescription pharmacy
co-payment.

Severely Disabled

None

Items Required for Application
Classification

Items Required

Expectant and Health insurance card

Nursing Mothers Seal Account Number Information
 Mother and Child Health Handbook
 Income Tax Certificate for the person whose income is to beconfirmed (Cases where the foreign national has beentransferred from another municipality) Certificate of Recipient of Medical and Welfare Expenses (inthe case of receiving Marufuku at the previous address)
 Something that shows your “My Number” (Individual NumberCard, Notification Card, etc.)

Child Health Insurance Card
 Seal Account Number Information
 Certificate of income tax for the person whose income is to be
confirmed (Cases where the foreign national has beentransferred from another municipality) Certificate of Recipient of Medical and Welfare Expenses (Inthe case of receiving Marufuku at the previous address)
 Something that shows your “My Number” (Individual Number
Card, Notification Card, etc.)

Single-Parent

 Health Insurance Card

Household Seal Account Number Information
 Copy of family register Certificate of income tax for the person whose income is to be
confirmed (Cases where the foreign national has beentransferred from another municipality) Certificate of Recipient of Medical and Welfare Expenses (Inthe case of receiving Marufuku at the previous address)
 Something that shows your “My Number” (Individual Number
Card, Notification Card, etc.)
Severely Disabled Health Insurance Card
 Seal Account Number Information
 Handbook, rehabilitation handbook, disability pension
certificate, mental disability health and welfare certificate, etc.
 Certificate of income tax for the person whose income is to be
confirmed (Cases where the foreign national has beentransferred from another municipality) Certificate of Recipient of Medical and Welfare Expenses (Inthe case of receiving Marufuku at the previous address)
 Something that shows your “My Number” (Individual Number
Card, Notification Card, etc.)*If you move in from outside Ibaraki Prefecture, you may be able to inquire about yourincome to other municipalities through information cooperation in the My Numbersystem.
If you are moving in from Ibaraki Prefecture, please bring the "Certificate of Issuance ofRecipient Certificate for Medical and Welfare Expenses" issued by the municipal
medical and welfare service counter where you moved out from.