INFORMATION FOR FOREIGN NATIONALS WHO ENROLL IN
THE KOBE CITY NATIONAL HEALTH INSURANCE SYSTEMThe National Health Insurance is a mutual support system that ensures that everyone enrolled can receive
medical treatment in case of an illness or injury. If you present your health insurance card at the hospital, you will
be able to receive medical treatment for a fraction (30%) of its cost. There is also a ceiling amount forout-of-pocket expenses, so should you require expensive treatment, you can apply for a refund of the fees you
paid in excess of this ceiling amount.
Foreign nationals under the age of 74, who are going to be registered as residents in Kobe for more than threemonths and are not covered by any other public health insurance program, must enroll in the National Health
Insurance System. Please note that having overseas travel insurance is not the same as being enrolled in a publichealth insurance program. Moreover, even if your current period of stay is shorter than three months, if you livein Kobe and your status of residence is either Entertainer, Technical Intern Training, Dependent, or DesignatedActivities*, you must enroll in the National Health Insurance System in case you are expected to stay in Japan inexcess of three months based on the documents you submitted.
*The following “Designated Activities” are excluded:
 Receiving medical treatment
 Activities supporting the daily needs of a person receiving medical treatment
 Tourism, recreation and other similar activities
 Spouses accompanying those taking part in tourism, recreation or similar activities

HOW TO ENROLL IN THE NATIONAL HEALTH INSURANCE SYSTEM*Please note that you may be asked to provide your Individual Number on the application.
Required Documents
You must carry out the enrollment procedures when...

Make sure to bring your Passport, Residence Card or Special Permanent
Resident Certificate (Alien Registration Card)

You move to Kobe from outside of the city

You move from another ward within Kobe (including
relocations between the jurisdictions of Suma Ward Officeand Kita Suma Branch Office)
You lose eligibility for other health insurance programs due
to:・ Resignation or retirement (except if you apply forvoluntary continuous coverage)
・ Termination of voluntary continuous coverage
・ Loss of eligibility as a dependentIf a new person is added to an existing household,
Health Insurance Card of the head of household

Health Insurance Card issued by the ward from which
you are moving
If a new person is added to an existing household,
Health Insurance Card of the head of household issued
by the ward you move into

If a new person is added to an existing household,
Health Insurance Card of the head of household
Certificate of Loss of Health Insurance Eligibility

When you have a childMaternal and Child Health Handbook
Health Insurance Card of the head of household

When your public assistance is discontinued or suspended

Public Assistance Discontinuation (Suspension) NoticePlease note that if your name is removed from the resident record due to a change in your residence status or other reasons while you areenrolled in the National Health Insurance System, we may need to confirm your status of residence.

 Please file an application for enrollment in the National Health Insurance System within 14 days.

June 2021, Kobe City National Health InsuranceWHAT TO DO IF YOU NEED TO GO TO A HEALTHCARE INSTITUTION
BEFORE RECEIVING YOUR HEALTH INSURANCE CARDIf you need to receive medical treatment, but cannot present your Health Insurance Card because it is in theprocess of being issued, you will first have to pay for all medical expenses out of pocket, and afterwards you will
be reimbursed for the portion covered by insurance benefits. In order to receive this reimbursement, you will
have to file an application with the National Health Insurance Service Desk at your local ward or branch office(Seishin Chuo Community Service Center for those who live within its jurisdiction) and submit all the necessary
documents, such as the statement of medical treatment and expenses, and a payment receipt. (You will bereimbursed within two to three months.)
 If you do not file your application in time, you may not be able to receive insurance benefits.

WHAT TO DO IN CASE YOU DO NOT UNDERSTAND JAPANESE(1) Ward office service desks may be unable to provide services in foreign languages. Therefore, if you would
like to receive a consultation or file an application at a ward office, if possible, please come with someone
who speaks Japanese.
(2) Kobe International Community Center provides free interpreting services for foreign citizens with limited
Japanese language skills, who want to make inquiries or seek consultation at ward offices or othergovernment institutions in Kobe. Interpreting assistance is available in English, Chinese, Korean, Spanish,Portuguese, Vietnamese, Pilipino, Nepalese, Thai and Indonesian. (Prior reservation required.)[TEL] 078-291-8441[URL] https://www.kicc.jp/ja/aboutkicc

June 2021, Kobe City National Health InsuranceINSURANCE PREMIUMS FOR FISCAL YEAR 2021+(1) Medical Treatment
Insurance Premiums(2) Insurance Premiums
for the Late StageElderly Support System+(3) Insurance Premiums
for Nursing Care
(only households withinsured persons
between 40 and 64years old)

=National Health
Insurance
Premiums

Insurance Premiums for (1) Medical Treatment, (2) Late Stage Elderly Support System and(3) Nursing Care are each calculated based on three factors, as follows:(1)(1) Medical Treatment
Insurance
Premiums

Income-based premium(charged based on the total income of all enrolled household members)
FY2021 income for calculation purposes ⨯ 8.81%(total income for calculation purposes of all insured persons)(2) Per-insured person premium(charged based on the number of enrolled household members)¥34,260 ⨯ Number of enrolled household members(3) Per-household premium(fixed amount charged to every household)¥23,650(1) + (2) + (3) = Annual insurance premium (¥630,000 if the total exceeds ¥630,000)(1)(2) Insurance
Premiums for theLate Stage Elderly
Support System

Income-based premium(charged based on the total income of all enrolled household members)
FY2021 income for calculation purposes ⨯ 3.30%(total income for calculation purposes of all insured persons)(2) Per-insured person premium(charged based on the number of enrolled household members)¥12,450 ⨯ Number of enrolled household members(3) Per-household premium(fixed amount charged to every household)¥8,590(1) + (2) + (3) = Annual insurance premium (¥190,000 if the total exceeds ¥190,000)

Note: applicable only for households with insured persons between 40 and 64 years old(1)(3) Insurance
Premiumsfor Nursing
Care

Income-based premium
FY2021 income for calculation purposes ⨯ 3.02% (total income forcalculation purposes of all insured persons aged 40 to 64 years old)
(2) Per-insured person premium¥13,890 ⨯ Number of enrolled household members aged 40 to 64 years old(3) Per-household premium(fixed amount charged to every household)¥6,760(1) + (2) + (3) = Annual insurance premium (¥170,000 if the total exceeds ¥170,000)

June 2021, Kobe City National Health InsuranceIf you enroll or withdraw from the National Health Insurance System in the middle of a fiscal year, yourinsurance premiums will be prorated on a monthly basis.

Your actual insurance premiums may be lower than the amount resulting from the aforementioned formula,once various reductions are taken into account.

In order to ensure that your insurance premiums are calculated correctly, please make sure to file your tax
returns in a timely fashion.

When do I need to start paying insurance premiums?
Insurance premiums are charged from the month in which you become eligible for enrollment in theNational Health Insurance System (not from the month when you actually applied for enrollment). If you failto enroll in the National Health Insurance System in due time, you will be charged the insurance premiums
retroactively (for up to two years).

Insurance premiums for one year must be paid in monthly installments from June to March of the nextyear (ten installments in total)
If you enroll in the middle of a fiscal year, you must pay your insurance premiums for the period startingfrom the month in which you became eligible. You will have to pay them in monthly installments startingfrom the month you enrolled or the following month, through March of the next year.

Insurance premium payments are due on the last day of each month (the following business day, if the last
day of the month is a bank holiday
If you set up an automatic bank transfer, the insurance premium payments will be charged to your accounton the 27th of each month (the following business day, if the 27th falls on a bank holiday).

SETTING UP AN AUTOMATIC BANK TRANSFER IS A SAFEAND EASY WAY TO PAY YOUR INSURANCE PREMIUMSYou can set up automatic bank transfers at various financial institutions, such as banks, shinkin banks,
credit unions and agricultural cooperatives, as well as the Japan Post Bank and post offices.
If you experience a significant decline in income due to resignation, retirement, bankruptcy or other reasons,you may be eligible for a reduction or an exemption from paying your insurance premiums. Should suchsituation arise, please contact us for consultation.

June 2021, Kobe City National Health Insurance