英語

Overview of the National Health Insurance System①

The National Health Insurance System enables everyone to receive medicaltreatment.

・All residents of Japan must be enrolled in a health insurance system. Japan’s
health insurance system is largely divided into health insurance from one’s
company and the National Health Insurance System.
・The National Health Insurance System is a system of mutual assistance for
reducing medical costs by a policy of regular payments in order to receive care in
the case of sickness or injury.

②Please enroll at your local municipal National Health Insurance Division.

(1) Enrollment into the National Health Insurance System (within 14 days)
・After creating a Resident Record (juminhyo), those with a resident visa
status of more than three months and who are not enrolled in another
health insurance system are required to join the National Health
Insurance System.(2012.7.9~)
・Those who have been in Japan for less than three months but have aproof of guarantee of employment for over three months, or those with aschool registration certificate are eligible for enrollment. (2012.7.9~)
・In the case of withdrawal from one’s employer’s health insurance plan, it
is necessary to enroll in the National Health Insurance System.
(2) Withdrawal from the National Health Insurance System (within 14 days)
・In the case of returning to one’s home country, transfer to anothermunicipality, enrollment into one’s employer’s health insurance plan, or if
one becomes a welfare recipient, notification of withdrawal must be madeto the division in charge of National Health Insurance, and one’s National
Health Insurance certificate must be returned.

1

An insurance certificate will be issued after enrollment in the National HealthSystem.

③(1) Issuance of Health Insurance Certificate
・The Health Insurance Certificate is an important document that isrequired when receiving medical treatment and proves that one is an
insured person.
(2) After Receiving Health Insurance Certificate
・Check the period of validity and registered information
・Please don’t lose or dirty the health certificate
・In the case of loss or damage, submit notification to the municipality
・In the case of section 2, article 2, the health certificate must be returned④

After joining the National Health Insurance System, the following benefits
are available.

(1) Medical Care
After presenting the health insurance certificate at the hospital or clinic
reception area, one shall bear only 30% of the treatment cost. Meanwhile,the burden of treatment cost differs for preschoolers and the elderly.
⇒Details at Table A1・Treatment of sickness or injury
・Medicine and injections necessary for treatment
・Hospitalization costs(2) High Cost Medical CareIn the case that medical expenses become expensive, depending onincome, if personal treatment costs exceed a certain amount, part of thetreatment fees shall be returned.
⇒Details at Table A2(3) Lump-Sum Birth Allowance
A lump-sum birth allowance shall be given at after delivery of a child.
⇒Details at Table A3(4) Funeral Expenses
In the case of death, funeral expenses shall be paid.
⇒Details at Table A42

⑤

Payment of health premiums (tax) is required after joining the National
Health Insurance System.

・In order to receive benefits of the National Health Insurance System, insurance
premiums (tax) must be paid. If one does not pay the fees either because offorgetfulness or because payment is bothersome, in addition to the financialresources of the Health Insurance System becoming endangered, one will not beable to use the insurance.
・Insurance premiums (tax) are a vital resource for the protection of everyone’s
health, so please pay the fees before the designated date.
◎Notwithstanding special circumstances, if insurance premiums (tax) are not paid
for more than one year, the insurance certificate must be returned. In this case, adifferent certificate will be issued and 100% of medical expenses must be paid attime of treatment.
Calculation of Insurance Premiums (Tax)Medical insurance, support for the elderly (over age 75), and nursing
insurance premiums (tax) will be calculated together based on taxable
capacity and benefits as follows.
⇒Details at Table B1① Ability to Pay (Changes based on taxable capacity)
・Income Rate: Amount is calculated according to each household’s income
from the previous year
・Asset Amount Rate: Amount is calculated according to each household’s
assets
② Benefits (Low-income bracket eligible for reducing measures)⇒Details at Table B2・Insured Individual Rate: Amount per person is calculated according to thenumber of those insured without regard to age or income・Household Rate: Amount per household is calculated equally
Note: Calculation methods of insurance premiums (tax) may vary by municipality. For
more information, please refer to the department in charge of the National Health
Insurance System.

3⑥National Health Insurance also covers traffic accidents.

・In the case of injury by a traffic accident or by a third party, treatment is covered by
National Health Insurance.
・If National Health Insurance is used to cover treatment costs, the insurer claimscompensation instead of the injured party.
・In the case National Health Insurance is used after a traffic accident, please submit
a police report.

⑦

Those over age 40 should undergo a specific health check-up once a year.

・To extend healthy life expectancy and reduce increasing healthcare costs, specifichealth check-ups were implemented in 2008 to prevent lifestyle-related diseases
such as cancer, heart disease, and stroke.
・Payment burden for these specific health check-ups fall into the B3 category.
・If the results of the check-up require lifestyle improvement changes, patients will
be eligible for specific health guidance.

⑧Medical Treatment System for Senior Citizens

・Beginning back in 2008, those over the age of 75 are to be enrolled in the MedicalTreatment System for Senior Citizens (koki-koureisha iryo seido).

⑨This pamphlet gives a brief overview of the National Health Insurance
System. For more information, please visit the department in charge of
National Health Insurance at your local government office.

【Contact Information】
Municipality

MAKINOHARA-SHI

Division in Charge of
National Health
Insurance System

MAKINOHARA-SHIYAKUSHOＫＯＫＵＨＯＮＥＮＫＩ-KA

Telephone Number0548-23-0023

ＦＡＸ Number

0548-23-0079

4英語
Benefits and Premiums Reference Chart (as of July 1, 2024)
A Benefits
A1 Individual Payment RateBracketRate

Under age 620%

Ages 6-6930%30%

Active Income Earners※

20%

Those who do not fall under one of thecategories above

Ages 70-74※

Those who fall in the ② section of Table A2 have a rate of 30% (see ※1)

A2

High-Cost Medical Care Copayment Ratio (Per Month)① Ages 69 and Below
Total for Household Enrolled in theBracket
National Health Insurance System
Those with a gross income exceeding
9,010,000 JPY after basic deductions

High-IncomeGeneralLow-Income

Those with a gross income between
6,000,001 JPY and 9,010,000 JPY
after basic deductions
Those with a gross income between
2,100,001 JPY and 6,000,000 JPY
after basic deductions

252,600 JPY ＋(Medical Expenses－842,000JPY) ×
1％
167,400 JPY ＋(Medical Expenses－558,000JPY) ×
1％
80,100 JPY ＋(Medical Expenses－267,000JPY) ×
1％

Those with a gross income of
2,100,000 JPY or below after basic
deductions

57,600 JPY

Those exempt fromresidence tax

35,400 JPY② Ages 70-74
IndividualBracket(OutpatientOnly)Household(Including Hospitalization)

Active IncomeEarners

taxable income exceeding

252,600 JPY

6,900,000 JPY＋(Medical Expenses－842,000JPY)×1％

taxable income exceeding

167,400 JPY

3,800,000 JPY＋(Medical Expenses－558,000JPY)×1％

taxable income exceeding

80,100 JPY

1,450,000 JPY＋（Medical Expenses－267,000JPY）×１％

5

Generaltaxable income below
1,450,000 JPY

Low-Income

Ⅱhouseholds exempt frommunicipal residence tax

18,000 JP
Y57,600 JPY

8,000 JPY

24,600 JPY

8,000 JPY

15,000 JPY

Ⅰhouseholds exempt frommunicipal residence tax※１※１ Households exempt from municipal residence tax and whose income does
not satisfy prescribed standards

BA3

Lump-Sum Birth Allowance
488,000 JPY(500,000 JPY for birth at a medical facility enrolled in the Japan ObstetricCompensation System for Cerebral Palsy)

A4

Funeral Allowance
50,000 JPY

A5

If You are Involved in a Traffic Accident, etc.
If you are injured in a traffic accident or other type of accident caused by a third
party (perpetrator) and receive treatment under your health insurance (NationalHealth Insurance, Later-Stage Senior Citizen's Health Care, Nursing Care
Insurance, etc.), please notify the respective insurer.

Premiums
B1

Health Insurance Premiums (Tax) Amounts
The levy limit for Later-Stage Support for Elderly has been raised by 20,000 yen asof April 2024.
① Ability to Pay Rate
Income Rate

Asset Rate

② Benefit Rate
Insured IndividualRate

HouseholdRate

Health Insurance

6.70 ％―

21,600 JPY

21,600 JPY

Support for Elderly(Age 75+)

2.50 ％―

7,200 JPY

7,200J PY

Nursing Insurance

2.20 ％―

16,000 JPY―6※The levy limit is the maximum amount of insurance premiums (tax) that can be paid bya person above a certain income level, even if his or her income increases above thatlevel. The maximum amount of insurance premiums (tax) is the maximum amount of
insurance premiums (tax) that a person above a certain income can pay even if his or her
income rises to a higher level.
Currently, the upper limit in the prefecture is 1,060,000 yen (650,000 yen for medicalcare, 240,000 yen for support for the elderly in the later stages of life and 170,000 yen for
long-term care).
B2 Reduction Rate Reduction System for Low-Income HouseholdsReduction
Reduction Standards
Rate
70% Reduction

Gross Income (Head of Household + Insured) ≤ 430,000 JPY※

Gross Income (Head of Household + Insured) ≤ 430,000 JPY※ + 295,000
JPY x Number of Insured
Gross Income (Head of Household + Insured) ≤ 430,000 JPY※ + 545,000
20% Reduction
JPY x Number of Insured※ In the case where the number of employed income earners and pension recipients ismore than one, 430,000 JPY + 100,000 JPY x (Number of Employed Income Earners andPension Recipients - 1)
50% Reduction

 Reduction System for Child Before School Age
In the case of a child under age 6 and before start of compulsory education, a 50%
reduction will be granted according to the individual rate for preschoolers.
 Reduction system for the involuntarily unemployed
For those aged 64 or younger who have left their employment due to reasons at theemployer (dismissal, bankruptcy, etc.), their salary income is reduced by 70% from themonth following the date of separation to the end of the following fiscal year.
 Reduction system for the period before and after childbirth
Exemption from income and per capita income for the period before and after childbirth(4 months for single births and 6 months for multiple births) of the expected month ofchildbirth (or the month of childbirth) for those insured during the period before andafter childbirth.
B3

Specific Health Check Copayment
1,000 JPY7