Guide to The National Health Insurance System

更新:2010年11月15日

Medical Treatment

Medical examinations and treatments are offered at hospitals and clinics. Each hospital sets its own outpatient hours, usually during weekday mornings. Hospitals and clinics are generally closed on Sundays and national holidays. If you do not speak Japanese, it is advisable that you are accompanied by someone who speaks Japanese .
When you enter a hospital, present your health insurance card at the reception desk. After you have been examined and have received treatment, you must pay your bill at the finance desk.

Medical Insurance System

You can apply for National Health Insurance at the Division of Health Insurance and Pension (Iryou hoken-ka; counter No.6) of the Hamada city office.
When you apply, you must present your Alien Registration Card and personal name stamp.

If any of the following changes occur, you must complete the required procedures at the Division of Health Insurance and Pension(Iryou hoken-ka;) of the Hamada city office (counter No.６) within 14 days. When you go there, you must present your Health Insurance Card, Alien Registration Card,and personal name stamp.

Starting or renewing your National Health Insurance membership	Items needed to apply for National Health Insurance membership
When you move from one city , ward, town or village to another	Personal name stamp and change of address certificate
When you register as a resident alien (does not apply to short-term residents)	Alien Registration Card
When your membership in another health insurance system ends When you are no longer a dependent of a household belonging to another health insurance system	Personal name stamp and certificate proving you have ended a membership in another health insurance system
When you give birth	National Health Insurance Card and Maternal and Child Health Handbook

Ending your National Health Insurance membership	Necessary Items
When you move from one city , ward , town or village to another	National Health Insurance Card
When you are a non-citizen and move from one city , town or village to another	National Health Insurance Card and Alien Registration Card
When you start a membership in another health insurance system When you become a dependent of a household belonging to another health insurance system	National Health Insurance Card and other health insurance system’s card
Upon death	National Health Insurance Card and death certificate
When you start receiving public assistance	National Health Insurance Card and letter indicating you will start receiving public assistance

Other	Items needed to make required changes
When your address , head of household or name changes	National Health Insurance Card
When your children move to another city , ward , town or village to another	National Health Insurance Card
When you move from one city , ward , town or village to another in order to move to another facility	National Health Insurance Card , facility membership certificate , etc.
When your National Health Insurance card becomes lost or unreadable ※ If your cards are stolen or lost while out , notify the police.	Personal indentification and the unreadable National Health Insurance Card (if applicable)

National Health Insurance Card

You will receive a health insurance card once you have completed the application process. One insurance card is issued per person. This card identifies the insured person, so you should keep it in a safe place. It should be presented at the hospital or clinic where treatment is received.

◆ Insurance Benefits...

　・In the event of illness or injury, the insured pays 30% of medical costs and the remaining 70% is covered by the insurer in most cases.

※　Infants up to preschool age ・・・・20%

School-aged children through adults up to 69 years old ・・・・30%

Adults between the ages of 70 and 74・・・・10% (except for wage-earners at their preretirement income level , who will pay 30%)

・Maternity benefits for children and nursing
・Funeral allowance in the event of death

・Hospital meal costs　

General National Health Insurance members (Members other than those below)		260 yen per meal
National Health Insurance members from households exempt from resident tax (TypeⅡlow-income National Health Insurance members who are 70 or older)	Total number of days hospitalized during past 12 months : 90 or less	210 yen per meal
	Total number of days hospitalized during past 12 months :More than 90	160 yen per meal
TypeⅠlow-income National Health Insurance members who are 70 or older		100 yen per meal

・Major Medical Costs（When medical treatment costs are high,a portion of your expenses may be refunded.）

※　If you fall behind in your National Health Insurance premium payments , you will not be able to receive a refund.

①　National Health Insurance members less than 70 years old

National Health Insurance member deductibles (monthly)

General members	80,100 yen＋（Total medical costs －267,000yen）×１％
High-income members	150,000 yen＋（Total medical costs －500,000yen）×１％
Members exempt from resident tax	35,400 yen

②　National Health Insurance members who are 70 or older (excluding members eligible for the Long Life Medical Care System)

	Copayment ratio	Outpatients (per individual)	Outpatients+inpatients (per household)
General members	10%	12,000 yen	44,400 yen
Wage earners at their preretirement income level	30%	44,400yen	80,100 yen＋（Total medical costs －267,000yen）×１％
Members exempt　 from resident tax 　Type Ⅱ	10%	8,000yen	24,600 yen
Members exempt　 from resident tax 　Type Ⅰ	10%	8,000yen	15,000 yen

Computation of National Health Insurance premiums

Insurance premiums are calculated on an annual basis from April to March of the following year. The premiums are based on the number of enrolled members in the household and the amount of city and prefectural taxes paid in the previous year.

In case there are multiple members in the household , the premium payment which is the total sum of each member computed individually will be imposed on the head of the household.

The head of the household is responsible for paying National Health Insurance premiums.

Notifications regarding National Health Insurance premiums are sent to the head of the household. Even if the head of the household is a member of their employer’s health insurance system and not a National Health Insurance member , helshe is still responsible for paying the National Health Insurance premiums if any other member of the household is a National Health Insurance member.

Payment procedure for National Health Insurance premiums

Deadline for payment is the last day of the month (exception: December). In the case that the designated due date is a Saturday or Sunday, the deadline for payment is the next working day.

Month	6	7	8	9	10	11	12	1	2	3
National Health Insurance premiums	1st period	2nd period	3rd period	4th period	5th period	6th period	7th period （28th）	8th period	9th period	10th period

① Using the National Health Insurance premium payment slip included with the premium payment notice (Financial Institution, Bank, etc.)

Financial institutions,where you can pay National Health Insurance premiums:

Sanin godo Ginko , Nihonkai Shinyokinko , Shimane Ginko , Shimane Masuda Shinyokumiai , Chugokuroudoukinko , Iwami Nogyokyodokumiai

Gyokyokyodokumiai JF Shimane , Post office

② Using an Automatic Bank Transfer

To apply for a bank transfer please bring your bank account book and name seal to your bank (Saningodo Ginko ,　Nihonkai Shinyokinko ,　Shimane Ginko ,　 Shimane Masuda Shinyokumiai ,　Chugokuroudoukinko ,　Iwami Nogyokyodokumiai ,　Gyokyokyodokumiai JF Shimane ,Post office)

Non-payment of National Health Insurance fees

IfNational Health Insurance premiums are not paid by the due date,an overdue charge of 14.6% will be added. No apparent reason and non‐payment continues because of against the fairness of premiums burden , usage restrictions of National Health Insurance card or seizure of the proprietary property and others will be implemented by necessity. If it is difficult to make a payment, do not leave the problem and come to the premiumspayer assistance.

◆ Penalties for failure to pay National Health Insurance premium by Deadline.

Non‐peyment of National Health Insurance premiums may result in the issuance of a special short-term National Health Insurance Card, which has a shorter validity period than a normal card.

　If the payment is more than one year late , that person will be asked to return their National Health Insurance card , and will be issued a National Health Insurance Eligibility Certificate in its place .

　Members who are issued a National Health Insurance Eligibility Ceretificate must initially pay the full amount of medical costs , Afterward,you may apply for the 70-90% refund of medical costs at the Hamada City Office.

If a National Health Insurance member is more than 18 months late in their payments, some or all of their National Health Insurance benefits may be stopped.

　If payments are delayed past the above periods of time, the fees that are incurred will continue to be added to their late payments,with no insurance benefits.

【この情報の提供元】

浜田市地域政策課　（庁舎配置図｜地域政策課の提供情報）
電話: 0855-25-9201(直通)　　FAX: 0855-23-0210　　Mail: chiiki@city.hamada.shimane.jp