保険・年金

国民健康保険

Guide to The National Health Insurance System

Guide to The National Health Insurance System (English version)

更新:2010年10月28日

Guide to The National Health Insurance System

Medical Treatment　（受診）

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.

診察や治療は医療機関で受けることができます。外来患者の診察時間は病院によって異なりますが、通常、平日の午前中が多く、日曜・祝日は休診です。できるだけ日本語の分かる人に同行してもらう方が良いでしょう。病院では、保険証を受付に出し、診察・治療が終わったら、会計で診察料を支払います。

Medical Insurance System （医療保険制度）

Everyone who lives in Japan is required to enter into one of the following public medical insurance programs: Employee Health Insurance or National Health Insurance. With regard to Employee Health Insurance, please ask your employer for details. Those who are staying in Japan for more than a year, for purposes of work or study, and are not covered by a Health Insurance Program at a place of employment are required to enroll in National Health Insurance.

日本に住む人は、誰でもなんらかの公的医療保険に加入しなければなりません。医療保険には、会社等に勤める人が加入する健康保険とそれ以外の人が加入する国民健康保険があります。健康保険について、くわしくはご自分の勤め先にご確認ください。就労や就学のために来日し、在留期間が１年以上で、会社や事業所の健康保険に加入していない人は、国民健康保険に加入しなければなりません。

Applying for National Health Insurance (Kokumin Kenko Hoken）（国民健康保険の申込）

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.

国民健康保険への加入手続きは、国民健康保険の受付窓口　浜田市役所医療保険課（窓口６番）で行ってください。申込みの際には、外国人登録証明書と印かんが必要です。

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.

次のときは、１４日以内に浜田市役所医療保険課（窓口６番）で手続きをしてください。その際には、保険証、外国人登録証明書と印かんをお持ちください。

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 （国民健康保険証）

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.

手続きすると保険証が交付されます。保険証は加入者１人に１枚交付されます。この保険証は保険に加入していることを証明するものですから、大切に保管してください。医療機関で診察を受けるときに提示してください。

Insurance Benefits...（国民健康保険による給付）

・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

●　病気やケガをしたとき、本人は治療費の３０％を支払い、残りの７０％は国民健康保険が負担

※　就学前のこども・・・・・・・・２割自己負担

就学後から６９歳未満の人・・・３割自己負担

７０歳から７４歳未満の人・・・１割自己負担（但し、現役並み所得の人は３割自己負担）
●　出産育児一時金
●　葬祭費

●　入院したときの食事代

260 円
住民税非課税世帯低所得者Ⅱ	過去１２ヶ月で９０までの入院	210 円
住民税非課税世帯低所得者Ⅱ	過去１２ヶ月で９０以上の入院	160 円
低所得者Ⅰ		100 円

●　高額療養費（一部負担金が戻ってきます）

※　国民健康保険料を滞納していると高額療養費を受けることができません。

1 ７０歳未満の人の場合

一般	80,100円＋（医療費－267,000円）×１％
上位所得者	150,000円＋（医療費－500,000円）×１％
住民税非課税世帯	35,400 円

2 ７０歳以上７５歳未満の人の場合（長寿医療制度に加入している人を除く）

	自己負担割合	外来（個人単位）	外来＋入院(世帯単位)
一般	1割	12,000 円	44,400円
現役並み所得者	３割	44,400円	80,100 円＋（医療費－267,000円）×１％
低所得者 Ⅱ	1割	8,000円	24,600 円
低所得者 Ⅰ	1割	8,000円	15,000 円

Computation of National Health Insurance premiums （国民健康保険料の算出方法）

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.

保険料は、４月から翌年３月までの１年を単位とし、加入者数と住民税を元に計算されます。

加入者が複数の場合は、それぞれ同様に計算した合計金額が世帯主に賦課されます。

世帯主が国民健康保険料の納付義務者となります。国民健康保険料の賦課決定通知書は世帯主に送られます。世帯主が保険制度に加入して国民健康保険に加入していない場合でも、世帯主は国民健康保険に加入している家族を代表して国民健康保険料の納付義務者となります。

Payment procedure for National Health Insurance premiums（国民健康保険料の納期限と納付方法）

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

保険料の納期限は、12月を除いて月末です。土日・祝日にあたる場合、翌週の最初の平日となります。

1 国民健康保険料賦課決定通知書に同封の納付書での納付　（金融機関等）

納付場所（株）山陰合同銀行　日本海信用金庫　（株）島根銀行　島根益田信用組合　中国労働金庫　いわみ中央農業協同組合　漁業協同組合JFしまね　㈱ゆうちょ銀行

2 口座振替

お取引先の金融機関〔（株）山陰合同銀行　日本海信用金庫　（株）島根銀行　島根益田信用組合　中国労働金庫　いわみ中央農業協同組合　漁業協同組合JFしまね㈱ゆうちょ銀行〕

へ預貯金通帳・通帳登録印を持参のうえお申し込みください。

Non-payment of National Health Insurance fees （国民健康保険料を滞納すると）

If National 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

納期限までに国民健康保険料が完納されないときには、延滞金が１４．６％の割合で加算されます。また、理由もなく滞納が続くと国民健康保険料負担の公平性に反するため、やむを得ず被保険者証の使用制限や所有財産の差し押さえなどの処分を行うことがあります。納付が困難な場合はそのまま放置せず、必ず納付相談をしてください。

Penalties for failure to pay National Health Insurance premium by Deadline.（国民健康保険料を納期限までに納付しないで放置されますと次の措置が講じられます。）

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.

一般証の代わりに有効期限が短い「短期被保険者証」が交付される場合があります。

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 .

１年以上国民健康保険料を滞納すると国民健康保険証の返還を求められ、「被保険者資格証明書」を交付されます。

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.

国民健康保険の資格者証を交付された人は、医療費を全額自己負担していただきます。後に７割から９割の保険給付分の支払いを市役所窓口に申請していただくことになります。

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.

1年６ヶ月国民健康保険料を滞納すると国民健康保険の給付が全部または一部指し止めになります。

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.

それでも滞納していると、差し止められた保険給付から滞納分にあてられます。

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

【この情報の提供元】

浜田市医療保険課　（庁舎配置図｜医療保険課の提供情報）
電話: 0855-25-9410(直通)　　FAX: 0855-23-3428　　Mail: hoken@city.hamada.shimane.jp

Guide to The National Health Insurance System (English version)

Guide to The National Health Insurance System

Medical Treatment （受診）

Medical Insurance System （医療保険制度）

Applying for National Health Insurance (Kokumin Kenko Hoken）（国民健康保険の申込）

National Health Insurance Card （国民健康保険証）

Insurance Benefits...（国民健康保険による給付）

1 National Health Insurance members less than 70 years old

2 National Health Insurance members who are 70 or older

(excluding members eligible for the Long Life Medical Care System)

Computation of National Health Insurance premiums （国民健康保険料の算出方法）

Payment procedure for National Health Insurance premiums（国民健康保険料の納期限と納付方法）

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

2 Using an Automatic Bank Transfer

Non-payment of National Health Insurance fees （国民健康保険料を滞納すると）

Penalties for failure to pay National Health Insurance premium by Deadline.（国民健康保険料を納期限までに納付しないで放置されますと次の措置が講じられます。）

Medical Treatment　（受診）