The National Health Insurance Scheme （国民健康保険）
The National Health Insurance Scheme_2024 (PDFファイル: 358.0KB)
Public health insurance is a system to reduce the burden of medical fees payable when an individual gets ill or is injured and receives medical treatment. Everyone living in Japan must be enrolled in some form of public health insurance.
There are two main types of public health insurance in Japan. Health Insurance is for those working at a company or a business, and the National Health Insurance scheme is for other people.
If you are not enrolled in health insurance at your workplace, you need to enroll in the National Health Insurance scheme.
If you were enrolled in the National Health Insurance scheme, and you then enroll in health insurance at your workplace, you will need to complete certain formalities to withdraw from the National Health Insurance scheme.
After Enrolling（加入）
After enrolling in the National Health Insurance scheme, each individual is issued with a National Health Insurance Certificate（国民健康保険証）(a card).
This is an important item: it proves that you are enrolled in the National Health Insurance scheme. When you have to go to a medical facility, be sure to take your National Health Insurance Certificate with you.
※ Please check with your workplace about the formalities for workplace health insurance.
Health Insurance Benefits（保険給付）
1. Reduction in medical expenses（医療費の軽減）
If you become ill or get injured, and you receive medical treatment, by showing your National Health Insurance Certificate, you will only have to pay a proportion of the medical expenses yourself, as shown below.
・Under 6 years of age (before starting elementary school): 20%
・Between 6 and 70 years of age: 30%
・Between 70 and 74 years of age: 20% (if you are an active income earner, 30%)
2. High-cost medical expenses（高額療養費）
If the amount of medical expenses (the costs you are liable to pay yourself, as shown above) you pay at a medical facility in a month is over the personal contribution limit, you can apply to have the excess paid back to you as a ‘high-cost medical expenses’.
If you know in advance that your medical expenses will be high, please apply at the National Health Insurance and Pension Division in the City Office for an Eligibility Certificate for High-Cost Medical Expense Benefits（限度額適用認定証）. If you show this certificate to the medical facility, the costs you are liable to pay yourself will not exceed the personal contribution limit.
3. One-off payments for childbirth and child-raising（出産育児一時金）
When an individual enrolled in the National Health Insurance scheme gives birth, a one-off payment for childbirth and child-raising is paid. Please enquire at the medical facility you are planning to use when giving birth as to whether you need to apply in advance for the one-off payment.
If you do not need to apply in advance, and the costs of giving birth are less than the amount of the one-off payment, you can apply after giving birth to receive the remainder of the one-off payment amount.
If you give birth overseas, please apply after you return to Japan.
4. Funeral expenses（葬祭費）
If an individual enrolled in the National Health Insurance scheme dies, a sum of 30,000 yen is paid to the person who conducts the funeral rites. Please apply at the National Health Insurance and Pension Division in the City Office.
Calculation of the amounts payable（保険税の決め方）
The amount payable is a total of a basic amount, a per-capita amount for support for the latter-stage elderly, and an amount for long-term care payment. Each of these amounts is the total of an income-based portion, based on the previous year's income of the enrolled members, a per-capita portion, and an average-based portion.
|
Category |
Subject to tax |
Basic |
Per-capita amount |
Amount for long- |
|---|---|---|---|---|
|
Income-based rate |
（Income amount） |
6.62% |
2.44% |
2.07% |
|
per-capita |
Per insured person |
27,950 yen |
10,288 yen |
10,605 yen |
|
average-based |
Per household |
18,294 yen |
6,563 yen |
5,182 yen |
|
Taxable limit |
ー |
650,000 yen |
220,000 yen |
170,000 yen |
Paying National Health Insurance Premiums（国民健康保険税の納付）
National Health Insurance premiums are calculated on a household basis, based on the enrolled members’ income in Japan for the previous year, the number of people in the household, etc. Therefore, if your income, or the number of people in the household, increases, your National Health Insurance premiums will also increase. The head of the household is responsible for the payment of the premiums for the household.
〈How to pay the premiums〉
◆By bank account transfer (apply at the National Health Insurance and Pension Division in the City Office, or at a financial institution that can deal with the payments)
◆In cash, using the payment slips sent to you by the National Health Insurance and Pension Division (you can pay at a financial institution, a Post Office, or a convenience store)
◆By PayB or PayPay (you will need to download the app)
>>> For details, see (Paying with a smartphone).
Declaration of Income（所得申告）
If your income is less than a certain amount, there is a system by which the amount you pay is lessened, but you cannot take advantage of this if you have not made a declaration of income. No matter whether you have income or not, please make a declaration.
Reductions of premiums（保険税の軽減）
Reductions for households whose overall income for the previous year (January to December) is less than a certain amount.（前年の総所得金額等が一定額以下の世帯）
The premiums payable (the per-capita portion, and the average-based portion) may be reduced by 70%, 50% or 20%, depending on the amount of income. If the head of the household, and the members of the household enrolled in the National Health Insurance scheme, have not made a declaration of income, there will be no reductions applied. Even those with no income, and those who are supported members of the household, need to make declarations of income.
Reductions for those who have not yet started school（未就学児に係る均等割額は減額されます）
For children who have not yet started school, the per-capita amount will be halved.
Also, if the household is receiving a 70%, 50% or 20% reduction based on income, the per-capita amount after any applicable reductions will be halved. It is not necessary to apply.
Reductions for those who lost their job（非自発的失業者に対する保険税の軽減制度）
Those who are under 65 who have lost their job through no fault of their own (because their term of employment came to an end, their employer went bankrupt, etc.) can apply for a reduction in their National Health Insurance
premiums.
Reductions for those who are in special circumstances such as damage from a natural disaster, job loss, etc.（天災、失業など特別な事情があるとき）
It is possible to apply for a reduction of or exemption from National Health Insurance premiums. When applying because of special circumstances such as damage from a natural disaster, job loss, etc., the period for applications is
from the day before the deadline for each payment until seven days before the deadline.
Exemptions from National Health Insurance Payments During Periods Before and After Childbirth（産前産後期間の免除）
A system of exemptions from National Health Insurance payments during periods before and after childbirth began in January 2024. You need to apply.
Cases in Which the Relevant Paperwork Should Be Submitted Within 14 Days（こんなときは14日以内に届出を！）
Even if you are late submitting notifications of enrollment or changes to details, you will still have to pay backdated premiums.
◆If you move into or out of Higashihiroshima City (including if you leave Japan)
◆If you have enrolled in or withdrawn from the health insurance in your workplace
◆If an enrolled person has given birth to a child
◆If an enrolled person has died
◆If there are changes to the information recorded on your Health Insurance Certificate
Enrolling in and withdrawing from the scheme part-way through the year（年度途中で国保に加入・脱退したとき）
If you enroll in the National Health Insurance scheme part-way through the financial year, your premiums will be calculated starting from the payment for the period during which the month when you gained coverage falls.
If you withdraw from the National Health Insurance scheme, you will no longer need to pay premiums, starting from the payment for the period during which the month when you withdrew falls.
The payment for each of the eight periods is not equivalent to the payment amount for one month, so even after you have withdrawn from the scheme, there may still be an amount remaining that you need to pay.
Withdrawing from the scheme because you have joined another health insurance scheme（他の健康保険への加入等による国保の脱退手続き）
If you enroll in health insurance at your workplace, etc., if you become covered by such insurance, or if you move to outside the city, you will need to complete the formalities to withdraw from the National Health Insurance scheme. If you fail to complete these formalities, you will continue to be subject to the premiums, and you may receive letters of non-payment.
When Moving Out of Higashihiroshima City, or Leaving Japan（転出・出国するときは）
If you move out of Higashihiroshima or leave Japan, please complete the formalities for withdrawing from the National Health Insurance scheme as early as possible. These formalities can be completed at the National Health Insurance and Pension Division in the City Office. If you have already paid the premiums for the month(s) after you move out of Higashihiroshima City or leave Japan, and you are late completing the formalities, it may not be possible for you to receive a refund of the National Health Insurance premiums you have already paid.
What to Do if You Are Involved in a Traffic Accident（交通事故に遭ったとき）
If you are enrolled in the National Health Insurance scheme, and you are injured in a traffic accident, etc., be sure to notify the National Health Insurance and Pension Division in the City Office.
As a rule, the person who caused the accident pays the medical fees for your treatment, but if it looks unlikely that the person who caused the accident will (be able to) pay swiftly, the National Health Insurance scheme will pay the part of your medical fees covered by insurance, and then this amount will be claimed back at a later date from the person who caused the accident.
Inquiries
National Health Insurance and Pension Division(Kokuho-nenkin-ka, 国保年金課) : 082-420-0933
Location: 1F Main building
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更新日：2024年04月09日