Global Major Cities Guide

Information about the health insurance system in Japan and how to obtain coverage as an immigrant or visitor.

Sections

1. Types of Health Insurance in Japan

Japan has two main types of health insurance systems:

A. National Health Insurance (NHI - 国民健康保険, Kokumin Kenkō Hoken)

Who is eligible?
- Self-employed individuals, students, part-time workers, retirees, and anyone not covered by employer-sponsored insurance.
- Foreign residents staying in Japan for more than three months and not covered by employer-sponsored insurance.
How it works:
- You pay monthly premiums based on your income and household size.
- The insurance covers 70% of medical costs, leaving you to pay 30% out-of-pocket at the point of service.

B. Employee Health Insurance (EHI - 社会保険, Shakai Hoken)

Who is eligible?
- Full-time employees and some part-time employees working for companies that provide this insurance.
How it works:
- Premiums are deducted from your salary and are shared between you and your employer.
- Like NHI, it covers 70% of medical costs, with 30% paid out-of-pocket.

2. Costs of Health Insurance

The cost of health insurance depends on your income, age, and household size. Below is a general breakdown:

A. National Health Insurance (NHI)

Premiums are calculated annually by the local city office (in this case, Kobe City Hall).
For low-income earners, subsidies or reductions may apply.
Average monthly premiums for a single person can range from ¥10,000 to ¥30,000, depending on income.

B. Employee Health Insurance (EHI)

Premiums are typically 8-10% of your monthly salary, with half paid by your employer.
This also includes contributions to pension and long-term care insurance.

3. Application Procedures

The application process differs depending on the type of insurance:

A. National Health Insurance (NHI)

Where to apply:
- Kobe City Hall or your local ward office (区役所, kuyakusho).
When to apply:
- Within 14 days of moving to Kobe or after losing employer-sponsored insurance.
Required documents:
- Residence Card (在留カード, Zairyū Kādo).
- Passport.
- My Number Card (マイナンバーカード) or Notification Card.
- Proof of address (住民票, Jūminhyō), which you can obtain from the ward office.
- Proof of income (if applicable).
Procedure:
- Visit the NHI counter at the ward office.
- Fill out the application form.
- Submit the required documents.
- You will receive your NHI card on the spot or by mail.

B. Employee Health Insurance (EHI)

Where to apply:
- Your employer handles the application process.
When to apply:
- Upon starting your job.
Required documents:
- Your employer will request necessary documents, such as your Residence Card and My Number.
Procedure:
- Your employer registers you with the insurance provider.
- You will receive your insurance card from your employer.

4. How Health Insurance Works

Coverage:
- Both NHI and EHI cover a wide range of medical services, including doctor visits, hospital stays, surgeries, prescription medications, and some dental and mental health services.
- Preventive care, such as health check-ups and vaccinations, may also be covered.
Out-of-pocket costs:
- You pay 30% of the total medical bill at the hospital or clinic.
- For children under 6 years old and seniors over 70, the out-of-pocket cost is reduced to 20% or 10%, depending on income.
Maximum out-of-pocket cap:
- There is a monthly cap on out-of-pocket expenses, which varies based on income. If your medical expenses exceed this cap, you can apply for reimbursement.
Pharmacies:
- Prescription medications are covered under insurance. You will need to present your insurance card at the pharmacy.

5. Health Insurance for Foreign Immigrants in Kobe

Short-term visitors:
- If you are staying in Japan for less than three months, you are not eligible for NHI or EHI. It is recommended to purchase travel insurance before arriving in Japan.
Long-term residents:
- Foreign residents staying in Kobe for more than three months are required to enroll in either NHI or EHI.
- Language support: Kobe City provides multilingual assistance for foreign residents. You can visit the Kobe International Community Center (KICC) for help with health insurance and other administrative procedures.
Students:
- International students are required to enroll in NHI. Many universities in Kobe, such as Kobe University, provide guidance and support for this process.

6. Local Considerations in Kobe

Kobe City Hall and Ward Offices:
- Kobe City Hall and local ward offices are the primary places to handle health insurance matters. Staff may not always speak English, so bringing a Japanese-speaking friend or using translation apps can be helpful.
Kobe International Community Center (KICC):
- Address: 1-4-1 Kano-cho, Chuo-ku, Kobe.
- Services: Multilingual support for foreign residents, including assistance with health insurance, housing, and other administrative matters.
- Website: KICC Official Website
Hospitals and Clinics in Kobe:
- Kobe has many hospitals and clinics that accept health insurance. Some facilities, such as Kobe City Medical Center General Hospital, have English-speaking staff.
Emergency Medical Services:
- In case of a medical emergency, dial 119 for an ambulance. Ambulance services are free, but you will need to pay for the medical treatment at the hospital.

7. Additional Tips

Always carry your health insurance card (保険証, Hokenshō) with you, as you will need it for any medical visit.
If you lose your insurance card, report it to your ward office or employer immediately to get a replacement.
If you leave Japan permanently, you must cancel your health insurance at the ward office and settle any outstanding premiums.

By understanding and enrolling in the appropriate health insurance system, you can ensure access to affordable and high-quality healthcare while living in Kobe. If you need further assistance, don’t hesitate to reach out to local resources like the Kobe International Community Center or your ward office.