Osaka

1. Types of Health Insurance in Japan

In Japan, there are two main types of health insurance systems that cover nearly all residents, including foreigners:

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

• Who it’s for:
  • Self-employed individuals, students, part-time workers, and anyone not covered by employer-sponsored insurance.
  • Foreign residents staying in Japan for more than 3 months are required to enroll.
• Coverage:
  • Covers 70% of medical costs (you pay 30% out-of-pocket at clinics and hospitals).
  • Includes doctor visits, hospital stays, surgeries, prescription medications, and some dental care.
  • Preventive care and maternity services are also partially covered.

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

• Who it’s for:
  • Full-time employees working for companies or organizations.
  • Employers are required to enroll their employees in this system.
• Coverage:
  • Similar to NHI, covering 70% of medical costs.
  • Additional benefits include paid sick leave, maternity leave, and family coverage (spouse and dependents can be included).
  • Premiums are shared between the employer and employee.

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2. Costs of Health Insurance

The cost of health insurance in Japan depends on your income and the type of insurance you are enrolled in.

A. National Health Insurance (NHI)

• Premiums:
  • Calculated based on your income from the previous year and the number of dependents in your household.
  • For low-income earners or students, premiums can be as low as ¥2,000–¥5,000 per month.
  • Higher earners may pay ¥20,000–¥50,000 per month.
• Discounts:
  • Discounts are available for low-income households or those with financial difficulties. You can apply for these at your local ward or city office.

B. Employee Health Insurance (EHI)

• Premiums:
  • Typically 7–10% of your monthly salary, with your employer covering half.
  • For example, if your monthly salary is ¥300,000, your contribution might be around ¥15,000, and your employer will pay the same amount.

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3. Eligibility Requirements

• Foreign Residents:
  • Must have a valid residence card and be staying in Japan for more than 3 months.
  • Enrollment in either NHI or EHI is mandatory under Japanese law.
• Short-term Visitors:
  • Not eligible for NHI or EHI. It is recommended to purchase travel insurance before arriving in Japan.

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4. Application Procedures

The process for enrolling in health insurance depends on your employment status and residency.

A. National Health Insurance (NHI)

1. Where to Apply:
   • Visit the local ward office (区役所, kuyakusho) or city office (市役所, shiyakusho) in Osaka.
   • Examples of ward offices in Osaka include Nishi Ward Office (西区役所) or Kita Ward Office (北区役所).
2. Documents Required:
   • Residence card (在留カード, zairyū kādo).
   • Passport.
   • My Number card (マイナンバーカード) or notification.
   • Proof of address (e.g., rental contract or utility bill).
3. Procedure:
   • Fill out the application form provided at the ward office.
   • Receive your health insurance card (保険証, hokenshō) on the same day or within a few days.

B. Employee Health Insurance (EHI)

1. Where to Apply:
   • Your employer will handle the enrollment process.
2. Documents Required:
   • Residence card.
   • My Number card or notification.
   • Bank account details for salary and premium deductions.
3. Procedure:
   • Your employer will deduct premiums directly from your salary and provide you with a health insurance card.

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5. Using Health Insurance in Osaka

Once you are enrolled in a health insurance plan, you can use it at any medical facility in Osaka that accepts public insurance (most do). Here’s how it works:

A. Visiting a Clinic or Hospital

1. Find a Facility:
   • Many clinics and hospitals in Osaka cater to foreigners and have English-speaking staff. Examples include Osaka University Hospital and Osaka Red Cross Hospital.
   • Use online directories like the Japan National Tourism Organization (JNTO) website to find English-speaking doctors.
2. Bring Your Insurance Card:
   • Present your health insurance card at the reception desk.
   • You will only need to pay 30% of the total medical cost.
3. Payment:
   • Payment is typically made in cash, though some larger hospitals accept credit cards.

B. Prescription Medications

• Prescriptions are filled at pharmacies (薬局, yakkyoku) located near clinics or hospitals.
• Show your insurance card to receive the 70% discount on medications.

C. Emergency Care

• In case of emergencies, dial 119 for an ambulance. Ambulance services are free, but you will need to pay for the medical treatment at the hospital.

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6. Cultural Tips and Considerations

• Language Barrier:
  • While many medical professionals in Osaka speak some English, it’s helpful to learn basic Japanese medical terms or bring a translation app.
  • Some hospitals and clinics offer interpretation services, but it’s best to confirm in advance.
• Punctuality:
  • Arrive on time for appointments. Japanese culture values punctuality, and being late may result in rescheduling.
• Politeness:
  • Be polite and respectful to medical staff. Bowing is a common gesture of gratitude.
• Health Checkups:
  • Annual health checkups (健康診断, kenkō shindan) are common in Japan and often covered by insurance. Employers may arrange these for employees, while NHI users can inquire at their ward office.

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7. Additional Considerations

• Private Health Insurance:
  • While public insurance is comprehensive, some people opt for private insurance to cover the 30% co-payment or services not included in public insurance (e.g., advanced dental care or private hospital rooms).
• Moving Within Japan:
  • If you move to a different city or ward in Osaka, you must update your address and insurance details at the local ward office.
• Leaving Japan:
  • If you leave Japan permanently, you must cancel your health insurance at the ward office and settle any outstanding premiums.

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By enrolling in the appropriate health insurance plan and understanding how to use it, you can access Osaka’s excellent healthcare system with ease. If you have further questions or need assistance with specific procedures, feel free to ask!