Sendai

Overview of Health Insurance in Japan

Japan’s healthcare system is built around two main types of health insurance:

1. National Health Insurance (NHI) (国民健康保険, Kokumin Kenkō Hoken)
2. Employee Health Insurance (EHI) (社会保険, Shakai Hoken)

Both systems are mandatory, and all residents of Japan, including immigrants staying for more than three months, are required to enroll in one of these programs.

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1. Types of Health Insurance

A. National Health Insurance (NHI)

• Who is eligible?

  • Self-employed individuals, students, part-time workers, retirees, and anyone not covered by Employee Health Insurance.
  • Foreign residents staying in Japan for more than three months and not covered by EHI.

• Key Features:

  • Administered by the local municipal government (in this case, Sendai City).
  • Covers 70% of medical costs (patients pay 30% out-of-pocket at clinics and hospitals).
  • Includes coverage for doctor visits, hospital stays, prescriptions, and some dental and mental health services.

B. Employee Health Insurance (EHI)

• Who is eligible?

  • Full-time employees of companies or organizations.
  • Employers are required to enroll their employees in EHI.

• Key Features:

  • Administered by employers or health insurance associations.
  • Covers 70% of medical costs (patients pay 30% out-of-pocket).
  • Includes additional benefits such as maternity leave compensation, injury compensation, and family coverage.

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2. Costs Involved

A. National Health Insurance (NHI)

• Premiums are calculated based on your income, assets, and household size.
• For low-income earners or students, premiums are significantly reduced.
• Average monthly premiums in Sendai range from ¥2,000 to ¥20,000, depending on your income level.

B. Employee Health Insurance (EHI)

• Premiums are shared between the employer and employee.
• Typically, 8-10% of your monthly salary is deducted for health insurance (half paid by the employer).
• The exact percentage varies depending on the health insurance association.

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3. Procedures for Enrolling

A. Enrolling in National Health Insurance (NHI)

1. Where to Apply:

   • At the Sendai City Hall or your local ward office (区役所, kuyakusho).
   • Sendai has five ward offices: Aoba, Miyagino, Wakabayashi, Taihaku, and Izumi.

2. Required Documentation:

   • Residence Card (在留カード, Zairyū Kādo).
   • Passport.
   • My Number Card (マイナンバーカード) or Notification of My Number.
   • Proof of address (e.g., Certificate of Residence, 住民票, Jūminhyō).
   • Previous health insurance card (if applicable).

3. Steps:

   • Visit the National Health Insurance counter at your ward office.
   • Fill out the application form (staff can assist if you don’t speak Japanese).
   • Receive your health insurance card (usually issued on the same day).

4. Important Notes:

   • Enrollment must be completed within 14 days of moving to Sendai or changing your residence status.
   • If you fail to enroll on time, you may be required to pay backdated premiums.

B. Enrolling in Employee Health Insurance (EHI)

1. Where to Apply:

   • Your employer will handle the enrollment process.

2. Required Documentation:

   • Residence Card.
   • My Number Card or Notification of My Number.
   • Bank account details (for salary deductions).

3. Steps:

   • Provide the required documents to your employer.
   • Your employer will register you with the appropriate health insurance association.
   • You will receive your health insurance card within a few weeks.

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4. Using Your Health Insurance

• At Clinics and Hospitals:

  • Present your health insurance card at the reception desk.
  • Pay 30% of the total medical cost at the time of treatment.
  • Many clinics and hospitals in Sendai have English-speaking staff, especially in areas with a higher concentration of foreign residents (e.g., near Sendai Station or universities like Tohoku University).

• Pharmacies:

  • Prescriptions are partially covered by insurance. Show your health insurance card when purchasing medication.

• Annual Premium Adjustments:

  • For NHI, premiums are recalculated annually based on your previous year’s income. Be sure to report any changes in income or household size to the ward office.

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5. Specific Considerations for Immigrants in Sendai

A. Language Support

• While most ward offices in Sendai have limited English-speaking staff, they often provide translation services or multilingual guides for health insurance enrollment.
• The Sendai Multicultural Center (仙台多文化共生センター) offers support for foreign residents, including assistance with health insurance and other administrative procedures.

B. Student-Specific Information

• If you are a student at Tohoku University or another institution in Sendai, you may qualify for reduced NHI premiums. Check with your university’s international office for guidance.

C. 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 private travel insurance before arriving in Japan.

D. High Medical Costs

• If your medical expenses exceed a certain threshold in a single month, you may qualify for a High-Cost Medical Expense Benefit (高額療養費制度, Kōgaku Ryōyōhi Seido). Apply for reimbursement at your ward office or through your employer.

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6. Key Locations in Sendai for Health Insurance Matters

1. Sendai City Hall (仙台市役所)

   • Address: 3-7-1 Kokubuncho, Aoba Ward, Sendai, Miyagi 980-8671
   • Phone: 022-261-1111
   • Hours: Monday to Friday, 8:30 AM – 5:00 PM

2. Ward Offices (区役所, Kuyakusho)

   • Aoba Ward Office: 1-8-1 Ichibancho, Aoba Ward, Sendai
   • Miyagino Ward Office: 5-6-1 Tsutsujigaoka, Miyagino Ward, Sendai
   • Wakabayashi Ward Office: 3-1-1 Iwakiri, Wakabayashi Ward, Sendai
   • Taihaku Ward Office: 3-1-15 Nagamachi, Taihaku Ward, Sendai
   • Izumi Ward Office: 2-1-1 Izumichuo, Izumi Ward, Sendai

3. Sendai Multicultural Center

   • Address: 3-11-15 Tsutsujigaoka, Miyagino Ward, Sendai
   • Phone: 022-224-1919
   • Services: Multilingual support for foreign residents.

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7. Additional Tips

• Always carry your health insurance card with you, as it is required for medical treatment.
• If you leave Japan permanently, notify your ward office or employer to cancel your health insurance and settle any outstanding premiums.
• For private health insurance options, consult with international insurance providers or brokers in Sendai.

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By following this guide, you should be well-prepared to navigate the health insurance system in Sendai, ensuring you have access to affordable and reliable healthcare during your stay.