Unlike many countries, Japan has limited choices for health insurance. Jeffrey Strain explains how to get the coverage you
need.
Health insurance in Japan isn't quite as
straightforward as you might first believe. If you look at most of the "help"
resources in Japan, they'll state that you must belong to either the Employee's Health
Insurance (koyou kenko hoken) or the National Health Insurance (shakai kenko
hoken) program. What these resources won't tell you is that it may be possible for
you to opt out of these two insurance programs and get health insurance through a foreign
private company.
The key word is "may." Japanese law requires that all people residing in Japan
for a year or more have health insurance. The vast majority of government officials
interpret this to mean either Employee's or National Health Insurance since these are the
only two primary health insurance programs currently recognized by Japanese law. There
are, however, a number of private foreign companies that offer worldwide health insurance
to non-Japanese nationals living in Japan. These companies have been tacitly allowed to
sell their policies through intermediary companies to non-Japanese living in Japan.
A healthy choice
Whether or not you'll be able to get out of your Japanese health insurance is largely a
matter of what type of health insurance you have, where you happen to live and how
open-minded the local official at your government ward office is. Due to foreign health
insurance still being a gray area with no official rules, a little luck also comes into
play.
If you are a full-time employee of a Japanese company, then it's most likely that you are
covered under one of the Employee's Health Insurance programs. Once enrolled, getting out
of this program will be quite difficult since it means a lot of extra paperwork for the
company, plus the company loses a de facto tax break. There are some companies, however,
with large foreign workforces that may let their employees opt out of the Employee's
Health Insurance program. Simply ask the department at your company in charge of health
insurance if it is possible and keep your fingers crossed.
If you're enrolled in National Health Insurance, you have a better chance of getting out.
This is especially true if you live in an area with a large foreign population. Generally
ward officials in these areas and in larger cities that have come across foreigners with
their own private health insurance before are more likely to help you get out of the
Japanese health insurance system. It's ultimately dependent, however, on the discretion of
the government official who happens to be dealing with your request at the time.
The big question is why is it worth bothering with the hassles of trying to get foreign
health insurance when Japanese health insurance is easily available? There are two main
reasons both dealing with coverage; monetary and geographic. To put things in the most
general terms, Japanese health insurance is great when you have to go to the doctor's
office with a bad cold or some minor cuts and abrasions-but it's definitely not the policy
you want to have if you really get sick or have a major accident. This is why almost all
Japanese buy private supplementary health insurance to cover the large gaps that the
National and Employee's Health Insurance programs fail to meet.
In sickness and in health
The coverage gap can be plainly seen when you realize that National Health Insurance
covers only 70% of each claim (Employee's Health Insurance covers 80%). That may not seem
like a lot on the surface, but if you do get into a major accident that requires
hospitalization, even after the insurance coverage pays out its portion, you'll still
easily have a bill of several hundred thousand yen to pay out of your own pocket.
Furthermore, if you do have a severe illness and want to go to your home country to
receive treatment, Japanese health insurance won't cover any of it.
Foreign private health insurance provides more complete coverage and is generally good in
most countries in the world. This is especially important for those who enjoy traveling or
return to their home country for visits on a regular basis. Although the price for this
health insurance varies from company to company, a general estimate is JY90,000 a year for
a 35 to 39-year old, which covers the entire world excluding North America. These premiums
will more than double for those who want their health insurance to include North America
due to the high cost of medical care in the US and Canada. In addition to the regular
health insurance you'd expect, many of these health insurance programs include services
directed towards those living overseas such as doctor referrals, travel insurance, income
replacement and personal liability insurance.
The one area where Employee's Health Insurance and National Health Insurance do stand well
above the foreign health insurance programs is with what is often referred to as
"alternative" medicine in the West, such as acupuncture and massage. It's much
more likely that the Japanese health insurance will cover these types of treatments if
administered by a qualified professional than the foreign health insurance companies.
For further information about private foreign health insurance, contact: Global All Japan (tel: 0120-63-4419; fax: 0798-64-3894) or Banner (tel: 03-6724-5100; fax: 03-5724-5300; www.bannerjapan.com).
They'll be able to provide you with a number of different health insurance plans from
which to choose and help you better determine if you can escape from Japanese health
insurance.
Employees' Health Insurance
(kaisha kenko hoken)
There are several types of this insurance depending on which type of industry you work
but, in principle, employees and employers pay 50% each of 8.5% of the employee's salary
each month toward premiums. Individuals must pay 20% of each claim, 30% of outpatient
treatment and 20% of the cost of drugs. Coverage does not include treatment in foreign
countries.
National Health Insurance
(kokumin kenko hoken)
This insurance is for all those who are not covered under Employees' Health Insurance and
includes those who are self employed, work as part time or contract workers and retired.
Anyone who will live in Japan for a year or more qualifies for this insurance. Premiums
are calculated on income. Individuals must pay 30% of medical expenses incurred. Treatment
received overseas is not covered.
Health Insurance for the
Elderly
(taikoshokusha iryo seido)
This is a supplementary program for those over the age of 70 with premiums calculated
based on income and assets. Outpatient care is JY500 per consultation with a maximum of
JY2000 a month; inpatient care is JY1200 a day.
ADVERTISERS