City of Sapporo > Medical Services/Health/Social Welfare > Public medical insurance (Koteki iryo hoken)

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Update:November 17, 2016

Public medical insurance (Koteki iryo hoken)

Public medical insurance is a mutual-aid system to reduce the burden of medical bills on the sick or injured through cost sharing, and everyone living in Japan is obliged to enroll.
There are two categories of public medical insurance programs: Employee Health Insurance, in which company employees are enrolled, and National Health Insurance and Medical Care System for People Aged 75 and over, which applies to those not eligible for Employee Health Insurance. Under these systems, the insured party pays only 30% or less of medical expenses at the hospital where treatment for illness/injury is sought.

Social Insurance (shakai hoken), Mutual aid (kyosai), National Health Insurance Society (kokumin kenko hoken kumiai) (for those aged 74 and younger)

Those employed by companies are enrolled in this health insurance program. The company handles the application procedure and automatically deducts premiums from salaries.
Showing an insurance card at the hospital allows the bearer to pay just 10 to 30% of the medical expenses incurred.

National Health Insurance (kokumin kenko hoken) (for those aged 74 and younger)

Persons eligible for residence registration in Sapporo (see page http://www.city.sapporo.jp/city/english/legal-procedures/registration.html) who are not enrolled in any form of workplace insurance are obliged to enroll in the National Health Insurance Program. (If you entered Japan temporarily with a designated activities visa for situations such as receiving medical care, accompanying someone receiving medical care, tourism/vacation or temporary work transfers, you may be exempted from applying for national health insurance if your country is part of the Social Security Agreement. Please visit your ward (see page http://www.city.sapporo.jp/city/english/facilities.html#page-city-hall) for further details.)

The relevant procedures can be completed at ward offices, and require the following:

  • A form of identification such as your residence card and passport
  • If you plan to have your insurance premiums paid by bank transfer, bring your bankbook, registered seal, and/or cash card (this procedure could be completed at later dates for those that do not have a bank account at the time).

If your address changes or you have a new baby, you must complete the related procedures to update your information at the ward office within 14 days.

Insurance premiums

Premiums are calculated based on the number of family members and the previous year’s income in Japan of the person insured. Payment of premiums for the year is made in 10 installments. There are two ways to pay: automatic remittance using the account transfer systems provided by financial institutions and direct payment to a collector who makes specific visits for this purpose.

Insurance cards

One health insurance card is issued per individual. Showing the card at the hospital allows the bearer to pay just 10 to 30% of the medical expenses incurred. However, medical examinations, preventive shots, cosmetic surgery, normal childbirth and other cases not defined as medical treatment of illness/injury are not covered by this insurance, and must be paid in full.

Health insurance benefits

Benefits are provided if the insured party gives birth, dies or incurs large medical bills due to hospitalization or for other reasons.

Medical Care System (koki koureisha iryou seido) (for those Aged 75 and over)

Those aged 75 years and older who are eligible for residence registration in Sapporo (see page http://www.city.sapporo.jp/city/english/facilities.html#page-city-hall) are obliged to enroll in the Medical Care System (If you are in Japan temporarily with a designated activities visa for situations such as receiving medical care, accompanying someone receiving medical care, or temporary work transfers, you may be exempted from applying for national health insurance if your country is part of the Social Security Agreement. Please visit your ward or your ward’s website (see page http://www.city.sapporo.jp/city/english/facilities.html#page-city-hall) for further details.)
Each person is issued 1 insurance card. When the card is presented at a medical facility, treatment for illness can be received with a self-pay ratio of 10%. Those whose income is above a certain level, however, pay 30%.
No procedures are required, except in cases where those between 65 and 75 years of age with certain disabilities are enrolled. The amount of premiums will depend on the receiver’s income.