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What is your health insurance in Japan, and how it works?

Three types of Japanese health insurance in Japan

Health insurance in Japan is divided mainly into three groups at large. They are: (1) employees' insurance (Hiyosha hoken, or 被用者保険) such as Health insurance Association, (2) National Health Insurance (Kokumin Kenko Hoken or Kokuho, 国民健康保険), and another is (3) Medical Care System for Older Senior Citizens. So, if you work at a company or other organisation in Japan, your health insurance is the (1) employees' one, and is deducted from your salary.

(1) Employees' insurance

If you work as an employee in Japan, your health insurance is an employee's. 50% of the insurance is covered by your employer, and you pay the rest. Your health insurance also covers your dependents.

(2) National Health Insurance (Kokumin Kenko Hoken or Kokuho, 国民健康保険)

Kokuho Insurance covers those who do not belong to (1) employee's insurance or (3) Medical Care System for Older Senior Citizens. If you work as a freelance or self-employed, Kokuho is your health insurance.

(3) Medical Care System for Older Senior Citizens

This system is comprehensive medical care for those over 75 years old, including health insurance. You'll be automatically added to this category on the birthday of 75 years old (65 years old for those disabled).

How is the amount of health insurance fixed?

The amount of health insurance you pay is fixed yearly, depending on your income.

If your health insurance is employee's, your employer pays half of your health insurance expenses, while Kokuho is 100% of your expenditure, which is a lot.

To be honest, in my case, I was shocked to see the bill when I became a member of Kokuho when I resigned from the first employer. I wasn’t aware enough because my social insurance as an employee, including health insurance and pension, was automatically deducted from my salary.

A corporation hiring more than five people is legally obliged to adopt health insurance and pension. To my surprise, one of my American friend’s former employer in Japan did not pay her social insurance but put her Kokuho. It took some time until she realised the employer’s wrongdoing because health insurance back home is expensive. If you are hired, please be noted that your health insurance is an employee’s, not kokuho.

Questions or comments? Contact us.

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