National Health Insurance
Inquiries: Benefits Section (Tel: 042-514-8276) or Insurance Premiums Section (Tel: 042-514-8279) of the Insurance and Pension Division
National Health Insurance (NHI) is a mutual assistance program in which members pool their money (insurance premiums) and use the money for medical treatment when necessary, since an illness or injury can happen at any time.
Everyone except those enrolled in the health insurance plan (health insurance union or mutual-aid union) of their place of employment and their dependents, and those who receive public financial assistance for everyday living, must be enrolled in NHI. This includes foreign residents who have completed foreign resident registration and are authorized to stay in Japan for three months or longer. (However, if your visa status is “Diplomat” or “Medical/Special Activities,” you cannot enroll in the program.)
Insurance premiums are calculated for the fiscal year (April through March of the following year) according to the total income the member earned during the previous year. Premiums are calculated by month if an NHI member joins or withdraws during the fiscal year.
As a rule, the payment of premiums for the fiscal year is done in nine installments from July through March of the following year.
Enrolling in NHI
Residents of Hino City to which 1 through 6 below do not apply must enroll in National Health Insurance.
- Enrolled in the insurance plan of their place of employment, and dependent family members of such
- Enrolled in a National Health Insurance union
- Enrolled in Latter-Term Medical Insurance
- Enrolled in special per diem coverage as designated by the Health Insurance Act, and dependent family members of such
- Receive public financial assistance for everyday living
- Exempted by the Ministry of Health, Labour and Welfare for a special reason
Withdrawing from NHI
- When moving out of Hino City
- Upon enrollment in your employer’s health insurance plan
- When an NHI member dies
- If you start receiving public financial assistance for everyday living
Notification Filing Period
If you change your address, such as when moving in or out of Hino City, you must file a notification within fourteen days.
Percentage of Expenses Personally Borne
Up to entrance to elementary school: 20 percent
From elementary school to 69 years of age: 30 percent
Between 70 and 74 years of age: 20 percent. (If your birthday is on or before April 1, 1944, the percentage is 10 percent. If your income is the level of a working person [Note 1], the percentage is 30 percent.)
Note 1: “Income level of a working person”: A household with an NHI member between 70 and 74 years of age whose portion of income taxed for resident tax is \1,450,000 or more.
National Health Insurance Benefits
- When receiving treatment for illnesses, injuries or dental treatment
- When medical expenses (the personally borne expense for insurance-covered treatments) exceed the maximum ceiling
- When you must continue expensive long-term treatment, such as for hemophilia, dialysis for chronic kidney failure, or treatment for AIDS
- If you receive medical treatment without bringing your health insurance card for some unavoidable reason
- If you receive treatment at a medical institution overseas for some unavoidable reason
- When you receive an Oriental or Western-style massage or acupuncture after agreement from the doctor who performs the insurance-covered medical treatment
- When you have a support device such as a corset made
- When a child is born
- When an NHI member in your household dies
- When a seriously ill patient needs to be transported, such as for hospitalization or to transfer between hospitals under the instructions of an insured doctor.
When Insurance Cannot Be Used
- Matters that are not considered illnesses or injuries
- Regular pregnancy/childbirth
- For an abortion due to financial reasons
- For health checkups, immunizations, complete health checkups or orthodontic treatment
- For cosmetic surgery
- For illnesses or injuries at work that labor casualty insurance can cover
- For illnesses or injuries resulting from fighting or drunkenness
- For illnesses or injuries induced deliberately or during criminal activities
Note: If health insurance is used for treatment of an injury caused by a third party, such as a traffic accident, then a notification must be filed.
National Health Insurance Premiums
National Health Insurance premiums are calculated for each household member and household, and the notification (invoice) is mailed to the head of the household. Accordingly, the head of the household is obliged to pay the premiums. Even if the head of the household is not enrolled in NHI, the notification (invoice) will be sent to him/her if a household member is an insured member. This is referred to as a “quasi-household.”
How the National Health Insurance Premiums Work
NHI premiums are determined from the total of the medical insurance portion, latter-term elderly support portion and nursing care portion.
Enrolling or Withdrawing during the Fiscal Year
NHI premiums are calculated for the fiscal year from April through March of the following year. Accordingly, if there are any changes during the fiscal year, such as enrollment or loss of eligibility, the premiums are calculated by the number of months of enrollment.
In the Case of Additional Premiums or Partial Loss
If you have a new household member to enroll in NHI or if a family member loses NHI eligibility due to enrollment in the insurance plan at their place of employment, the premium amount will be recalculated based on the number of months of enrollment, and the annual premiums will be adjusted.
企画部 市長公室 広報担当
〒191-8686 東京都日野市神明1丁目12番地の1 日野市役所4階