国民健康保险指南
國民健康保險是日本的公辦醫療保險制度。在日本，如果沒有健康保險而接受診療，會被要求支付高額的醫療費。持有在日本就業資格且在公司就職的外國人及其家人，可以利用在公司加入的社會保險；除此以外的人，則加入國民健康保險。加入國民健康保險則給付診療費的70％，支付餘下的30％費用就可以接受診療。
留日資格在1年以上，如果沒有加入其他健康保險，就必須加入國民健康保險。加入國民健康保險，需要外國人登記證等。保險費因收入、來日時間、居住地區等而異。但拿6個月的「就學」在留資格的人，根據辦理地的地方政府的規定不同，可能會要求提出記載有1年以上在學預定期間的在學證明書。而留學生另有加碼補助「留學生的醫療費補助」，想使用這個制度時，須事先向所屬大學的留學生課登錄申請，最低可以只有6％的負擔。
這一制度是為了減輕醫療費等負擔，目的是相互幫助，即從平時起就共同出錢，用做生病及受傷時的醫療費。
按規定，居住在日本的人均要加入某種公共醫療保險，因此未加入工作單位健康保險等的人必須加入所住市町村的國民健康保險。
另外，40歲～64歲的人將自動成為護理保險的護理第2號被保險者。
但是，過了75歲生日的人將成為後期高齡者醫療的被保險者，國民健康保險會被自動解除。
成為被保險者的條件
① 在留期間超過3個月。居住在名古屋市內，進行了外國人登錄。但是，即使在留期間在3個月以內，未進行住民登錄，但根據資料等的確認，入境時被認可有可能滯在超過3個月的情況也包含在內。
※在留資格是「特定活動」，入境目的是「接受治療活動」或者是「照顧某人的日常生活活動」的人除外。
② 持有短期滯在以外的合法在留資格。
③ 未加入工作單位的健康保險等（不包括旅行保險及外國的醫療保險等）。
④ 未受到生活保護。
完全符合以上4項條件的外國人，請到所住區的區政府或分所辦理加入名古屋市國民健康保險的手續。
公共醫療保險是一種所有人相互幫助的社會保險制度，因此不能以自己健康不需要、或者是保險費高不喜歡等不負責任的理由退出。
在國民健康保險中，也有所需費用的全額必須由自己負擔的時候。如住進醫院的單人房等時的「差額床費」、使用在健康保險中沒有被承認的高額的特殊治療藥時及牙科需要裝金冠等的特殊治療。分娩、墮胎也是全額由自己負擔。
以下的情況，就算支付了全額醫療費，如果申請而經審查通過的話，診療費的70％可以退回來。
- 因突然事故受傷，在沒有國民健康保險資格的醫院接受了治療，或急病以及旅行中生病、受傷、忘記拿保險證接受治療時。
- 因病情嚴重的理由，醫生認為需要護理時的護理人員費用。
- 以醫生指示接受按摩、針灸等的治療，骨折及扭傷時接受接骨院的治療。
- 整形、矯正等的費用。
- 不能接受正常渠道所供給的營養而輸血的血費。
- 重症病人的入院、轉院等的移送費。
另有高額醫療費補助制度，同一人在同一家醫院支付醫療費的月負擔額，如果超過一定金額時（比如1999年度，在東京都是63,600日元，沒有支付住民稅的家庭是35,400日元）申請可享受高額醫療費補助的制度，即超過上述金額的部分可以退回來。以此避免醫療界的漫天喊價行為。
關於健康保險無法受理的因事故等造成受傷及使他人受傷、物品的損害賠償，有傷害保險及個人賠償責任保險。
- 傷害保險 - 傷害保險是關於日常生活及交通事故、旅行中等造成受傷時的補償。
- 人賠償責任保險 - 個人賠償責任保險是因本人的過失而使他人受傷、機器物品損壞時的補償。
National Health Insurance (国民健康保険, Kokumin-Kenkō-Hoken?) is one of the two major types of insurance programs available in Japan. The other is Employees' Health Insurance (健康保険, Kenkō-Hoken?). National Health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private insurance is also available, all Japanese citizens, permanent residents, and any non-Japanese residing in Japan with a visa lasting one year or longer are required to be enrolled in either National Health Insurance or Employees' Health Insurance.It is defined by the National Health Care Act of 1958.[
Japan’s first health insurance system was introduced in 1922. It took effect in 1927 to cover laborers and in 1938 was extended to cover farmers also The system originated from labor unions representing workers in dangerous industries, and over time was gradually extended so that currently all Japanese citizens and residents should be covered.
The current NHI system, which is managed by local municipal governments, was introduced in 1961. The information in this article relates to Minato Ward in Tokyo, and NHI conditions in other municipalities may differ.
Joining NHI
People are required to join NHI within two weeks of becoming eligible. This is required if a person moves to the municipality from another municipality or overseas and isn’t covered by Employees' Health Insurance, withdraws from Employees' Health Insurance (for example, due to job loss), stops receiving public assistance, or is born (and not covered under parents Employees Health Insurance).
Those who do not register when they become eligible and register later, can be charged for up to two years of back payments.
A person applies to their local ward office or city office, which issues them with a NHI card, and invoices for the NHI premiums. The insured person then pays the premiums, and is now covered.
How the National Health Insurance works
When the insured person uses a medical facility that accepts NHI, they will only need to pay part of the cost.
The medical facility will then send invoices for the remaining amount to the National Health Insurance Federation, which reviews and pays the medical facility. After this, the NHIF reports on the invoices to the municipal office, which reimburses the NHIF.
Withdrawing from NHI
There are several different grounds for withdrawing from NHI.
- As NHI is managed by local municipalities, if an insured person moves to another municipality, they must withdraw from their current municipality’s NHI and enter the NHI of their new area.
- If the insured person is not a Japanese citizen and leaves Japan without intention of returning, or without re-entry permission they must settle their premium in advance.
- NHI members also withdraw if they join Employees' Health Insurance, start receiving public assistance, or pass away.
Other notifications
Insured people are required to notify the city if they change their address, their name, the head of household, lose their NHI card, or the NHI members covered under the card have changed.
Insurance Premiums
There are three types of NHI premiums. The head of household is responsible for payment, even if they are not a NHI member. The rate at which the premiums are calculated is based on the Resident's tax (住民税, juuminzei?) amount charged by the local municipal government. This is in turn based on income earned by that member during the previous calendar year. Resident’s tax is determined in June, and notifications are sent in July. Because of this, the yearly NHI premium is divided into 10 installments.
- Category 1 - The basic premium (for regular NHI members.)
Calculated by multiplying the total residents tax paid by all NHI members in the household by 0.80. This is the income levy. Then multiplying the number of insured household members by 31,200. This is the per capita levy. These two levies added together are the annual premium that must be paid. The maximum possible is 500,000 per year.
- Category 2 - The premium for supporting the elderly (for people older than 75.)
Calculated by multiplying the total residents tax paid by all NHI members in the household by 0.23. This is the income levy. Then multiplying the number of insured household members by 8,700. This is the per capita levy. These two levies added together are the annual premium that must be paid. The maximum possible is 130,000 per year.
- Category 3 - For nursing care (for people in long-term care)
Calculated by multiplying the total residents tax paid by all category 2 NHI members in the household by 0.11. This is the income levy. Then multiplying the number of category 2 household members by 12,000. This is the per capita levy. These two levies added together are the annual premium that must be paid. The maximum possible is 100,000 per year.
Collection procedures
If NHI members do not make payment, a reminder will be sent. If payment is still not received after the reminder, the members NHI card will be replaced with a short term (6 month) card.
If payment has not been received for a year, NHI members may have to return their NHI card, and will be provided with an eligibility certificate. This shows that the person is a NHI member and can receive treatment, but must bear all the costs themselves. However, it is possible that the amount that NHI bears can be applied to the members premiums at a later date.
If payments are not made, the municipality may have the members property (savings, salaries, telephone lines, etc.) seized to pay for the arrears.
NHI benefits
General Medical Benefits
When the insured person uses a medical facility that accepts NHI, they will only need to pay part of the cost. As of 2011 this copayment will be either 10% or 30% depending on the income of the insured person, and in April 2011 the lowest rate will rise to 20%
Those aged between 70 to 74 are entitled to a NHI Elderly Recipient Certificate. Those with this certificate have to make a copayment of either 10% or 30% depending on their income.
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