Japanese Health Insurance

I desperately need advice on a good health care option.

*I would like to know whats the best option for a woman hoping to have a baby in the near future?

*Is the Japanese plan best or an International plan?

*If International plans are possible has anyone had trouble using them, such as rejection or lack of coverage?

*What about spouses?

*How would these plans work for me and my Fiance who is Japanese?

*Is there a way out of the Japanese plan that I am already signed up for?

When I moved to Japan 2 years ago with my Fiance I knew nothing about the Japanese health plans. I wanted coverage so I thought it would be less of a hassled to sign up for the Japanese plan before spending hours searching through International plans.

I found my first year so inexpensive I paid then in advance (5,000). However, when the second year came around my fees rocketed to 20,000. I then stopped payment and decided to search for a good International plan. I also knew that my marriage would be approaching and thought it would be best to wait for the change.

Recently, I have received calls from the Japanese government asking me to pay for their Health plan. I told them I would like to cancel and they told me I couldn't get out.

I hope to get answers soon before I try to pay 1 years worth of Health Insurance. :/

Japanese national health insurance (kokumin kenko hoken) is by far the best option for most people- almost the entire fee the hospital/clinic charges for the birth (around 450,000 yen) is either refunded or paid directly to the hospital for you by Japanese national health insurance.

Once you report the pregnancy to your ward/city office you will also receive vouchers which make the routine prenatal checks either free or just 1,000-2,000 yen or so (depends on the clinic) although if you have blood tests it can cost more for that visit.

As far as I am aware most of the expat plans available do not cover childbirth, although it may be worth doing some research.

As you have found, though, once on national health it is not usually possible to opt out again. In any case I really doubt that you will find a private insurance that will cover childbirth better than NHI does-I switched to NHI last year and am now 6 months pregnant, and I am extremely pleased that I changed when I did- the benefits will far outweigh the 17,000 yen a month I am now paying for NHI (which is about the same as I paid for private insurance).

um, I dont really want to comment on the baby thing, because i had my baby in the US, and then came back here.

But um.... are you working? usually if you change over to social insurance with your job, you can get out of NHI.

Does your fiance/husband work?

When you do get married, if he works, he can claim you as dependent and you be covered under his insurance plan as well and should be able to can get out of NHI scheme.


Well my first year of insurance is 2500 yen per month, which is more than you paid for the year and I am unemployed and have a baby. so i dont know how they expect me to pay for that if I didnt have savings already or take money from other people. Hoping my insurance isnt too expensive next year either when march/april comes around. Probably I will still be unemployed and living off savings.

your city or ward also give you a birthing allowance/gift of like 300,000 yen or more, for the birth of the baby. but i think you claim it after the birth, so you would need to pay the hospital out of pocket first. I dont know how much that will be. In the U.S, it was $6,500.


I have NHI and never use it.. I dont go to doctor or anything, and when I do, still have to pay the fees for that. I wish the money going towards NHI could pay for those rare visits. lol. I would ask for suggestions on how to use NHI so I can get my money's worth every month, but it will be just more money wasted since I still need to pay for each visit.

The reason they won't let you leave the scheme is that Japanese law requires anyone resident in Japan for more than 12 months to be enrolled in a health insurance scheme either an employer's (shakai kenkou hoken) or if you are unemployed, student, or work part time or for a small employer then national social insurance (kokumin kenkou hoken). Foreigners opting to break the law and use only private international schemes may find their visa renewals rejected or face a large bill for back payment in the future.

Just consider this a tax that you must pay, but can see tangible returns on. Many other countries have similar requirements.

Regarding pregnancy, birth, and children. The insurance scheme makes part payment for tests/check-ups during pregnancy - you get 15 vouchers, which mean the cost is reduced to about 2000 yen per visit and 2,5000 for the big blood test one early on. You also get 42,0000 yen paid at birth (or if you lose the baby after 6 months pregnancy or more). The hospital can normally claim directly for this payment. The birth fee depends on hospital (private, public, or small clinic) and how long you stayed and if their are complications. It is in the range 30,0000 - 60,0000 for a normal birth.

National insurance also means that your new dependant will get a free health insurance card and so free health care until 16 years old.

Hope that helps

Sorry I missed out 0's in my numbers

Birth support payment is 420,000 yen and hospital fee is 300,000-600,000 yen

Also, don't forget to apply for child benefit (kodomo teate), which is 13,000 yen per child per mouth. Set to double to 26,000 next year.

I was reading the newspaper the other day and it said it will raise to 2man en 2011. you have a link somewhere that says its doubling to 2.6 man?

What I see in the news is that it will go up to 20,000 for children under 3 (recently raised from children up to 2) from April next year- I have not seen anything reporting the figure 26,000 yen.

Reina Jess, if you are on NHI and go to an ordinary hospital or clinic, then your fees *are* covering 70% of the costs- you are only paying 30% at the hospital, that is how NHI works. With most of my prenatal visits there is no charge at all. I wonder why you think you aren't covered if you are paying into it? Or are you going to expat clinics which don't accept NHI?

2,500 yen per month is about a tenth of what most people pay anyway, although I'm sure it seems a lot if you are unemployed.

Sira and Jess are correct. The increase is to only 2,0000 yen. I got my figures from an old source; presumably the government couldn't find the budget for their intended increase. Sorry for any confusion.

And regarding the prenatal checks: if you attend a private clinic or hospital, they will charge a handling fee for using the vouchers. Your cheapest option is your local public hospital, where the vouchers will cover the majority of costs (although the blood test one will still be expensive around 20,000 yen).

And there are some private clinics and hospital that don't accept vouchers or the NHI 70% part-payment. Mostly, expat centres.

I go to the hospital nearest me, which is run by a Catholic foundation, and as I said I don't pay anything except for the extra blood tests etc- not sure if that means it's a "public hospital" or not, but smaller clinics almost always seem to cost more, as do the central Tokyo hospitals popular with expats for giving birth, like Saint Lukes, Seibo and Aiiku.

These are the answers to the questions ive been searching for.
We are both gaijins here and was thinking about starting a family but i was concerned about all the expences that goes with child birth.

candy,

Japan has one of the lowest infant mortality rates in the world, and from what I have experienced myself so far as well as what I have heard from others, the level of prenatal care here is excellent, although things may be somewhat different to your home country in some areas- an example is that epidurals are rare, although available in some places. Hospital/birth centre stays after giving birth are also longer than many other places- the average is 5 days for a normal birth, 10 days for a C-section.

There are lots of options as far as birth plans go here, and people I know who have given birth here have mostly had very positive experiences.

If you are in the Tokyo area perhaps look at joining Tokyo Pregnancy Group- they have a Facebook page as well as a normal website.