Help! Natl. Health insurance problem!

[dogjam]

I really need help with this one guys-- I went to the ward office on friday to get information about the national health insurance program. My current program does not include dental, and I figure I will stay in Japan for awhile so I wanted some more info. Anyway, I end up signing up for it- thats when they tell me that I owe 1 year's premiums from the time I moved into the ward! The amount will be calculated later, they said but I guess it would be about 190,000 yen. Naturally I don't want to pay this. So today I go down there and say I want to cancel, and, as I read on the forums here, they say no I cant cancel.
How can I either 1, Cancel the insurance for the time being, or 2. somehow get a waiver on last year's premiums?
I have heard it depends on the ward office .. Anyway thx for the help.

[trip_hop]

You can ask for deferred, divided payments - called bunkatsubarai - and pay it off over an agreed period.

They can charge up to 2 year of back payments.

th

[dogjam]

thanks Trip Hop. Has anybody ever gotten past this? Since I am paying (and paid) for another insurance, I really don't want to pay this. Also, for those who do have national health insurance, how do you find it? I really need dental. Do you feel it is worth the cost?

[dogjam]

Good point downtown, I'm not against paying it at all. I just don't want to pay for LAST year when I was paying another insurance company. I have no problem with paying it from now, when I enter. Also. I have lived in Japan for 5 years. Why not charge me for 5 years instead of just the 1 year that I have lived in my current ward? If I move tomorrow to Kita-ku, does that mean I can start from scratch? Thats the problem with the system.

[swordfishtrombone]

downtown, your logic doesn't quite work. if you pay a health insurance provider in new zealand (or wherever), they still wind up paying the hospital bills, don't they? i think you misunderstand the meaning of insurance, unless you believe japan is a socialist society (which i suppose you could argue....). whether it's the NHI or some other plan, it still pays the bills. and that's what supports the health infrastructure.

the NHI is a bloated, inefficient and costly program. as a consumer living in a democratic society with a free market economy (okay i may be exaggerating this here in Japan) shouldn't i have a choice of health insurance? why should i be required to support the japanese NHI? just because i live here? isn't it logical that if people opt out of the NHI, the NHI would be forced to operate more efficiently? (that is the expected dynamic in a market economy, isn't it?)

japan pays me? i don't know about that, but my income taxes paid to the Japanese government are my contribution back to the society as far as i'm concerned. i do not feel obligated to buy into the NHI because i don't think it is the right choice for my health insurance needs. i have the right to make that choice, legally and morally.

[swordfishtrombone]

"premiums, however, are kept abroad and retained as income and profit. "

so, what's your point? they provide a service and should profit from it.


"I believe that Japanese Health Insurance should be mandatory for Gaijin English teachers."

i'm not an english teacher. should it be mandatory for me??


"Every industrialized country in the world has national health care - except for the US. "

socialized medicine is great but the cost to the average user in japan is much higher than in any other country. health insurance in japan is higher for many people than in it would be in the US - go figure! it's great idea if it's working, but here in japan the system is so dreadfully inefficient you can't expect people to simply jump on board just because the bureaucrats say you have to.


"95% of foreigners in Japan come here JUST to make MONEY and they'll do whatever they have to to get here and stay here"


well they certainly don't come here for good health care cover.

[dogjam]

Downtown, according to the local ward office, Its is mandatory for everyone. But there is something wrong with the system if they can't make everybody pay.
Even a lot of Japanese don't pay.

[swordfishtrombone]

dogjam,
japanese law requires everyone to be covered by health insurance, but the law does not specify which insurance (NHI or other) and it also does not contain an enforcement mechanism (they can't make people pay).

of course it would be wrong to receive the benefits of the NHI without paying, but you could bypass the NHI and get into a foreign insurance plan (like ones advertised on this site) which are much much cheaper, and often reimburse 100% of medical costs rather than 70% like the more expensive NHI.

don't be fooled by downtown's twisted logic. money paid to hospitals supports hospitals. money paid to bureaucrats supports bureaucrats.

[dogjam]

They need to tell people that they need to enter the system. Why do I go down there , 1 year after moving to my ward, and owe LAST years premiums? They should have told me that before. Had I known I would have started last year.
Companies are obviously negligent as they do not tell their workers that they have to enter the system. If you are so concerned, downtown, why don't you turn in all the foreigners not registered?

[jane]

What about if you've been in Japan for 5 years on private health insurance and then you get married and apply to be on your husbands medical insurance? How does that work? What about when you make a claim? Does the husbands company have to pay 70% and you pay 30%? It's all a bit confusing!!!!

[iwantmyrightsnow]

Actually, japanese law does specify that you must be part of the system here. Being in a system soes us GFlobal Health insurance or Nova's JMA does not fullful you legal obligation.

If you are eomplyed for 30 or more hours you are required to be part of the employers health/pension scheme. And it is your employers legal obligation to enroll you.

If you are not in such a schem you are legally required to enroll in your ward office's scheme.

Of course some people choose not to do either and there is no real enforcement of the system. That does not obslove you of your legal obligation.

And there reasons to be part of the national scheme.....sometimes what you can claim makes it worthwhile.

[iwantmyrightsnow]

Downtown said he/she believes National Health Insurance should be compulsory for foreign teachers.

It is! If we work 30 or more hours at a company with more than 5 employees, the company is legally required to enroll us in pension/health fund. If they do not THEY are breaking the law. Of course this happens throughout the industry and nothing happens. But who knows how long this will continue. The government may well decide to enforce the law. I think Nova would owe about 1.5 billion yen per month ( may be a zero out there).

I wouldn't mind being enrolled as long as there was a way of getting ALL my pension payments back and not just the current limit that is about 2.4 x your monthly salary.

[swordfishtrombone]

1. the law does not specify the NHI. it only says you have to have health insurance.

2. the law does specify the national pension. (for companies with over xx full-time employees).

3. many companies subscribe to group plans that cover both pension and NHI, and are offered jointly to employees without options to split.

4. that is why your companies tell you that you have to enroll in both. and that is why people get confused over this issue.

5. it is not a legal obligation to enroll in the NHI.



if your company does not belong to a 'joint' plan (pension + NHI), you CAN opt out of the NHI by enrolling in any other LEGAL health insurance program.

i have been to 3 different ward offices in Tokyo (while moving around) and have never had a single problem with this, as long as i show proof of insurance.

[dogjam]

Swordfish, the people down at the ward office kept saying it's a "gimu".. I hope you are right. Where can i get documentation in japanese that says what you just stated? If it's true, I want something on paper to wave in front of their faces. They are adamant that it's the LAW that everybody must have NHI..
thanks

[swordfishtrombone]

dogjam,

from what i understand, different ward/city offices have different points of view on this. some are adamant that you join the NHI (traditional/narrow interpretation of the law), and others openly accept other forms of insurance (because the law does not specifically state that you have to be in a certain plan, just that you have to have insurance). are you in Tokyo?

in any case, there is no enforcement mechanism. they can't 'come after you'. so you could simply get your private insurance and ignore the ward office. if they ever hassle you just bring in your insurance card/papers and say 'i do have insurance'. make them prove to you that you have to have the NHI.

the actual laws are really hard to read but you can find them on the MOHW site.

there is also and English explanation of health insurance policy. note that it is not very specific:

http://www.mhlw.go.jp/english/org/policy/p34-35.html

[dogjam]

Thanks a lot for the link, yes Im in Tokyo. I'll give it a try if they try bill me for the previous year.
thanks a lot