Aug 23, 2018

Health Insurance shock

              Health Insurance shock photo

Many will agree that Japan - with coverage of at least seventy percent of the total hospital, outpatient consultation costs, and medicines, has one of the best health insurance systems in the world, or at least among developed nations. This is probably one of the reasons why many foreigners prefer to stay in Japan rather than return to their home countries.

It is mandatory for citizens and basically anyone who will establish even temporary residence in this country to obtain health insurance, whether through his or her employer, or through the city or town government. As a result, part of the foreign resident's list of bills is his or her insurance premium.

With a private health insurance, it is easy to ignore the monthly premiums simply because it's automatically deducted from one's salary. The same can be said for those who are under the national health insurance but are paying through automatic bank transfer. If you are under the national health insurance, you may want to reconsider your automatic payment after reading this piece. Here's why.

Your monthly premium may have already increased significantly from the previous year and you have not noticed it yet. There are two main factors affecting this increase:

1. Your income - simply put, as your salary increases, so do the taxes you pay and your insurance premiums.

2. Your age - apparently the premium increases significantly once the insured reaches the age of 40 .

Now, perhaps these increases are justified. However, what is alarming is the manner in which they are introduced to the insured. Let me share with you what I have recently experienced regarding this matter.

Around the 1st week of August 2018, I received a set of bills for my health insurance this year (Envelope 1). Just a week after, another bill came to my door - and this is for an additional premium which I had to pay in a lump sum (Envelope 2). This was an adjustment made by my city government to my health insurance due, apparently, to the income I've earned the previous fiscal year. In other words, they're asking me to pay more since I earned more. Fine.

Just 2 weeks after I received Envelope 2, in came Envelope 3 which contained a new set of bills for my health insurance. I noticed right away that my monthly premium has increased by 2,000 yen. Because the envelope got into my mailbox on the first day of the obon break, I had to wait (anxiously) for at least 3 days before I could go to our city hall and sort these out.

When I did, I was in for a bigger - er, more expensive - shock: although Envelope 1 can now be disregarded (and discarded), I still had to pay the bills in Envelope 3, AND the ones on Envelope 2! A simple computation led me to discover that this government is now charging me approximately 40,000 yen more in health insurance premiums for this year!

Ok, ok. As we turn 40 we become eligible for additional medical tests that our city government provides us annually. I guess I should actually be grateful for that. However, what I believe doesn’t work in this situation is the ineffective dissemination of information regarding the premium increase. Yes, there are the leaflets that are enclosed with the bills, but let’s face it: these leaflets are often ignored and just go straight into the trash, right?

Simply put: had there been a letter (or any correspondence) addressed specifically to the person insured, informing him/her of the premium changes due to the new age bracket, then situations like this (and the stress that went along with it) wouldn’t have to happen.

Look, I certainly would not mind paying for health insurance, since I am aware of what great benefit I can actually get - something that I'll never be able to afford back in my home country. In addition, I am grateful that arrangements can be done to be able to pay for the monthly premiums in an easier manner.

However, I wonder if there is a more efficient way of collecting our health insurance premiums, without having to receive unwelcome surprises every year. I truly believe that is something the government can - and should - look into.



A teacher by profession, yet always a student of life. Currently living in Kanto, but in love with Kyushu.

1 Comment

  • helloalissa

    on Aug 24

    That sounds frustrating - as if the city office got updated info too late and had already sent out the bill. I was aware that the insurance bills are based on your income for the previous year, but this is good info for anyone who wasn't. I agree that the preventative care is great (especially for those of us over 40). If you're even older (not sure on the age but maybe 60+), the percentage you pay goes down to 10% of costs! I heard the country is loosing money on their health insurance system, mostly because they provide healthcare for an aging population at such a low cost.