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mushroomyakuza
Joined: 17 Sep 2009
Posts: 140
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 Posted: Mon Aug 30, 2010 12:56 pm Post subject: KKH question |
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Hi all
Quick question about the health insurance stuff. Tomorrow I have to go to my ward office to get on Kenkomin Kenkomin Hokum (spelling?). Before anyone starts, yes I know this information is probably widely valuable on the forum, but I'm a hurry and don't have the time to scour old threads looking for it. So, my question is what exactly do you get with KKH? I assume you can have access to a doctor but I wanted to be sure. I'm long overdue an appointment so I'd like to know as much as possible. And also, how does this work with getting access to an English speaking doctor? I'm aafraid I don't speak enough Japanese to explain the problem properly without English.
Cheers |
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fluffyhamster
Joined: 13 Mar 2005
Posts: 3292
Location: UK > China > Japan > UK again
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| Posted: Mon Aug 30, 2010 1:01 pm Post subject: |
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This seemed a pretty clear and useful thread:
http://forums.eslcafe.com/job/viewtopic.php?t=78556
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3. kokumin kenko hoken (National Health Insurance)
(abbreviated to kokuho)
A social medical insurance scheme designed to plug the gaps left by shakai hoken. It is used by the unemployed, self-employed, and many part-time workers and employees of small firms. kokuho offers slightly fewer medical benefits than shakai hoken.
kokuho is administered at a ward level, and prices vary from ward to ward. Your premiums are calculated from last year's income, so when you first arrive in Japan will find it cheap. After a year, it gets expensive -- dearer than shakai hoken -- although in some cases shakai hoken is only a better deal because the employer has to pay 50%.
Joining kokuho can be very expensive if you have previously been resident in Japan but outside the social insurance system. You could be asked for up to 2 years of backpayments. Some people get around this problem by moving to another ward, since many wards do not share records of contribution histories.
Finally, note that if you have dependents, you will have to buy kokuho for them too. This can make kokuho a much poorer deal than shakai hoken. |
Of course you'll get access to doctors, hospitals, pretty nurses etc - it's NHI/medical insurance!  
When I had NHI I was luckily never too ill or injured, so whatever minor treatments I sometimes needed could be easily paid for in petty cash plucked straight out my wallet (i.e. there was no need to withdraw loads from an ATM to pay for a vaccination, or an X-ray and sling, or whatever little thing), and I could never be bothered reclaiming for such small amounts. I'm not quite sure therefore how the whole "You only pay up to 30% at most for most treatments, and the government covers the rest" NHI thing works in relation to serious/expensive/chronic cases - I guess the hospital would only ask you for that 30% at most (and then at some later date rather than in advance of treatment would probably be OK i.e. they'd surely not object to invoicing you); that is, you likely wouldn't be needing to cough up 100% before or too soon after treament and then claiming back 70%. Anyway, the most important thing is that your decapitated corpse actually has an NHI card to wave whilst they (only then agree to?) spend the equivalent of millions of yen sewing your head back on following a grisly collision with a bento delivery cyclist or whatever, and the NHI will of course in these serious sorts of cases be saving you money regardless of the exact way the treatment is paid.
As for the language barrier, the only thing you can really do is prep from and take along a good E-J dictionary or phrasebook. |
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Bread
Joined: 24 May 2009
Posts: 318
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| Posted: Mon Aug 30, 2010 4:27 pm Post subject: Re: KKH question |
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| mushroomyakuza wrote: |
| Kenkomin Kenkomin Hokum |
 This made my day, thanks. It sounds like a magic spell!
The first time I went to the doctor in Japan when I spoke almost no Japanese, I went to a major hospital's ER to get prescriptions. They gave me an English-speaking doctor who set me up with an appointment with a regular doctor who spoke English that I've been going to see for a long time now. A lot higher percentage of doctors speak English than most of the general population, and if you go to a big hospital then you can almost certainly see one. The hard part, without Japanese skill, is getting through the receptionists and nurses who probably won't speak any English on the way to the doctor. Just prepare a few phrases and be sure to have your ID card and such for registration. |
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mushroomyakuza
Joined: 17 Sep 2009
Posts: 140
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| Posted: Mon Aug 30, 2010 4:47 pm Post subject: |
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Thanks guys.
Sorry for the magic spell.
So I'd have to go to a hospital to see a doctor? I'm looking for the equivalent of your standard GP appointment like in the UK - is this not possible out here? Got a problem with food getting stuck in my throat and feeling sick all the time. It's ew. I just blew chunks with self-imposed vomitting. I feel like a bulemic teenager. Need to solve this  |
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Bread
Joined: 24 May 2009
Posts: 318
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| Posted: Mon Aug 30, 2010 5:27 pm Post subject: |
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| There are smaller clinics as well, but in Japan it's very normal to go to the hospital if you have a cold. Lots of doctors do their office hours there. Some smaller private clinics don't accept national health insurance to keep down the waiting times for their (wealthier) patients, so be careful of that too. I know there's a special English-speaking clinic somewhere in Tokyo that doesn't take the insurance because they don't want to get flooded with Japanese people who just go there because it's the closest one to their house. |
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G Cthulhu
Joined: 07 Feb 2003
Posts: 1373
Location: Way, way off course.
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| Posted: Mon Aug 30, 2010 8:23 pm Post subject: |
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| mushroomyakuza wrote: |
So I'd have to go to a hospital to see a doctor? I'm looking for the equivalent of your standard GP appointment like in the UK - is this not possible out here? Got a problem with food getting stuck in my throat and feeling sick all the time. It's ew. I just blew chunks with self-imposed vomitting. I feel like a bulemic teenager. Need to solve this |
GP's exist, but as someone else said, they're not all that common. No one will be surprised by your visiting the hospital and it's what the vast majority of the population do. And for what you describe (thanks, btw ) you might want to start out with an ENT specialist anyway rather than a GP. No sense in hanging about if it's not going to cost you extra.
ENT dept, btw & on the off chance you don't know it in Japanese, is jibiinkooka - sorry, can't do the kanji or proper romanji from this computer. |
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Bread
Joined: 24 May 2009
Posts: 318
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| Posted: Mon Aug 30, 2010 8:43 pm Post subject: |
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| G Cthulhu wrote: |
| ENT dept, btw & on the off chance you don't know it in Japanese, is jibiinkooka - sorry, can't do the kanji or proper romanji from this computer. |
耳鼻咽喉科 (じびいんこうか）, should be helpful to copy that down. |
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mushroomyakuza
Joined: 17 Sep 2009
Posts: 140
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| Posted: Tue Aug 31, 2010 1:03 am Post subject: |
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Okay, thanks guys.
Seems like EMT department is the way to go, but this leads to me to two questions. One being, there's no garuentee they'll speak English there, and I just can't explain the problem in Japanese. There's no way. So logically I should go to the clinics you mentioned, but you said they're often not included on KKH - what does that mean exactly? That I'd pay a seperate fee?
Could I go to one of these English speaking doctors without the healthcard, explain my problem, pay a fee and get it solved that way? If so that's probably better.
Sorry for the continuing questions, but you both seem more savvy with this than anyone I know socially and I appreciate the help. |
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Apsara
Joined: 20 Sep 2005
Posts: 2142
Location: Tokyo, Japan
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| Posted: Tue Aug 31, 2010 5:33 am Post subject: |
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You can go to any clinic or hospital here without your health insurance card and you will be seen, but you have to pay the full amount of the fee, not the 30% that you would pay with the card.
Basically unless it's a central Tokyo clinic aimed at expats or something similar, anywhere you go should take KKH. As far as English-speaking doctors go, you're just going to have to try your luck- you won't be guaranteed one anywhere unless you have specific information beforehand that there is one at that particular place.
I haven't come across any doctor resembling a GP in Japan- they are all specialised in some way- internal medicine or external medicine are about as general as they get. If I were you I would go to a hospital and either ask for the ear nose and throat specialist that someone mentioned above, or an internal medicine (内科) doctor.
If you are anywhere near Tokyo you could visit one of the international clinics, but I'm guessing you aren't? |
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fluffyhamster
Joined: 13 Mar 2005
Posts: 3292
Location: UK > China > Japan > UK again
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| Posted: Tue Aug 31, 2010 5:49 am Post subject: |
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| Apsara wrote: |
| You can go to any clinic or hospital here without your health insurance card and you will be seen, but you have to pay the full amount of the fee, not the 30% that you would pay with the card. |
(Just to give the OP some indication of costs:) That's reassuring, Apsara. I wonder then if the 15,000 yen or so that I paid for a short series of shots was 30% or 100% of their total cost (I don't recall flashing my NHI card like it was an FBI one much, at least not before the actual moment of paying). And when I didn't have NHI, and thus definitely paying 100%, an X-ray (to certify to a BOE and dispatcher that I - and all the other AETs they were hiring LOL! - hadn't got TB) cost only 5,000 yen.
And any drugs that the doctor may prescribe are usually dispensed from and can be picked up within the hospital itself, right? (Again, I can't quite remember about this myself, but seem to recall it was/is the case).
Last edited by fluffyhamster on Thu Dec 30, 2010 9:40 pm; edited 1 time in total |
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Apsara
Joined: 20 Sep 2005
Posts: 2142
Location: Tokyo, Japan
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| Posted: Tue Aug 31, 2010 6:25 am Post subject: |
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Well, to be accurate, there are some procedures and tests that appear to be covered by NHI and some that aren't. A pregnant friend of mine told me recently that she had to pay only a small percentage for some of the blood tests she was required to have, but the full cost for others.
However a consultation should be charged at the standard 30%. I would expect shots to cost a lot more than an x-ray, but I'm only speculating. Usually I've had to show my NHI card when I first arrive at the hospital, not at the time of paying.
Yes, they seem to have a dispensary at every hospital. Not sure about the clinics, but there is usually a dispensary somewhere near those. |
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