Job Discussion Forums

[reasonJP]

I'm completely confused about health insurance and I'm hoping there's somebody here who might understand.

I've been in Japan for three years, working for an Eikaiwa who have a private third party health insurance system. I'm in the process of changing jobs right now, though, and my new employer asked me to join Kokumin Hoken (national health insurance), since they don't use a private insurer.

I waltzed into my city hall to take care of it, but was told everybody must be enrolled into Kokumin Hoken (or the company wide Shakai Hoken) and because I hadn't, I had to pay a huge sum in back payments.

For the last two weeks I've been trying to understand the health insurance system and for the life of me, I can't figure it out. If I have to join Kokumin or Shakai Hoken then just having private insurance isn't enough, right? That would appear to me to suggest my current employer and their insurance company are breaking the rules a bit, since I was always told my private insurance works as a substitute for one of the national health insurance systems.

The problem is, it's not clear what the rules are. I have read various guides from various city halls and prefectures that say you must be enrolled in national health, no exceptions and private health insurance isn't good enough. I've called the foreign resident's advisory line for Tokyo government, and they had the same stance. Meanwhile my prefectural government website, and their foreign resident's advisory service said you don't have to be enrolled in national health insurance if you don't want to be. The woman on the phone then said the law doesn't alter from prefecture to prefecture and should be the same everywhere which added to the confusion. What's also confusing is that if my private insurance is good enough, why should I have to pay back payments when I join Kokumin Hoken- back payments for a period I was insured anyway?

I'm feeling totally lost. If there's anyone out there who's gone through the same experience, or who's an expert on this sort of thing, please give me some advice.

[ripslyme]

The "private third party health insurance" provided by that eikaiwa is not considered real health insurance by the Japanese government - hence the back payment requirement. As an individual, you really aren't required to do anything. Enrollment in Kokumin Hoken is voluntary. Your new employer should put you on Shakai Hoken. If not, ask why.

So basically your options are this:
1.) Go uninsured or find some other "private third party health insurance".
2.) Enroll in Kokumin Hoken and pay the back payments.
3.) Get your employer to enroll you in Shakai Hoken.

[Mapleblondie]

So, you're saying that if you choose not to enroll in kokumin koken then paying backpayments is not mandatory? I am trying to figure out whether I want to sign up for shakai hoken with ECC (which is a pricey 30,000 per month!) OR go with a cheaper private insurance, such as GlobalHealth. I am only planning on staying in Japan for a year and a month or two this time around.

[Glenski]

By law you are required to have some sort of health insurance (although nobody really checks, and I know people who have had none in 5 years).

What you have depends on your work situation:

1. if the employer uses a loophole to claim you as a part-time employee (by counting only your classroom hours as work time), then you are not eligible for shakai hoken. Get kokumin hoken or a private insurance. As mentioned, some private insurance is not recognized by the government, so it is like you never had any, and will have to make backpayments.

2. if the employer does not use the loophole, he will offer shakai hoken (which is more than just health insurance). Not sure if you can use private insurance in lieu of shakai hoken. Companies may have their own policy in this regard.

3. If you are self-employed, you get kokumin hoken.

NOTE: You can get back most of the pension payments up to 3 years' worth when you go home. So, don't shrug off shakai hoken just because you think you are losing money in the deal for a pension you will never collect (after 25 years).

[Mapleblondie]

Thanks Glenski. You are always so knowledgable about these things...

So, since ECC technically has a pt contract, and you have to specially request the extra half hour to be given shakai hoken priveleges, would you recommend I do that? Or would National insurance be better, since it's pretty cheap for the first year in Japan (as there is no previous year for them to charge based upon). I am not a person who gets sick often, but I definitely want SOME SORT of insurance, just in case. So, any recommendation you might have would be great. Thanks

[Glenski]

My guess is, you won't be given the half an hour you want. Places that use this loophole don't want to make the copayments into shakai hoken for you.

Private agencies like Global Health may require that you pay all medical fees up front, and wait a month or more before you get reimbursed. Nice for 100% reimbursement, but pricey to have to wait.

Kokumin hoken may sound like a nightmare because of backpayments, but you only have to shell out 30% on the spot every time, and it is recognized practically anywhere, whereas some private insurance plans are not.

Besides, it is always feasible to negotiate with the ward office on monthly payments to repay those backpayments, rather than being expected to pay it all at once.

[Mapleblondie]

Apparently, the union won the right for ECC employees to ask to be put on shakai hoken and ECC can't refuse to provide it...but I wondering whether it's even really worth all the hassle to get it if I am only planning on staying for a year this time anyways. NHI seems to have its downfalls but its a cheap and recognized option, as you say...so maybe that would be the best bet to cover my health costs mostly (rather than having to foot the bill entirely on my own up front). Thank you, Glenski, once again for your insights.

[reasonJP]

[southofreality]

Is ECC basically offering foreign teachers the choice of being either full-time or part-time employees? If they're offering full-time teachers the choice of enrolling in Shakai Hoken or their own private plan, they're breaking the law. Check out the Social Insurance Agency website

For a good basic introduction to what's required:
http://japanordie.com/2008/07/japans-national-health-insurance-and-pension-systems/

[southofreality]

[reasonJP]

Yeah, I'm resigned to the fact I'm out a large sum of money whatever happens and I don't have the financial or emotional resources to fight it out in court. I'm just a bit pissed off, and I'm thinking really that my company (not ECC incidentally, but they shall remain nameless) should be held accountable to an extent for giving me bad information. I've been to the insurance company's website as well, and it seems like if what you're saying is true, then their material is misleading as it states their insurance will always work as a substitute for kenko hoken. Given that pretty much everybody where I work is under the same set up as me, I'm almost tempted to shop everybody and hope the fallout lands on my employer's shoulders.
Thanks for the advice anyway..　がんばります。。

[Glenski]

[chinagirl]

Can we make this a sticky? This question comes up time and time again, and this is a good post.

[Glenski]

I think it already is a sticky. Part 2 FAQ sticky, item 31. Rather lengthy and heavy on NOVA (now defunct), but what's not there that is in this thread (other than the ECC stuff)?

[southofreality]