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  • fuckedgaijin ‹ General ‹ Working in Japan

Health Coverage while in Japan

The secrets to securing the coveted Token Gaijin position.
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Health Coverage while in Japan

Postby karekora » Fri Jul 23, 2004 3:50 am

I'm going to Japan for a year in December, so far Ive not found a job, but I'm continuously looking, and will go to Japan no matter what now!!! I've been saving for too long!

:arrow: My question is about HEALTH COVERAGE.
As I understand it, I can't get the National Health Coverage as everyone gets in Japan, so to make sure I don't end up paying thousands if I get ill, I figured I'd have to arrange my own private Health Cover for when I go.

Anyone know of any decent companies, or can at least help me in starting to look? I've looked in the Yellow Pages, but they seem more concerned about Private Health Coverage. Is this correct??

I'm totally in the dark about this and would appreciate any help...!!

Thanks :D
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Postby omae mona » Fri Jul 23, 2004 11:03 am

Um, exactly what visa are you planning to have when you come to Japan? I'm not 100% certain, but assuming you're here on anything but a tourist visa (in other words, if you're here legally) you are entitled to national health insurance.

(anybody heard otherwise?)
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Postby amdg » Fri Jul 23, 2004 11:11 am

This issue might have been dealt with before (check the archives), but I am also interested in what people have to say. When I left my previous job I ceased payments under the national insurance scheme. Starting my new job, with a higher salary, I was now told that my health insurance payments would now be around 60,000 Yen /month. So I'd like to know what alternatives are out there and whether you'd have any trouble getting treatment if you're not on the national scheme.
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Postby Taro Toporific » Fri Jul 23, 2004 11:43 am

amdg wrote:This issue might have been dealt with before (check the archives), but I am also interested in what people have to say. ...


GomiGirl and others have private insurance which is cheaper. She's happy with it, I believe she uses GLOBALHEALTH.JP. but ask her. http://www.globalhealth.jp/

For a younger FG without health issues private insurance is always cheaper and the few foreign ones that are Japanese based ones can handle Japanese paperwork. (Conversely, old farts like me make out like bandits in the national pool. My private coverage in the States is over $4,000/m and "pre-existing conditions" are excluded: I live in healthcare exile :( .)




Other companies:
http://www.healthcareinternational.com/
http://www.x-pat.net/
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Postby kamome » Fri Jul 23, 2004 12:36 pm

If you are employed by a Japanese company, then the law says that you must be covered by the National Health Insurance scheme (and the rest of the social insurance package as well). The company pays half your premiums and the other half is automatically deducted from your payroll.

My advice: do NOT seek Japanese national health insurance, if you can avoid it. Get yourself on one of the private plans. This is because you don't want to have J-social insurance deducted from your salary and because you will want to have coverage for yourself whenever you go back to your home country.

Btw, I use BUPA International.
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Postby amdg » Fri Jul 23, 2004 2:28 pm

If you are employed by a Japanese company, then the law says that you must be covered by the National Health Insurance scheme (and the rest of the social insurance package as well).


Yes, that's what my company told me, but they also said they could 'fix' it so that I didn't have to pay if I didn't want to by changing my contract basis.

My advice: do NOT seek Japanese national health insurance, if you can avoid it. Get yourself on one of the private plans. This is because you don't want to have J-social insurance deducted from your salary and because you will want to have coverage for yourself whenever you go back to your home country.


- Hmm I'm tending to agree with you on both of those points.

Btw, I use BUPA International.


- Any problems with them?
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Postby kamome » Fri Jul 23, 2004 5:36 pm

amdg wrote:
If you are employed by a Japanese company, then the law says that you must be covered by the National Health Insurance scheme (and the rest of the social insurance package as well).


Yes, that's what my company told me, but they also said they could 'fix' it so that I didn't have to pay if I didn't want to by changing my contract basis.

My advice: do NOT seek Japanese national health insurance, if you can avoid it. Get yourself on one of the private plans. This is because you don't want to have J-social insurance deducted from your salary and because you will want to have coverage for yourself whenever you go back to your home country.


- Hmm I'm tending to agree with you on both of those points.

Btw, I use BUPA International.


- Any problems with them?


Their way of fixing it would be to move your payroll offshore. If the company has an office in another country and you are paid in that country, then the social insurance people here can't track you in their system. Saves you from paying into that black hole known as the J-pension scheme. Of course, all of this does not exempt you from paying Japanese taxes on your income.

I've never had a problem with BUPA. I believe the other companies that Taro mentioned are also very good. Best to do some comparison shopping.
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Postby karekora » Sun Aug 08, 2004 5:08 am

Thanks for your help.

I got a quote from xpat and bupa, and I'm just reading about Globalhealth.jp now. The quote I got from Bupa is 43pounds (Y8600??) a month for Inpatients and Outpatients cover. I know NOTHING about this field, and was wondering if this was a good deal??

For xpat, the quote I recieved was 250pounds for a WHOLE YEAR. That seems too cheap in comparison to Bupa!! Is it a deal not to be missed or am I being cheated? They didn't state whether it was Inpatients & Outpatients cover though, so I'm guessing its just Inpatients.

Anyway, 43pounds a month. Would you pay it??
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Postby kamome » Mon Aug 09, 2004 3:45 am

karekora wrote:Thanks for your help.

I got a quote from xpat and bupa, and I'm just reading about Globalhealth.jp now. The quote I got from Bupa is 43pounds (Y8600??) a month for Inpatients and Outpatients cover. I know NOTHING about this field, and was wondering if this was a good deal??

For xpat, the quote I recieved was 250pounds for a WHOLE YEAR. That seems too cheap in comparison to Bupa!! Is it a deal not to be missed or am I being cheated? They didn't state whether it was Inpatients & Outpatients cover though, so I'm guessing its just Inpatients.

Anyway, 43pounds a month. Would you pay it??


That's a big difference. My BUPA plan isn't quite so high, but my company provides it as part of a group plan, which reduces the monthly premium.

I noticed from your post in another thread that you're thinking of coming here to look for a job without a degree, and maybe for just one year. If that's the case, then you probably won't be paid much and you definitely won't be given a nice ex-pat package that includes offshore health care plans. I'd stick to whichever is the most economical choice, even if it means paying into the Japanese system. That means figuring out what your salary will be and the premiums you would have to pay under the Japanese scheme versus the health care premiums you would be paying for a global plan. Keep in mind that if you pay into the Japanese system, at least you can claim a lump-sum partial rebate on your J-pension payments and a rebate on the tax thereon after you return to your home country.
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Postby GomiGirl » Mon Aug 09, 2004 1:38 pm

Hey Kamome - I just received my BUPA quote and nearly fell off my chair. Over USD3K for 12 months.. Screw that.

I have just renewed with MedExPlan

Only around USD800 for 12 months and includes 30days anywhere in the world, including the US, full cover. No dental though.
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escape from kokumin houken

Postby omae mona » Mon Aug 09, 2004 1:45 pm

Anybody had any luck on getting OFF of national health insurance after entering the program? When I moved back to Japan last year, boy was it a great bargain, since it was based on my previous year's salary (0 from Japan's point of view). Woohoo! Well, my new premiums just kicked in. Unfortunately I had a good enough year last year that the monthly payments are pricer than any of the private plans would be.

I was just about to make the switch to BUPA or something like that. But after a little bit of googling, it looks like perhaps once you're enrolled in kokumin houken, they won't let you quit unless you leave the country. Anybody have experience with this? Is it possible to escape? Wanted to check here before I trudge over to the ward office and start grovelling.
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Postby GomiGirl » Mon Aug 09, 2004 1:50 pm

I have heard of a way - now please do not quote me or use this advice in your defence should you get busted...

BUT I have heard, that National Health Premiums are similar to the NHK bills. You can get your national health number but not pay the bills. After a few years your debt is forgiven and it starts again. But when showing up at the hospital with your National Health number they will treat you as it is not checked whether you pay your premiums or not.

Again, this is a second hand story of a guy who has lived in Japan for YEARS and NEVER paid his premiums but has enjoyed full National Health cover.

Read the above disclaimer again.. I do not know this for fact and nor do I advocate that you do this. I have my own health cover and have never used National Health.
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Re: escape from kokumin houken

Postby Taro Toporific » Mon Aug 09, 2004 1:52 pm

omae mona wrote:...once you're enrolled in kokumin houken, they won't let you quit unless you leave the country. Anybody have experience with this? Is it possible to escape? Wanted to check here before I trudge over to the ward office and start grovelling.


From what I hear, you have to pretend to you leave the country and come back. Even the Japan Times' Help Column lady, Jean Pierce, had huge problems escaping kokumin houken---back in the 80s she wrote about her "escape" adventure for SIX months in the paper.
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Postby kamome » Mon Aug 09, 2004 2:27 pm

Yeah, BUPA is high, now that I think about it. But you get all coverage anywhere around the world, including Medevacs in case you get some horrible disease like SARS and need to be transported back to the States for treatment.

I know one way to escape from Kenkou Hoken: switch jobs. I went from a position that paid me onshore to a new job that paid me offshore. No more shakai houken for me after that. :D
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Postby GomiGirl » Mon Aug 09, 2004 2:38 pm

kamome wrote:Yeah, BUPA is high, now that I think about it. But you get all coverage anywhere around the world, including Medevacs in case you get some horrible disease like SARS and need to be transported back to the States for treatment.


Mine has Medevacs and world wide coverage - even when on holidays. Don't need separate travel insurance either as it is all covered.

All the expat policies have world-wide coverage and medevac. I have top hospital - all the bells and whistles.

I think BUPA is sold to corporations in bulk for the employees. For single policies it is outrageous.
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Postby omae mona » Mon Aug 09, 2004 4:30 pm

kamome wrote:I know one way to escape from Kenkou Hoken: switch jobs.

That's gonna be tough... I'm self-employed and enjoying it too much. Maybe I can do this by setting myself up a little yugen-gaisha for me and my employee (Mrs. Omae Mona). Something tells me that insurance companies don't want to provide benefits to a 2-person company, though..
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Postby karekora » Thu Aug 19, 2004 3:39 am

&quot wrote:Hey Kamome - I just received my BUPA quote and nearly fell off my chair. Over USD3K for 12 months.. Screw that.

I have just renewed with MedExPlan

Only around USD800 for 12 months and includes 30days anywhere in the world, including the US, full cover. No dental though.


Above quote from GomiGirl...

I've read about the MedExPlan, and to me, it sounds excellent, they offer just what I'd want. I'm interested in the Silver Plan, and if they have a reasonable quote I'll go with them.

... I thought ...

Until... I phoned up their England base in West Sussex. The girl didn't seem to speak much English (She wasn't Japanese either as I tried that!) and didn't understand a word I said. She seemed confused why I had called even after me repeating myself 5 times in a v-e-r-y low voice thAT I just wanted a quote for the Silver MedExPlan cover. She didn't want to know and asked for my email and said someone will contact me soon.
That was last Thursday...
I emailed them again on Monday night to remind them, but...

After phoning up BUPA and them being so helpful, I'm surprised at the lack of interest from MedEx, as I'd really prefer to go with them now.

So, my question for GomiGirl is..
How did you find getting a quote from them?
When in Japan, if you phone them, are they friendly and helpful and put you at ease? (i.e. they don't keep saying "Why have you phoned again?")
And, on their website, they only mention the Outpatient clinics in Tokyo, they do have clinics elsewhere in Japan though right?

Maybe this was a bad experience or maybe this is what its like. I just know that BUPA was alot more professional. (...but they don't cover you for so much... T_T)

So, thanks for any help, advice, etc.... ^^

(I don't really want to go with the JNH as I don't really understand it, and its something I'd have to sort out there (?). I'm not the kind of person that is always getting ill, so it could be cheaper, but as I said, I am completely in the dark about how is works. I don't even understad the UK system, let alone Japan! :( I guess I just want peace of mind BEFORE I hit the ground in Tokyo!)
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Postby GomiGirl » Thu Aug 19, 2004 1:27 pm

Why did you call England? The guy who I go through is based in japan.

did you email info@medexplan.com?

or arouth@medexplan.com

phone number. 03-3825-7074 (Tokyo number)
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Postby namakemono » Thu Aug 19, 2004 4:08 pm

How expensive is prescription medicine in Japan, compared to elsewhere?

eg in Australia here all prescription medicines are covered under a system where the max you pay is $23.70. i.e. I pay $23.70 for a $170 drug
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Postby GomiGirl » Thu Aug 19, 2004 4:12 pm

namakemono wrote:How expensive is prescription medicine in Japan, compared to elsewhere?

eg in Australia here all prescription medicines are covered under a system where the max you pay is $23.70. i.e. I pay $23.70 for a $170 drug


Bring all your medicines from home. Stock up on Panadol as you can't get it here and cold medicine is crap so stock up on the Codral cold and flu tabs.

Also all of your deodorant and other personal items.
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Postby amdg » Thu Aug 19, 2004 4:21 pm

namakemono wrote:How expensive is prescription medicine in Japan, compared to elsewhere?

eg in Australia here all prescription medicines are covered under a system where the max you pay is $23.70. i.e. I pay $23.70 for a $170 drug


If you're taking prescription medication, then you'll want to make sure with your company that they will organize your health insurance for you. If you are under the National scheme (a kind of medicare) then you will only pay a small percentage and the rest will be borne by the government. You might also want to check that the medication you take, or an appropriate substitute, is available in Japan. I don't know how you'd go about doing that, but maybe some of the other forum members will know.
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Postby Taro Toporific » Thu Aug 19, 2004 4:39 pm

amdg wrote:You might also want to check that the medication you take, or an appropriate substitute, is available in Japan.


Yes! Many Japanese "substitutes" for medication are non-functional (close to 40% if I remember one Japanese expose' about this).

Do NOT believe anything a Japanese doctor says about Japanese "substitute"---get the chemical name of the Japanese "substitute" medication and have your Real World doctors double-check the content and dosage (Japanese people are small so dosages are too low for robust FGs).

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Postby namakemono » Fri Aug 20, 2004 1:04 pm

amdg wrote:If you're taking prescription medication, then you'll want to make sure with your company that they will organize your health insurance for you. If you are under the National scheme (a kind of medicare) then you will only pay a small percentage and the rest will be borne by the government. You might also want to check that the medication you take, or an appropriate substitute, is available in Japan. I don't know how you'd go about doing that, but maybe some of the other forum members will know.


It was only a temporary prescription, but I'll keep that in mind.

What's jp customs like for bringing medical drugs in? Do they have really low limits or what?
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Postby amdg » Fri Aug 20, 2004 1:14 pm

From memory, a two-month limit (for internally ingested medicine), and a 24 dose limit for topical medications.
Mr Kobayashi: First, I experienced a sort of overpowering feeling whenever I was in the room with foreigners, not to mention a powerful body odor coming from them. I don't know whether it was a sweat from the heat or a cold sweat, but I remember I was sweating whenever they were around.
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Postby karekora » Fri Aug 27, 2004 1:24 am

"Anyway, 43pounds a month. Would you pay it??"

That was for BUPA.. My quote from Med Ex wasn't that much cheaper - £485 a year - £40 a month.

Yet you all seemed shocked by BUPA's high quote before...

I'm starting to think this is average for health cover, right?

Remember, I want Inpatient and Outpatient care (Excluding GPs for BUPA)

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Postby kotatsuneko » Fri Aug 27, 2004 8:46 am

not all companies will pay for your national health insurance, if you work fairly few hours for example they don't have to pay, even then its not *so* bad I mean, I found paying for a cancer investigation was not so expensive and of course I got seen immediately (unlike the nhs in the uk where you wait and die)

I found the healthcare I received in Sapporo both at the doctors and dentists was incredible and I didnt encounter any pills with no lables or explanations either, I did boycott one hospital tho as it was owned by the Sokka Gakkai and found a local one, smaller but owned by a Hokkaido farming associaton . sorry, rambling!

trust GomiGrrl on the deodorant issue tho!!
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Postby kamome » Fri Aug 27, 2004 1:57 pm

karekora wrote:"Anyway, 43pounds a month. Would you pay it??"

That was for BUPA.. My quote from Med Ex wasn't that much cheaper - £485 a year - £40 a month.

Yet you all seemed shocked by BUPA's high quote before...

I'm starting to think this is average for health cover, right?

Remember, I want Inpatient and Outpatient care (Excluding GPs for BUPA)

Karekora


Well, no one said health coverage is cheap. It's one of the highest of my monthly expenses (and maybe it would be the highest if I cut out all expenses related to home pr0n viewing--broadband access, subscription fees, lost productivity, etc. :wink: j/k)
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TO GOMI GIRL

Postby karekora » Sun Oct 31, 2004 5:26 am

TO GOMI GIRL

about medexplan, they are joint with img right??

anyway, what are the deductables?? i don't understand it. I emailed alex ruth about it, but still didn't understand. What are the deductable choices??

help?

thanks loads! :_)
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Postby karekora » Wed Nov 03, 2004 9:00 pm

..............Hello?! :)
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a little late in the thread

Postby james » Mon Dec 13, 2004 12:02 am

but someone was asking about getting off of kokumin hoken. i was on it for about four years, and like quite a few people, i'm self-employed.

well the bill came in this year at Y300,000 for the year. literally double what i paid the two previous years despite little change in my income and now with two kids in tow. i'd already paid in full but that didn't stop me from wanting out.

i can assure you that at the time as a healthy 29 year old male who doesn't smoke, hardly drinks, is reasonably fit and with no known health issues at all that i was floored by such an exhorbitant amount.

as for getting out of it though, i really had no problem. wife called the local ward office to let them know i was coming, i filled out a form, stamped it and as of that day was no longer part of it. i live in a very small town of about 8000 people. not sure if that had anything to do with it, but from what i've heard and read i got off miraculously easy, but not free. they still managed to nail me for a good 90,000 yen because their billing is delayed. by the time you receive the bill, you're already about a third into the current coverage year, which here runs with the fiscal year starting in april. remarkably though, there was no problem *at all* in getting the unused (but paid) portion refunded. so, i swallowed my 90,000 yen loss then bought coverage from globalhealth, which also covers me when i make a saunter back home to canada, and i still came out about 100,000 yen ahead for it. my coverage with global was about 80,000 yen for the year.

i also have a supplementary insurance coverage with JA for emergency hospital visits. the premium is 16,000 yen per month but there's a cash back every five years of 300,000 yen if you make no claims in that five year period. there's also some cash-out at the end. with this coverage it really didn't make sense for me to have kokumin hoken. i get sick to the point i need to stay in bed maybe once a year, sometimes not. for me, it'd be far cheaper to just pay out of pocket, really.

the kokumin hoken system is fine as long as you're not earning too much, but it can really sneak up on you if you start pulling in some decent coin. my father-in-law tells me that payments are capped at 600,000 yen per year. i don't know if the laws have been revised, but i think it's easier for foreigners to get out of it now. i've heard that changing municipalities is another way.

if you like, i could have my wife call your ward office :P
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