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Tokyo University of Agriculture and Technology
Medeical Care
HOME >>TUAT Life >> Medical Care

Medical Fee Reimbursement System for International Students

1. Japan’s Health Insurance System

If you receive medical treatment at a hospital or health clinic, your medical expenses may be considerably higher than what you might expect.
For example, it costs about ¥5,000 to see a doctor about a simple cold, several tens of thousands of yen to have a cavity filled, and nearly ¥10,000 to ¥50,000 to undergo medical testing.
The financial burden can add up quickly. A one-week hospital stay for appendicitis can cost as much as ¥200,000, while a serious illness or injury requiring a month or longer of hospitalization can cost as much as ¥1 million per month.
Japan has therefore established a health insurance system that reduces the burden of health care on the individual by distributing medical expenses between the national government, local government, workplace, and individual.
All Japanese nationals, as well as all foreign residents who have permission to remain in Japan for a year or longer, are required to subscribe to one of the following programs:

a. Health Insurance – For company employees.
b. National Health Insurance (NHI) – For people not eligible for (employee) Health Insurance.

International students (except those whose period of residence is less than one year) must therefore subscribe to NHI. However, international students whose period of residence is less than one year can also obtain assistance from Japan Study Support (JSS).
For details about this program, see section 3.

2. National Health Insurance (NHI)

(1) Mandatory Subscription to NHI

No matter how healthy you are, you never know when you may become ill or injured.
NHI distributes the medical expenses that an individual has to pay when they suffer an illness or injury between the national government, local government, and individual. This is one of the health insurance systems in Japan whose goal is to ensure that people can receive medical treatments without economic concerns.
International students intending to stay in Japan for a year or more are required to subscribe to NHI and may not arbitrarily withdraw from it at will.

(2) Subscribing to NHI

You can subscribe to NHI by visiting the National Health Insurance Section (NHI Section) of the municipal office where you completed your Foreign Resident Registration.
If you bring your Foreign Resident Registration Card with you to complete the necessary procedures at the NHI Section office, your National Health Insurance Certificate will be issued to you. Under the NHI system, all family members become subscribers (individual who are eligible to receive medical care) when the head of household subscribes to the system.
If a subscriber’s name, head of household, address, or other information changes, those changes must be reported within 14 days. When your stay in Japan has ended, you must notify the NHI Section before returning to your home country.

(3) Payment of Insurance Premiums

Monthly premiums for subscribing to NHI differ slightly by municipal office. Your premiums will increase if your income increases, if you start a part-time job, for example.
However, individuals recognized by the NHI Section as having an income under a certain amount may be eligible for a discount on their insurance premiums (scholarships and other student financial aid are not usually considered income).

(4) Medical Expenses Not Covered by NHI

Even if you are an NHI subscriber, the following procedures will not be covered:
- Medical care not covered by insurance, additional expenses for an individual room or a special double room, meal expenses while hospitalized, materials expenses, etc.

a. Health checkups
b. Vaccinations
c. Cosmetic surgery
d. Teeth straightening
e. Normal childbirth and elective abortion for economic reasons
(If abnormalities occur during delivery, procedures are covered as insured medical care.)

3. The JSS International Student Medical Expense Subsidy Program

(1) Program Overview

JSS subsidizes a part of medical expenses paid by international students to Japanese medical institutions for the treatment of an illness or injury.

Eligibility
International students who are enrolled in a university and whose residence status is “College Student” are eligible for this program. Their family members are not eligible.
Medical Expenses Covered
Because this program subsidizes medical expenses as stipulated in the Health Insurance Law, the following medical services are either not subsidized or are subsidized only up to certain limits.
a. Medical care not covered by insurance
b. Document fees (fees for certificates, etc.), container costs, and specified medical expenses incurred during an initial exam
c. Medical expenses of a “non-NHI subscriber” who was not eligible for an NHI exam.
d. Cases in which the patient receives medical expense reimbursement from overseas travel insurance, etc.
e. Medical expenses of a “non-NHI subscriber” who was not eligible for a health insurance exam
f. Cases in which the patient will be reimbursed by NHI (such as for major medical expenses)
g. Traffic accidents

(2) JSS Medical Subsidy Program

The subsidy provided under the JSS medical subsidy program is 80% (rounded to the nearest ¥100) of medical expenses incurred as a result of medical treatments as stipulated in the Health Insurance Law. Thus, the subsidy percentages for international students who subscribe to NHI are as follows.

Total amount of medical expense subject to insurance

Portion covered by NHI (claim filed by the insured medical institution) 70%

A portion of the charges (30% + prescriptions)

JSS subsidy
35% of a portion of the charges

65% of a portion of the charges

(3) JSS Medical Subsidy Application

International students who want to receive a JSS medical expense subsidy for medical expenses paid out-of-pocket must submit an International Student Medical Expense Subsidy Application Form along with an original copy (photocopies will not be accepted) of either document (1) or (2) shown below, prepared by an insured medical institution. These documents must be submitted to the International Student Division at the university in which the student is enrolled by the date designated by the university.

a. A receipt (by month or day) clearly showing the portion covered by insurance and the portion not covered by insurance in such a way that the amounts charged for treatments addressed by the Health Insurance Law can be identified.
b. Medical Expense Receipt (a prescribed form for the JSS Medical Expense Subsidy Program)

JSS medical expense subsidy amounts are usually reimbursed through the applicant’s university within 2-3 months after the application is submitted.

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