Health insurance

[KCLenny]

So I’m on basic national health insurance. It covers me and my wife (who doesn’t work). It’s about ¥20,000 a month. My company doesn’t offer any benefits of any kind. I believe that’s due to us being such an incredibly small company (1 boss, 2 teachers, and 1 receptionist).

My question is, is it worth looking into getting any kind of private health insurance? Would it be cheaper? Would there be any other benefits or perks (for example, points)? It would it just not be worth the hassle?

[Beaglehound]

National health insurance is not optional, so best to stick with that.

[beanhead]

What problem are you trying to solve? Have you had issues with getting the care you need or some specific treatment with the national health insurance?

If not, there is no benefit to additional insurance.

[KCLenny]

No explicit problem. I just didn’t know if if I got a different health insurance plan I could cancel the national health insurance. And then if I had a different plan I could find a cheaper one?
Is that a thing or not? I’m not very on top of the whole insurance plans etc having come from the U.K. where this stuff is just done automatically. My company doesn’t provide anything and I didn’t know if it was possible to get a cheaper health insurance than the national one.

[Butterball]

You can't dis-enroll from public health insurance so there's no potential for saving money.
People sometimes get additional private insurance on top of the public to give extra coverage in case of catastrophic illness.

Back in the day, this used to be a slightly greyer area where the government wouldn't really care if foreigners didn't enroll, and some of us paid for private insurance instead. There are probably some people around who still have managed not to enroll. So just to address the hypothetical where you somehow managed to get out of NHI, in my experience, dealing with private insurance just made for more aggravation and probably ended up costing more anyway. Plus, if you ever do need medical care, you may be forced to enroll in NHI at the hospital and make backpayments for the period you weren't enrolled.

[mighty58]

Private insurance in Japan is primarily to cover the 30% that is not covered by the National health insurance, and any ancillary expenses such as if you want to upgrade to a private room while in hospital. If you couldn't afford, say, 1-2m yen to pay for this out of pocket (in the case of a serious illness like cancer) then get the private medical insurance. If you can cover that amount, by selling some holdings or with cash, you're ok being self-insured for the 30% portion. In Japan, you will not face the US-style horror stories of people having unexpected bills of several hundred thousand dollars.

[KCLenny]

Right I see. Okay. Thanks everyone. I won’t bother then!
Thanks again

[RetireJapan]

Private insurance in Japan is primarily to cover the 30% that is not covered by the National health insurance, and any ancillary expenses such as if you want to upgrade to a private room while in hospital. If you couldn't afford, say, 1-2m yen to pay for this out of pocket (in the case of a serious illness like cancer) then get the private medical insurance. If you can cover that amount, by selling some holdings or with cash, you're ok being self-insured for the 30% portion. In Japan, you will not face the US-style horror stories of people having unexpected bills of several hundred thousand dollars.

There is also a monthly cap on health expenses (around 80,000 yen for an average earner) based on income. You don't have to pay above that cap.

My surgery in March was around 2m yen, but I only paid around 85,000 yen: https://blog.gaijinpot.com/hospital-sta ... ou-expect/

I have private health insurance, but mainly to keep my wife happy. I don't think it is necessary.

[mighty58]

I wasn't aware of the monthly cap, that's very interesting and significantly lowers the worst-case scenario. In your article on GaijinPot though, you mention you need to apply beforehand... can you still be eligible if you don't/can't apply beforehand?

[zeroshiki]

It seems like the application is if you want to reduce your bill at the hospital. If you don't apply, its a refund.

https://www.kyoukaikenpo.or.jp/g3/sb3020/r151/

The absolute worst case scenario (if you earn more than 8.5M JPY a year) is:
252,600円＋（総医療費※1－842,000円）×1％

So 252,600 + 1% of the total bill minus 842k. I assume this is also the 30% share after insurance as well. Coming from a country with no social insurance, this is very impressive to me.