Relocating from the US to Japan

[Beaglehound]

You can apply for PR after a year of residence with a 3-year spouse visa.

That's faster/sooner than I would have guessed.

Me too, but I can vouch for that as it was the route I took. It’s weird as they still ask for three years worth of some documents, which is clearly an impossibility…

[Snoochibear]

Thanks for the reply.

I am retired military and will have access to Tricare Overseas health care coverage. Just wondering if I will be required join the 国民保険。Perhaps it will be beneficial to have that as long as monthly premiums are not too high. For those who have 国民保険, how much do you pay?

[beanhead]

Thanks for the reply.

I am retired military and will have access to Tricare Overseas health care coverage. Just wondering if I will be required join the 国民保険。Perhaps it will be beneficial to have that as long as monthly premiums are not too high. For those who have 国民保険, how much do you pay?

If you are under 60 years old, it is not optional.
See more details here:
https://retirewiki.jp/wiki/Japanese_pension_system

[captainspoke]

Thanks for the reply.

I am retired military and will have access to Tricare Overseas health care coverage. Just wondering if I will be required join the 国民保険。Perhaps it will be beneficial to have that as long as monthly premiums are not too high. For those who have 国民保険, how much do you pay?

IMO--which is free, so that's what it's worth--this would be inconvenient at best. No clinic or hospital here will accept that (in the way that they accept the typical insurance cards here), so you will be viewed (taken in, treated, etc) as an uninsured person. You will then (I think) have to submit your receipts to tricare for reimbursement.

You may be able to use the tricare to cover what isn't covered here. With 国民保険 you still pay 30% of the cost, and you may be able to recover that from tricare. For most medical expenses I don't think the probable paperwork would be worth it, but for something major, perhaps so. For hospitalizations, a common choice is the standard room (paid/covered by insurance) vs the option of a private room (not paid/covered, and there can be tiers of those). Tricare may cover the private room cost, something to check on.

The monthly premiums are based on your income, and there is a lag that is sometimes hard for a new person to understand. Your first year here, you will have no evidence of past income, so your health coverage (and residence taxes) will be cheap. Residence taxes and health are administered locally, so what happens is that you file your national tax return in Feb/Mar of a given year (let's say for tax year 2021), and this data filters down to your local govt by summer 2022. In late June, everyone gets their residence tax and healthcare adjustments. So right now, I pay those things based on my 2021 income (as declared on the national return). These continue until the cycle repeats itself--in Feb 2023, I'll file my national return (for 2022), and then in June 2023 I'll get a revision and pay residence tax and healthcare accordingly.

For most salaried workers these numbers are pretty stable from year to year. For a retiree, given that their income streams will be stable, probably the same after some continuity is established (assuming no big stock gains or changes in yearly dividend income).

[SLW]

As for health insurance, I have some experience both ways. Currently I am on a diplomatic/official visa with US based international insurance (Cigna) and do not have access to Japanese National Health. My wife has National Health as she is employed and on a work visa while also being on my insurance through Cigna.

I simply pay the full amount at any Japanese doctor or hospital and submit to Cigna. The cost in Japan are a tiny fraction of US costs, so Cigna pays the 80% share quickly. It is very simple. My wife uses National Health and then submits 30% copay invoice to Cigna which pays 80% of the copay. Using both National Health and private insurance gets her share down to just 6% (i.e. 20% x 30%) of the very small cost. No matter what you do, healthcare costs in Japan will be mind boggling low if you are used to US costs even fully insured.

[Wales4rugbyWC23]

As for health insurance, I have some experience both ways. Currently I am on a diplomatic/official visa with US based international insurance (Cigna) and do not have access to Japanese National Health. My wife has National Health as she is employed and on a work visa while also being on my insurance through Cigna.

I simply pay the full amount at any Japanese doctor or hospital and submit to Cigna. The cost in Japan are a tiny fraction of US costs, so Cigna pays the 80% share quickly. It is very simple. My wife uses National Health and then submits 30% copay invoice to Cigna which pays 80% of the copay. Using both National Health and private insurance gets her share down to just 6% (i.e. 20% x 30%) of the very small cost. No matter what you do, healthcare costs in Japan will be mind boggling low if you are used to US costs even fully insured.

Doesn't Cigna have a deductible of about 10,000 yen? Is it really worth claiming for visits to the Doctor, even without national health insurance it is quite cheap. I have only claimed once with Cigna with for an operation and they jacked up my premiums after that.

[SLW]

I guess it would depend on the plan. Mine is employer provided so the premium cannot be raised based on my claims. Even if you have a deductible, it would be useful to submit to clear the deductible as early as possible and start getting reimbursed.