FW-53 -- Japan Health Care Options - Understanding the System

J@pan Inc Magazine Presents:

* * * * * ** F R U G A L W A T C H * * * * * * * *
A weekly roundup of how to be frugal in the world's most
expensive country to live (unless you read this!), written
and compiled by Wendy J. Imura.

Regular edition, April 18, 2005 Issue No. 53

- What's New (Japan Health Care Options - Understanding the System)
- Event Notice: (Golden Week Travel Deals)
- Frugal tips (Cheap Kyoto Hotels)
- Credits

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============== ICA EVENT ==================
Special Joint Round Table Discussion on Mobile Technology
TOPIC: "Telematics: Consumer Applications Take-off with 3G

RSVP required complete event details at
Date: Thursday, April 21, 2005
Time: 6:30 Doors open, buffet dinner included
Cost: 3,000 yen (members), 5,500 yen (non-members),
Open to all - Location is Foreign Correspondents' Club


Dear Frugal Readers,

Well, I just spent a fun three hours at city hall (ha!)
switching from one health care system (EHI) to another
(National Health), and thought I would spend some time
today discussing health insurance options in Japan.

Health care for foreign residents in Japan usually falls
into four categories: the National Health Insurance plan,
corporate plans (part of the public health system but
separately administered), private 'ex-pat' oriented plans,
or those without health insurance.

Hopefully, you fall into one of the prior three categories:
treatment in Japan can be very expensive. Some options
for the uninsured include private groups (The Minatomachi
Foreign Migrant Workers' Mutual Aid <045-453-3673>, or
Bright International Cooperative Society <03-3590-9110>)
that run cooperative mutual aid societies with a private
network of clinics. These societies require a membership fee
of 2,000-3,000 yen per month, and have various payment
systems. They are geared to foreign workers and offer
minimum coverage to non-Japanese who (for some reason
or another) are not eligible for coverage under the
other systems.

Another option for foreign students with offical student
visas planning on staying in Japan for one year or more
who can participate in the NHI system is the Association
of International Education (AIEJ) in Japan. The AIEJ
reimburses students 80% of their 30% co-payments.
Registration can be made through universities and colleges,
or by telephone (03-5454-5213). For cash-strapped students,
this extra help is certainly a boon: you would, in essence,
recieve back 1,600 yen of a 2,000 yen co-payment, for

If you work full-time (or 3/4 of the hours of a full-time
worker) for a large company with its Employee Health Care
(EHI) public plan, you can join this system. Most of these
plans are linked to the company pension system, so short-term
foreign employees may be excluded (though the Social Insurance
Agency is currently cracking down on this). EHI plans are called
"shakai hoken." Once enrolled in the plans, you cannot quit,
short of quitting your current employer or going on a part-time
contract. You can, however, maintain your company plan for up
to two years after you quit your job as part of "ninii hoken" or
compulsory extended insurance.

National Health, or kokumin hoken, is the remaining catch all -
foreigners qualify for (and are required to join) if they are
not covered at their workplace or are granted a residence permit
of a year or longer in Japan. All of the members enrolled in
NHI within the same house will be included in one policy: there
is a maximum household premium limit of 530,000 yen annually,
with the lowest premium of 26,100 yen per person. Your
premiums are based on your previous year's municipal taxes:
if you did not pay taxes last year, you will be charged the
minimum 26,100 yen per person per year, but may see a startling
jump in premiums the following year.

With regards to costs for NHI insured families: note that the
maximum income cutoff for salaried persons per household is
around 6-6.5 million yen per year: if you make more than that
per household, you cannot be charged more than the 530,000
yen per year (or 44,000 yen month) for your entire family's
health insurance (providing everyone lives at the same address
on paper and is enrolled in NHI). For couples with children
not eligible for EHI, this makes NHI a bit of a better deal
than some ex-pat plans.

If you were eligible to enroll in NHI (ie you moved into the
area, registered as a foriegn resident, or left your EHI plan)
in the past but did not, a new rule states that you may be
required to pay up to two years in back payments when you do
decide to join. Thus, if you've been thinking about enrolling
in NHI but haven't done it yet, early April is a good time
to go - the start of the Japanese fiscal year means lower
back-payments. Also, avoid entering the system at the end
of the month (the 31st, for example): you will still
be charged for that month's premium even if there is only
one day left in the month. Finally, if you do have a
legitimate case of financial hardship (a single-parent
family, for example)which you can prove, there are systems
in place to either reduce or totally eliminate your NHI
payments. Please check with your local government office.

This is only the briefest overview of information, and I
plan to write a review of ex-pat plans available on the
market soon. However, if you'd like more detailed information,
check out the Japan Health Handbook (Maruyama, Shimizu,
Tsurumaki) - written by three foriegn nurses/long-time
Japan residents. It is literally a treasure trove of
information - which I also borrowed from for today's
article. Enjoy!

Frugally yours,
Wendy J. Imura

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This coming May, Norio Murakami, President of Google Japan
Inc., will be presenting, "The Past, Present and Future of

Date/Time: Tuesday, May 10th 7:00 pm
Location: City Club of Tokyo - Maple Room (Canadian Embassy
Language: English
Website: http://www.ea-tokyo.com
Email: info@ea-tokyo.com

+++ BARGAIN ROUNDUP: Golden Week Bargains

Yes, it's that time of year again. Only two more weeks
until Japan's largest extended holiday descends upon us.
This year's looking pretty good in terms of national
holidays: April 31st (a Friday), and May 3-5th (the
following Tues-Thurs) are all off, giving one the
possibility of nine days of extended leave using only
two days of holiday. However, most cheap international
tickets have long been snapped up, leaving domestic
travel as the only legitimate option. While expensive,
there are a few bargains available for people willing to
travel off peak or too non-traditional locations.
Here are a few ideas:

* ANA Hotel (Tokyo Zenniku Hotel) (8,000-12,200 yen/person)

Tokyo's deluxe ANA Hotel is offering a number of discount
plans for the Golden Week holiday (April 29-May 5th).
Located in the heart of Tokyo, and very convenient to
Roppongi and Akasaka, the hotel has recently been renovated
and is quite stylish. The bare bones no-meals plan
(price quoted above) is for one or two persons, and
guarantees a non-smoking room located on the 18-27F.
Having booked business guests in this hotel for 30,000
yen per person per night or more, this is an excellent deal!
(Search Rakuten's Travel page for more details).

* Shiraiso Grand Hotel (14,700-25,200 yen per person/2-4 people)

Certainly not the MOST frugal option, but 14,700 yen for an
ocean-view room at a luxury onsen hotel with two meals at
this time of the year is actually not a bad deal. A limited
holiday special (April 28-May 08), this Wakayama hotel
has a lovely sandy beach and rotemburo/inside bath. If
you live in the Kansai area, this might be a nice option
to escape the Osaka crowds at a reasonable price. (Also
a Rakuten Travel special plan.)

*Kyushu Trip (3 days, 2 nights - 23,700-63,700 yen)
Obviously, the best deals on this trip are on the off-peak
days: a May 8 Sunday departure is 23,800 yen, while a
Tuesday May 3rd departure is 63,700 yen. The other dates
during GW vary. This package includes a round-trip ticket
from Haneda to Fukuoka, Oita, Miyazaki, Nagasaki, or Kumamoto
airports, plus two overnight stays at any of six regional
cities, including Nagasaki. While you cannot choose your
exact hotel, they will guarantee a single or double room
with a private bath and toilet (most likely business hotels).
With the exception of airport and hotel, this travel plan
includes no mandatory tours or anything: just enjoy
yourself in Kyushu! All flights are on ANA.
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+++ FRUGAL TIPS (Cheap Kyoto Hotels)
*Frugal Kyoto ryokan/minshuku
"A nice and cheap place is the Station Ryokan Seiki. 5 min
from Kyoto St. Two people: 9,000 yen, Three people: 12,000
yen (tax not included). Breakfast is 600 yen. I'm not sure
if all rooms have bathrooms. There is no fancy dinner,
that's why it is cheap. Make your reservation early.

"I've stayed at a place called Ryokan Hinoomoto (075-351-4563).
It's been awhile but the last time I stayed there I was with my
mom and even she was impressed. It's very clean and basic and
very Japanese. Every night we'd come back to the room and there
would be sweets or fruit and tea. It was very nice. The ryokan
is in central Kyoto so it's easy to walk to a lot of places.
It's about 5,500 yen a night per person without meals."

"I've heard good (cheap) things about Gojo in Kyoto.

"Other options:
Kyoto Hostel Tour www.kyotojp.com
Hanakiya Inn. Book through www.hostels.com
Econo Inn Kyoto www4.ocn.ne.jp/~econoinn/eec/frame_e.htm
K's House Kyoto kshouse.jp "
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Written by: Wendy J. Imura (frugalwatch@japaninc.com)
Edited by: JI

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