Japan is renowned for its efficient and accessible healthcare system, offering universal coverage to its citizens and residents. However, for expats, students, or travelers, it is essential to fully understand this system and purchase appropriate international health insurance.
The Health System in Japan and the Importance of International Health Insurance
The Japanese health system: universal coverage
Japan’s healthcare system is based on a universal health insurance model, which provides medical coverage to all residents, whether Japanese citizens or foreigners. This model is renowned for providing quality care at affordable prices, thanks to a well-organized structure regulated by the government.
The two main health insurance plans
National Health Insurance (Kokumin Kenko Hoken) : This plan is designed to cover residents who are not employed by a company, such as the self-employed, students, retirees, and job seekers. Expatriates and foreigners residing in Japan for more than three months must also enroll in this plan if they are not eligible for employee insurance. Premiums are income-based, allowing the cost of insurance to be tailored to individual economic circumstances. Typically, policyholders pay about 30% of medical expenses, while the government subsidizes the remaining 70%. However, certain categories of the population, such as those over 70 and low-income households, are eligible for even more coverage, with reimbursement of up to 90% of costs.
Employee Health Insurance (Kenko Hoken) : This plan is mandatory for employees and is managed by companies and unions. Unlike National Health Insurance, where contributions are paid directly by residents, under Kenko Hoken, contributions are shared between the employer and employee. One advantage of this plan is that the employee and their family receive coverage without having to purchase additional insurance. As with National Insurance, medical expenses are largely subsidized, with 70% to 90% of the cost of care covered.
The limits of the system for expatriates
Although efficient, the Japanese healthcare system presents challenges for the French. First, the language barrier can complicate access to care, as few doctors speak English. Furthermore, the reimbursement model requires patients to pay medical expenses upfront before being reimbursed, which can be a barrier for expensive care, such as hospitalizations.
The cost of specialized and non-reimbursed care
Although most basic care is well covered, some treatments or services are not covered by Japanese health insurance plans. This often includes specialized care or alternative medicine treatments. For example, complex dental care, such as implants, orthodontic treatments, or certain prosthetics, is often only partially reimbursed, or not covered at all. Similarly, the cost of glasses or contact lenses can be high and is not fully covered by Japanese insurance.