A good result with Japan’s health insurance system


Traveling a lot you begin to be truly thankful for what we take for granted in Japan.

I am writing this outside of Washington D.C., and, having been a week in China before this there is one thought that crosses my mind a couple times each day — “If only I was in Japan.”

It is easy to complain, but just take a quick trip awayand you will quickly realize, as I am now, how much we take for granted.

Medical expenses

We asked for any experiences from our readers using the Japanese Medical Insurance for overseas expenses and we received a wonderful letter from Hugh, who had a pretty good experience with the system.

“Dear Lifeline; a few years back when I was in Yamagata, I took a few weeks to visit home over the summer. While at home I availed myself of every doctor I could think of as my experience with Japanese doctors at that time was not encouraging. I inquired about reimbursement and was given a contact address. I gathered all my medical receipts and begin to go through them comparing expenses to the list of approved items.

I began to write up a long, detailed list explaining the various expenses. Then I changed my approach and simply listed the overseas receipts, included the actual receipts themselves and sent it in. Two months later 100 percent of the charges landed in my bank account.

There is a very important clause in the National Health Insurance rules that state that all expenses greater than 63,000 yen incurred in one calendar year at one medical institution should be reimbursed.

If your out of pocket expenses exceed that amount, you need only travel to your local ward or city office for the reimbursement.

Recently I had knee surgery and was hit with a very large bill, even with National Health Insurance. The next day I visited the City Office. I was asked to fill out a few forms and 20 minutes later the lady came back with the cash – 85 percent of the total I had paid out.

It was not until two months later that I figured out what it was. I received a letter in the mail saying that the “loan” I had received had been canceled and I would be receiving shortly the complete amount.

I have received excellent care and was happy to have had my surgery done in Japan.” — Hugh in Yamagata

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Dear Lifelines; My question concerns re-entry. I have finished one visa and am in the process of receiving a new visa since my previous visa expired and I have not received my new new one yet.

My father is extremely ill and I need to visit him but was told by immigration that if I left without a re-entry permit my 20 years of residency would be finished. Is there anything I can do?” — Nick in Nagoya

Dear Nick; Two words you need to memorize are honne and tatemae. Tatemae is the official or outward reality. Honne is the true or actual reality. Everything in Japan operates with those two sides. Find the honne and you will be fine.

When you call up immigration, the answer you will receive is the tatemae. The reality, or honne, of the situation is that if you follow proper procedure immigration, will generally help, particularly if there is a family situation.

During the limbo period, technically you may not leave the country, as is the case in any other country. In reality, though, if you can demonstrate a family emergency and have a professional do the paperwork you should be able to leave and return.

For both of the above you need to immediately go to a gyosei shoshi, who specializes in immigration. They go to the Immigration Office daily, know everybody there, are trusted and will be able to negotiate with the department to get a good result for you.

We can start you on your way with two such people: Mr. Inomoto at 03-3582-7482, and Mr. Nakai at www.tokyovisa.co.jp.