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National Health Insurance

 

With National Health Insurance...

With National Health Insurance...
 

We disease contribute for insurance tax with all the members so that medical care is received in peace when had injury, and is system that it is said to bear necessary medical expenses. (please inquire for national health insurance tax to Tax Affairs Section.)

 

 

Member (person insured) of National Health Insurance

Member (person insured) of National Health Insurance
 

Person taking out health insurance and medical system for elder senior citizens of the workplace, all people except person who is on welfare become member (person insured) of National Health Insurance.


  Person who joins

◆Person of self-employed people running shops

◆Person who runs agriculture and fishery

◆Person who retired, and stopped health insurance of the workplace

◆Person who is behind part parttimers, and does not take out health insurance of the workplace

◆Foreigner that it was admitted that we were doing alien registration and stayed in Japan more than one year

Participation is household unit, and each family is person insured. Identification of person insured became card form by one.

 

Report of participation, withdrawal

Report of participation, withdrawal
 

When you take out National Health Insurance of Yuasa-cho or you withdraw, please report by all means within 14 days.


  When we join

◆ When we moved into from other municipalities

◆ When we withdrew from health insurance of the workplace

◆ When we were not on welfare

◆ When child was born

Insurance tax is collected retroactively to point of participation (not report day) when we acquired qualification of person insured when report is late.


  When we withdraw

◆ When we are transferred to other municipalities

◆ When we took out health insurance of the workplace

◆ When we have begun to be on welfare

◆ When member died


  It is ... by report at such time

◆ When it was moved to in town

◆ When family nurturer, full name changed

◆ When we lost health insurance card and we polluted and were not usable

◆ When we became a target of retiree health insurance

 

Retiree health insurance

Retiree health insurance
 

Person and the dependent who resign from company, and receive pension take out National Health Insurance and receive medical care in retiree health insurance.


  Target person 

  ※The person (person who fits all the following items)

◆ It is person younger than 65 years in members of National Health Insurance

◆ In recipients of welfare annuity and mutual pension, participation period of pension is more than 20 years or person having after 40 years old pension participation period more than ten years

  ※ Dependent (person who fits all the following items)

◆ Spouse or relative in the third degree who lives together with retirement person insured, and maintains living by income of the person

◆ It is person younger than 65 years in members of National Health Insurance

 

When company was resigned from

When company was resigned from
 

When company is resigned from, we will have you select whether health insurance of the workplace is continued voluntarily, or you take out National Health Insurance.


  Any continuation

We take out health insurance of the workplace more than two months and can continue health insurance of the workplace sequentially for two years if we apply within 20 days after the retirement. (please ask association of company where you worked for or national health insurance in detail.)

 

Payment that is received in National Health Insurance

Payment that is received in National Health Insurance
 
Payment of medical treatment

Disease if show health insurance card at window of medical institution of the National Health Insurance handling when had injury, only pay a part of the medical expenses, and can receive medical treatment. National Health Insurance bears remaining expense.

 
 Self-pay ratio
Compulsory education
Until attendance at school
After the compulsory education attendance at school
Until ... 69 years old
We are younger than 75 years old 70 years old or older
General / low place profit II, I Income earner at the same level as active play
20% 30% 20% 30%
※One born in before April 1, 1944 is 10% as special measures.
 
Allowance for family medical expenses

At bone fracture by bonesetter doing the handling of National Health Insurance, time when we underwent surgical operations such as sprains, as for massage, tension, moxibustion, the massage that admitted that doctor is necessary therapeutically, surgical operation is received in co-payment like medical institution. In addition, National Health Insurance examines, and for insurance benefit is refunded later by application when we purchase harness for treatment that doctor recognized as need therapeutically and pay in full. Statement of position, wearing certificate of doctor and receipt are necessary for application. For more details, please contact person in charge of healthy promotion.

Style of allowance for family medical expenses supply application is this.

 
Large amount allowance for family medical expenses

When foreheads (meal charges and hospital room not covered by a health insurance plan charges are excluded) which paid to medical institutions during one month from 1st of month to the last day exceed the self-pay ceiling as for the large amount allowance for family medical expenses, thing that exceeded is system refunded as large amount allowance for family medical expenses. As you notify applicable person two or three months after the moon which received medical treatment, please keep receipt by all means.

Style of expensive allowance for family medical expenses supply application is this.

We can assume payment at windows such as medical institutions to the self-pay ceiling when we show "ceiling application certificate" to medical institutions when we are hospitalized. As you issue "ceiling application certificate" by person in charge of healthy promotion, please refer to person in charge of healthy promotion in detail. We may still less issue (but "ceiling application certificate" is not issued, but, about belonging to "general income earner" "III at the same level as active play" in 70 years old or more, it is similar handling) when National Health Insurance tax is behind with.

 
 1.The self-pay ceiling
 

 The self-pay ceiling (per one month) of table 1 one younger than 70 years

Division
Income requirements
The self-pay ceiling
After the year fourth
A
Income after basis deduction
More than 9,010,000 yen
252,600 yen +
(medical expenses -842,000 yen) *1%
140,100 yen
i
Income after basis deduction
... more than 6 million yen
9,010,000 yen or less
167,400 yen +
(medical expenses -558,000 yen) *1%
93,000 yen
Cormorant
Income after basis deduction
... more than 2,100,000 yen
6 million yen or less
80,100 yen +
(medical expenses -267,000 yen) *1%
44,400 yen
Oh
Income after basis deduction
2,100,000 yen or less
57,600 yen 44,400 yen
o
 
Residence tax tax exemption
 
 
35,400 yen
 
24,600 yen

※The presentation of "ceiling certificate" is necessary at window of medical institution. For more details, please contact person in charge of healthy promotion.

Household where person is where is not reported income to becomes a.

・ When we reach the amount of upper limit more than four times in one household for the past 12 months, the ceiling falls down after the fourth.

・If there are multiple medical institutions (separate in hospitalization and the outpatient department) which paid self-burden more than 21,000 yen in one household before the same month, we add up those sums and are provided with sum beyond the ceiling.

※The self-pay ceilings such as chronic kidney failure, hemophilia giving artificial dialysis 10,000 yen (as for the high-ranking income earner 20,000 yen)
 It becomes in this. As applicable person has to submit "*tei*byo*yoju*sho" to window of medical institution, we apply to person in charge of healthy promotion, and let's receive grant.

 
 

The self-pay ceiling of 74 years old from table 2 70 years old

Division
Burden
Ratio
The large amount of allowance for family medical expenses self-pay ceiling
Outpatient department (together with individual)  Foreign + hospitalization (household unit)
gen
Position
Regular
See
*1
Taxable income
More than 6,900,000 yen
30%
252,600 yen
+ (medical expenses -842,000 yen) *1%
<< after the fourth per year 140,100 yen >>
Taxable income
More than 3,800,000 yen
167,400 yen
+ (medical expenses -558,000 yen) *1%
<< after the fourth per year 93,000 yen >>
Taxable income
More than 1,450,000 yen
80,100 yen
+ (medical expenses -267,000 yen) *1%
<< after the fourth per year 44,400 yen >>
General * 2
20%
*5
18,000 yen
Annual upper limit 144,000 yen
※August - next year July
57,600 yen
<< after the fourth per year 44,400 yen >>
Low-income person
(residence tax tax exemption household)
*3
20%
*5
8,000 yen 24,600 yen
*4
15,000 yen
(* 1) Income earner at the same level as active play: Person who has National Health Insurance person insured younger than 75 years 70 years old with more than 1,450,000 yen of residence tax taxable income or older in the same household. But, in the case of less than 5,200,000 yen, under of 3830000 yen per person, it is by application in two or more in division of "the public", and total incomes of National Health Insurance person insured younger than 75 years burdens 20% 70 years old or older.
(* 2) The public: Person who has person of residence tax taxation among family nurturer of the same household and National Health Insurance people insured alone. Household where person is where is not reported income to becomes treated like "the public".
(* 3) Low-income person II: Person that family nurturer of the same household and National Health Insurance person insured are residence tax tax exemption households.
(* 4) Low-income person I: Family nurturer of the same household and National Health Insurance person insured are residence tax tax exemption, and each income of the household subtracts expense
Person who is 0 yen when we deducted (pension income calculates deductions as 800,000 yen).
(* 5) One born in before April 1, 1944 is 10% as special measures.
◎The presentation of "ceiling certificate" is necessary at window of medical institution. But at first please refer to person in charge of health promotion on the telephone as ceiling certificate is not issued in the one corresponding to "public" "III at the same level as active play".
◎The self-pay ceiling of 75 years old arrival month becomes a half.
◎The patient's share of medical expenses ceilings such as chronic kidney failure, hemophilia giving artificial dialysis are 10,000 yen (when they receive authorization about chronic kidney failure that high-ranking income earner carries out artificial dialysis 20,000 yen). As applicable person has to submit "specific illness medical treatment receipt" to window of medical institution, let's receive grant in people in charge of healthy promotion.
 
2. Calculation method of refund

Based on application of family nurturer, National Health Insurance calculates refund by the following method.

(1) Household only for person younger than 70 years

We calculate outpayment using table 1.

(2) Household where there is person younger than 75 years 70 years old or older

①Using table 2, we calculate every individual about outpatient department of person 70 years or older.

②We match hospitalization with outpatient of person 70 years or older and, using table 2, calculate.

③①We add up ② in this and calculate outpayment about person 70 years or older.

④Using table 1, we calculate outpayment in conjunction with person younger than 70 years.

⑤③Sum that added up ④ in this becomes outpayment of the whole household.

 
Meal allowance for family medical expenses at admission

Hospitalized meal charges pay their own following standard burden, and National Health Insurance bears the remainder as meal allowance for family medical expenses at hospitalization.

Meal charges (self-burden per one meal) when we were hospitalized

The a i way public, active regular
460 yen
o
Low-income person II
Hospitalization until 90 days 210 yen
It is hospitalization more than 90 days in the past 12 months
160 yen
Low-income person I 100 yen
※As O low II, low I has to show "ceiling application, standard burden reduction certificate" to medical institution, let's receive grant in people in charge of health promotion.
※When payment that we surpass the self-burden mentioned above is done, we can receive refund of thing that exceeded by application of family nurturer.
 

Food expenses, residence costs when we were admitted to medical treatment bed (70 years old or older)

  The food expenses (per one meal) Residence costs (per 1st)
The public (person except the following) 460 yen
(with some medical institutions 420 yen)
320 yen
Low-income person II 210 yen 320 yen
Low-income person I 130 yen 320 yen

※ It does not become targeted for supply of large amount allowance for family medical expenses.

※ When residence tax tax exemption household, person of low-income person II, I are hospitalized, "ceiling application, standard burden reduction certificate" is with need
Please apply in rimasunode, people in charge of healthy promotion.

 
Delivery child care lump sum 420,000 yen (in the case of the outside targeted for the obstetrics medical care compensation system addition 390,000 yen)

※ Delivery child care lump sum is paid to medical institutions by contracting medical institutions and direct payment at birth, and window burden will be expected to pay the balance beyond 420,000 yen (390,000 yen).

※ When we do not hope for case that expenses did not exceed 420,000 yen (390,000 yen) and direct payment, we will have person in charge of healthy promotion request receipt after attachment.

 
   Funeral costs 30,000 yen

※ When National Health Insurance person insured died, person (the funeral chief mourner) performing the funeral is paid funeral costs.

 
   Large amount care adding up allowance for family medical expenses

 We add up medical insurance until July and self-burden of each care insurance in - next year in August and are provided when we exceed the established ceiling. For more details, please refer to healthy person in charge of promotion or person in charge of care insurance.

 
   Reports such as traffic accidents

 When we use National Health Insurance when medical treatment is received by act of third party including traffic accident, report is necessary. For more details, please contact person in charge of healthy promotion.

 

Medical system for elder senior citizens

Medical system for elder senior citizens
 

Medical system for elder senior citizens is medical insurance system that we intended for 75 years old or older toward all of (including person having obstacle above a certain level 65 years or older).

Wakayama elderly aged 75 or over medical care interjurisdictional affiliation performs administration (insurer), but performs window duties such as reception desk of documents of application and report, the collection of premium, consultation about system in the municipalities. Please contact person in charge of healthy promotion for thing and consultation not to understand.

 

◆Identification of person insured

 



◆About premium

 



◆Payment that is received

 

Identification of person insured

Identification of person insured
 

Identification of person insured of medical system for elder senior citizens (health insurance card) is issued to one by one piece. Please show identification of this person insured by all means if you have a medical examination to medical institutions.

As identification of person insured is to perform update (not precocious only for this when there is nonpayment of premium) all at once every year on August 1, we send out every year from government office by the end of July. In addition, we send out to person becoming 75 years old to arrive by the end of the last month of birth month.

When we lose identification of person insured and we pollute and are not usable, please apply for regranting in people in charge of healthy promotion.

 

About premium

About premium
 

Wakayama elderly aged 75 or over medical care interjurisdictional affiliation decides premium of medical system for elder senior citizens. As for the premium, it is the total of the amount of per capita rate and the amount of income allotment that all of you bear equally to bear according to income of the last year. As for the low income, premium is reduced more.

There are two kinds of ordinary collection to pay by special collection deducted from pension which we put and receive in one of premium and financial institution, government office window and fund transfer.

As a general rule, please put premium by special collection, but is deducted from pension by condition of the amount of pension and the amount of premium; may not collect extra. In that case, please pay with sent payment notice before date as you are replaced by ordinary collection.

Please contact person in charge of healthy promotion for consultation about premium including case having difficulty in payment of premium.

 

Payment that is received

Payment that is received
 

As for the insurance benefit received in medical system for elder senior citizens, thing which is approximately similar to National Health Insurance is received.


Payment (when treated) of medical treatment

Self-pay ratio when we were treated for medical institutions is 10%.

But income earner (person insured of medical system for elder senior citizens with more than 1,450,000 yen of amount of standard of imposition of residence tax and person insured who is in household same as the one) at the same level as active play becomes 30%.

※ In one judged to be income earner at the same level as active play, gross earnings burden 10% when they apply for of less than 3,830,000 yen (with less than 5,200,000 yen in gross earnings that they included member of household in when the same household needs more than 2 one 70 years or older).

 
Allowance for family medical expenses (when we paid our own in full out of necessity)

As for the cases that we received, refund is received by application without having time when we made assistive devices such as corsets by instructions of doctor and identification of person insured.

 
Large amount allowance for family medical expenses (when monthly medical expenses became large)

As you send supply application from government office when person insured of medical system for elder senior citizens corresponds to large amount allowance for family medical expenses by the following standards, please submit to person in charge of healthy promotion. In addition, the later large amount of allowance for family medical expenses does not need application when we will submit application once (transferred to account registered by the last application).

 

The self-burden ceiling

Division Burden ratio The self-pay ceiling
Outpatient department (we calculate every individual) Foreign + hospitalization (the ceiling every household)
 Income earner at the same level as active play 30% 44,400 yen 80,100 yen + (medical expenses -267,000 yen that it cost) *1% ※4
 The public ※1 10% 12,000 yen 44,400 yen
 Low-income person II ※2 8,000 yen 24,600 yen
 Low-income person I ※3 15,000 yen

※Person of household where there is person of residence tax taxation among members of one household alone. Household where person is where is not reported income to is public handling
 itonarimasu.

※Person that all two households are residence tax tax exemption households.

※All three households residence tax tax exemption and income 0 yen (as for the deductions from income such as basis deduction, allowance for old person, spousal deduction line trap
 Is; is person of household of).

※When we receive large amount of medical expenses more than four times of four years, after the fourth, it is 44,400 yen.

※  As "ceiling application, standard burden reduction certificate" is necessary for person of low-income person II, I when we are hospitalized, please apply in people in charge of health promotion.
Window burden at admission is with the range of the ceiling when we show "ceiling application, standard burden reduction certificate" with medical institutions
rimasu.

 
Meal allowance for family medical expenses at admission
The public, income earner at the same level as active play One meal of 260 yen
Low-income person II  Hospitalization until 90 days One meal of 210 yen
 Hospitalization (the ever 12-month hospitalization days) more than 90 days One meal of 160 yen
Low-income person I One meal of 100 yen
 

Food expenses, residence costs when we were admitted to medical treatment bed

  The food expenses (per one meal) Residence costs (per 1st)
The public (person except the following) 460 yen 320 yen
Low-income person II 210 yen 320 yen
Low-income person I 130 yen 320 yen
Old-age welfare pension recipient 100 yen 0 yen

※ It does not become targeted for payment of large amount of medical expenses.

※ As "ceiling application, standard burden reduction certificate" is necessary for person of low-income person II, I when we are hospitalized, please apply in people in charge of health promotion.

 
 Funeral costs (when person insured died)

Person (the chief mourner) who held funeral service is paid 30,000 yen as funeral costs.

 
 Large amount care adding up allowance for family medical expenses

We add up medical insurance until July and self-burden of each care insurance in - next year in August and are provided when we exceed the established ceiling. For more details, please refer to healthy person in charge of promotion or person in charge of healthy employee services care insurance.

 
 Reports such as traffic accidents

When we use identification of person insured when we receive medical treatment by act of third party including traffic accident, person in charge of healthy promotion needs report by all means.

 

 Downloading such as styles from Wakayama National Health Insurance group federation HP

 →http://www.kokuhoren-wakayama.or.jp/contents/other/style_download.html

 

Subsidy program of medical expenses

Subsidy program of medical expenses
 

In healthy employee services, we sell old man (67 years old - 69 years old) and person with a disability having low income, single-parent home, subsidy programs of medical expenses for child until junior high school graduation.

 

・As you issue identification of recipient who is different from identification of person insured of medical insurance taking out, please show in total when it is had a medical examination in hospitals.

・As a general rule, with medical institutions in Wakayama, window burden becomes unnecessary (old man medical expenses bear 10%). But meal charges, hospital room not covered by a health insurance plan charges at admission and uninsured medical treatment, document charges are out of the furtherance.

・We refund copayment when we have you request receipt (the original) from healthy employee services after attachment when it is had a medical examination with medical institutions of outside the prefecture.

・When medical insurance to take out changed, report is necessary if it was off object of each system.

・We handle about the following systems in healthy employee services.

 

Old man medical expenses

Old man medical expenses
 

When it applies to all following conditions among people from 1st of the moon arriving at 67 years old to the last day of the moon arriving at 70 years old, self-pay ratio of medical expenses becomes 10%.

①Residence tax tax exemption household

When residence tax (town prefectural tax) is not imposed all the one belonging to the same household.

②Incomes of the last year are less than standard

When the in the previous year income (including tax-free incomes such as survivor's pension and disability pension, pension) totals of one belonging to the same household of one year are less than the following standards.

 It is household alone :  1 million yen

 Two households :  1,400,000 yen

 Three households :  1,800,000 yen (we add by 400,000 yen whenever we increase by following one)

③Financial assets are less than standard

When the total of financial assets (securities such as deposits and savings, government bonds, stocks) which one belonging to the same household holds is to the 3,500,000 yen X household number of people.

④There are not assets which can conjugate

When we are not owning assets such as real estate except living land house now.

⑤We are not supported by person of the other household

When we are not supported by person belonging to other households (specifically following time)

 ・ We do not become support relative in the tax law of income tax, town prefectural tax

 ・ We do not become dependent of medical insurance such as health insurance

 

Severeness mind and body child with a disability person medical expenses supply system

Severeness mind and body child with a disability person medical expenses supply system
 

We provide with copayment to pay when person with severe psychosomatic disorder received medical care at hospitals.

  Person who is targeted for payment

◆One where is corresponded to to certificate of the physically disabled 1, the second grade, nursing notebook A1, the A2, Special Child Dependent's Allowance first grade. (income restrictions existence)

◆When person corresponded to to the certificate of the physically disabled third grade was hospitalized. (residence tax tax exemption household)

Even if one 65 years or older corresponded newly as above from August 1, 2006, severeness mind and body child with a disability medical expenses system was not got.

 

Single-parent home medical expenses supply system

Single-parent home medical expenses supply system
 

We provide with copayment to pay when father of single-parent home or mother and child received medical care at hospitals.

  Person who is targeted for payment

◆ Home (there are income restrictions) where boy without spouse or girl supports child (until first March 31 of afterward to reach 18 years old)

 

Infants medical expenses supply system, child medical expenses supply system

Infants medical expenses supply system, child medical expenses supply system
 

We provide with copayment to pay when child until junior high school graduation received medical care at hospitals.

  Person who is targeted for payment

◆Infants (object of infants medical expenses) from 0 years old to before elementary school attendance at school

◆Children (object of child medical expenses) from elementary school entrance to school to junior high school graduation

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453217
[Yuasa-cho government office]
 
 〒643-0002
 
 Wakayama
 
 Yuasa-cho, Arida-gun
 
 668-1, Aoki
 
TEL
 0737-63-2525

FAX
 0737-63-3791
 
  From 8:30 a.m.
   Until 5:15 p.m.
(shut agency on Saturday, Sundays and holidays)
  
 
 Number of the households 5,447 zone
 A population of 12,110 people
 Man    5,688 people
 Woman    6,422 people
 As of November 1, 2018
<<Yuasa-cho government office>> 〒 643-0002 668-1, Aoki, Yuasa-cho, Arida-gun, Wakayama TEL: 0737-63-2525 FAX: 0737-63-3791