National Health Insurance

Joining the National Health Insurance (NHI)

All individuals, except those who are enrolled in their workplace health insurance or are receiving welfare assistance, must join the National Health Insurance.

Notification of Eligibility Information or Issuance of Eligibility Certificate Card

  • For those with a My Number Health Insurance Card, an "Eligibility Information Notice (A4)" is provided. (The insurer information in the My Number Card will be automatically updated the day after the eligibility notification is submitted.)
  • For those without a My Number Card or who have not registered it as their health insurance card, an "Eligibility Certificate (Paper Card type)" will be issued.
  • When receiving medical treatment, always present your My Number Health Insurance Card or NHI Eligibility Certificate at the medical institution's counter.
  • Additionally, individuals aged 75 and older (or those aged 65 and older who are certified as disabled) will receive medical care through the Elderly Medical Care System.

Medical Treatment Benefits

When receiving treatment for illness or injury, 70% or 80% of the medical expenses will be covered according to the burden category (you will be responsible for the remaining 30% or 20%).
Other benefits include medical expenses, high-cost medical treatment benefits, high-level nursing care combined medical expenses, childbirth lump-sum benefits, and funeral expenses.

When to report changes

Please report any changes within 14 days of occurrence.
If you are enrolled in National Health Insurance, please bring your My Number Health Insurance Card or National Health Insurance Eligibility Certificate.
For foreigners, a residence card is also required.
For exampleRequired Documents
Joining the National Health InsuranceWhen transferring from another municipalityMoving-out Certificate from another city, town, or village
When quitting workplace health insuranceSocial Insurance Loss Certificate, etc.
When no longer a dependent under workplace health insuranceSocial Insurance Loss Certificate, etc.
When a child is bornMy Number Health Insurance Card or NHI Eligibility Certificate, Maternal and Child Health Handbook, proof of head of household’s bank account number (if applying for childbirth lump-sum, a certificate and receipt from the medical institution are also required)
When no longer receiving welfare assistanceNotification of welfare assistance termination
Cancellation of National Health Insurance When moving out to another municipalityMy Number Health Insurance Card or NHI Eligibility Certificate
When entering workplace health insuranceWorkplace Insurance Enrollment Certificate or Workplace Insurance Eligibility Certificate, etc., and NHI Insurance Eligibility Certificate
When becoming a dependent under workplace health insurance
When the insured diedNHI Insurance Eligibility Certificate, proof of funeral (such as a funeral attendance letter or funeral expenses receipt), and the chief mourner's bank details
Beginning to receive welfare assistanceNHI Insurance Eligibility Certificate, welfare assistance start notification
OtherWhen changing address within townMy Number Health Insurance Card or NHI Eligibility Certificate
When there is a change of household head or name
When a household is divided or comes together
When registering a separate address for school attendanceMy Number Health Insurance Card or NHI Eligibility Certificate, Student Registration Certificate
When you lost your insurance card (or when it becomes dirty and can not be used)Identification (such as an expired qualification certificate)
When your period of stay has been renewed (for foreigners)New residence card, My Number Health Insurance Card or NHI Insurance Eligibility Certificate

National Health Insurance and Traffic Accidents

If you are injured in a traffic accident, the responsible party is usually required to pay for your treatment. You can receive treatment under NHI, but the insurance will later claim the costs from the responsible party. If using NHI for treatment, you must report the accident.

Documents to bring

  • My Number Health Insurance Card or NHI Eligibility Certificate
  • Personal seal (hanko)
  • Traffic accident certificate

High-Cost Medical Expenses

 If you present an "Eligibility Certificate for Ceiling-Amount Application" at the medical facility counter, the payment will be limited to the ceiling amounts as listed below. You can apply for the "Eligibility Certificate for Ceiling-Amount Application" at the Town Hall (Health and Welfare Division, Health Insurance Section). Please bring your My Number Health Insurance Card or NHI Eligibility Certificate, and a personal seal. If you cannot apply for the ceiling amount certification in advance, you will need to pay the costs upfront at the counter, then apply to NHI for reimbursement. Once approved, you will be reimbursed for the high-cost medical expenses.                                    

Self-payment limit (monthly) for individuals less than 70 years old

Income categorySelf-Payment Ceiling
PrincipleMultiple Times
Taxable householdIncome of over 9.01 million yen252,600 yen + (medical expenses - 842,000 yen) x 1%140,100 yen
BIncome 6 ~ 9.01 million yen or less167,400 yen + (medical expenses -588,000 yen) x 1%93,000 yen
CIncome of 2.1 ~ 6 million yen or less80,100 yen + (medical expenses -267,000 yen) × 1%44,400 yen
DIncome less than 2.1 million yen57,600 yen44,400 yen
ETax-free household35,400 yen24,600 yen
  • 【A】When there is a NHI insured person (including the fictitious head of household) in the household who is subject to resident tax, and the total gross income after basic deductions of the NHI insured person (excluding the fictitious head of household) in the household exceeds 9.01 million yen
  • 【B】 When there is a NHI insured person (including the fictitious head of household) in the household who is subject to resident tax, and the total gross income amount after basic deductions of the NHI insured person in the household (excluding the fictitious head of household) is more than 6 million yen but not more than 9.01 million yen
  • 【C】 When all the insured persons in the household (including the fictitious head of household) are subject to resident tax, and the total gross income after basic deductions of the insured persons in the household (excluding the fictitious head of household) is more than 2.1 million yen but less than 6 million yen
  • 【D】When all the NHI insured persons in the household (including the fictitious head of household) are subject to resident tax and the total income amount after basic deductions of the insured persons in the household (excluding the fictitious head of household) is 2.1 million yen or less
  • 【E】 When all of the NHI insured persons in the household (including the fictitious head of household) are exempt from resident tax

*If there is someone in your household who has not filed an income tax return, the household's income cannot be determined and you will be treated as "Income Category A."Regardless of whether you have an income or not, you must file an income tax return (resident tax return and final tax return).

*If you have received high-cost medical care benefits exceeding the limit four or more times within the past 12 months, you will be considered to have received multiple payments.

Self-payment limit (monthly) for individuals over 70 years old

Income categoryOutpatient (individual unit)Outpatient + hospitalization (household unit)Multiple Times
Persons with income comparable to active workers (4)Income of over 9.01 million yen252,600 yen + (medical expenses - 842,000 yen) × 1%140,100 yen
Income above 6 million yen but below 9.01 million yen167,400 yen + (medical expenses -588,000 yen) x 1%93,000 yen
Income over 2.1 million yen and 6 million yen or less80,100 yen + (medical expenses -267,000 yen) × 1%44,400 yen
General 318,000 yen (maximum annual amount 144,000 yen)57,600 yen44,400 yen
Low income persons 28,000 yen24,600 yenN
Low-income persons 18,000 yen15,000 yenN
  • Persons with income comparable to active workers (4): If there are NHI insured persons aged 70-74 with taxable income of 1.45 million yen or more in the household.
・Other cases will fall under General 3 or Low-income 2/1 depending on specific conditions.   
  1. National insurers aged 70 to 74 are alone for households, income is less than 3.83 million yen
  2. Even if income is more than 3.83 million yen, some people have been transferred to the latter-stage elderly medical care system in the same household, and the total income is less than 5.2 million yen
  3. There are two or more national security insurers aged 70 to 74 in households, and the total income is less than 5.2 million yen
  4. Household with new insured who will be 70 years old after January, Heisei 20, the total of the gross income after deducting the basic insurance premiums of 70-74 year-old insured (excluding fictitious household head) is 2.1 million yen Less than
  • [Low-income person 2]
When the household's National Health Insurance Insurer (including fictitious household head) is not subject to inhabitant tax
  • [Low-income person 1]
In the case that the income is 0 yen, corresponding to low-income person 2, with the individual pension deduction amount of 800,000 yen for National Health Insurance (including fictitious household head) aged between 70 and 74
  • [General household 3] In case that it does not correspond to any of the above income divisions

*If there is someone in your household who has not filed an income tax return, the household's income cannot be determined and you will be treated asGeneralRegardless of whether you have an income or not, you must file an income tax return (resident tax return and final tax return).

*If you have received high-cost medical care benefits exceeding the limit four or more times within the past 12 months, you will be considered to have received multiple payments.

National Health Insurance Tax

For details, please see the following page.

Niseko Town National Health Insurance Data Health Plan

For details, please see the following page.

Niseko Town Health App Project

Starting in June 2025, we have launched the health app "kencom" for Niseko Town National Health Insurance subscribers aged 19 and over.
For more details, please see the following page.

Application and notification forms

You can download the file from the following link:
(For procedures not listed here, please contact us below.)

Inquiries 

Health & Welfare Division, Insurance and Medical Care Section
TEL:0136-56-8840
FAX:0136-44-3500