PUBLIC INSURANCE SYSTEM
日本国内に住所のある人は、いずれかの公的医療保険に加入しなければなりません。民間の事業所に努めている授業員とその家族は健康保険、自営業者やその家族などは国民健康保険、75歳以上の者は原則として後期高齢者医療制度に加入します。 健康保険では、一定の事業者の従業員（被保険者）とその家族（被扶養者）の業務外の事由による疾病、負傷、出産、死亡などについての保険給付が行われます。被保険者の業務上と通勤途上の事由によるものは労災保険から保険給付が行われます。被扶養者には保険料の負担はありません。被扶養者と認定されるには年収が130万円未満（60歳以上または一定の障害者は180万円未満）で、かつ被保険者の年収の半分未満であることが必要です。2017年10月より、大企業の短時間労働者は年収106万以上の場合、勤務先の健康保険の被保険者となり年収130万円未満でも被扶養者になりません。全国健康保険協会管掌健康保険（協会けんぽ）に加入している場合保険料は、都道府県ごとに保険料率が設定され労使折半となります。標準報酬月額および標準賞与額に同じ保険料を乗じて計算されます。医療を受けた場合は療養の給付家族療養費として保険給付がありますが、一部負担をします。義務教育就学前の子は2割、70歳未満は3割、70歳以上75歳未満は2割をそれぞれ負担します。同一月の一部負担金が一定額を超えた場合、超えた分について高額療養費が支給されます。他にも傷病手当金、出産手当金、出産育児一時金、家族出産育児一時金といった保険給付が受けられます。 市区町村に住所があり、職域保険（健康保険など）の被保険者と被扶養者や生活保護を受けている世帯を除き、国民健康保険に加入しなければなりません。健康保険とは異なり、業務上か否かにかかわらず保険給付が行われます。療養の給付の一部負担割合、高額療養費、出産育児一時金などは健康保険と同様です。 国民健康保険は医療分保険料（74歳以下の医療費に当てる分）、支援金分保険料（後期高齢者医療制度の加入者の医療費に充てる分）、及び介護分保険料（介護費に充てる分、40歳から64歳の方が対象）で構成されています。さらに、それぞれについて、所得割額（国保加入者全員の前年の所得から算出）、均等割額（加入者数に応じる）、平等割額（一世帯あたりにかかる）により構成されています。 令和元年度を例にとると、札幌市在住の人は次の額面を合算した金額が1年分の医療分保険料になります。前年の所得から33万円を差し引いた金額に9.78％を乗じた所得割額。18120円に加入者数を乗じた均等割額（人数割額）。平等割額（世帯割額）である33010円です。所得とは給与所得（給与収入-給与所得控除）、年金所得（公的年金等収入-公的年金等控除）、事業所得（事業収入-必要経費）などの合計で、社会保険料控除や扶養控除などの各種所得控除前の金額です。支援金分保険料は、所得割額として前年の所得から33万円を差し引いた金額に2.97％を乗じた金額、均等割額として5530円に加入者数を乗じます。平等割額として10070円を乗じた金額の合算です。介護保険料は所得割額として前年所得から33万円を差し引いた金額に2.56％を乗じた金額、均等割額として5310円に加入者数を乗じた金額、平等割額として7440円の合算です。 75歳になると誰もがそれまで加入していた健康保険からは脱退して後期高齢者医療制度に加入しなければなりません。
If you have an address in Japan, you must have one of the public health insurance. In principle, employees and their families working at private offices are enrolled in health insurance, self-employed people and their families are as well individually enrolled in the Health Insurance System, the elderly at the age of 70 more enrolled in Late elderly care system Health insurance provides insurance benefits for illness, injury, childbirth, death, etc. due to reasons outside the work of employees (insured persons) and their families (dependents) of certain business operators. Insurance benefits are provided from workers’ compensation insurance for reasons on the business and on the way to work of the insured person. Dependents are not covered by insurance premiums. To be recognized as a dependent, the annual income is less than 1.3 million yen (180 million for the people over 60 years of age or a certain disability), and less than half of the insured person’s annual income. Starting in October 2017, if the number of part-time workers of large companies has an annual income of 10.6 million or more, you will not be a dependent even if you become an insured person of your employer’s health insurance and earn less than 1.3 million yen a year. If you are enrolled in health insurance (Association Kenpo) of the National Health Insurance Association, the insurance premium rate is set for each prefecture and it becomes labor-management half. Calculated by multiplying the standard monthly remuneration and the standard bonus amount by the same premium. If you receive medical treatment, there is insurance benefits as a family medical treatment expense, but you will be paid a part of it. 20% of preschool children in compulsory education, 30% for under-70, people between the ages of 70 and 75 will be responsible for 20 percent of each. If a partial contribution in the same month exceeds a certain amount, a high medical treatment fee will be paid for the excess. In addition, insurance benefits such as injury and illness allowance, maternity allowance, childbirth and child care lump sum, family birth and child care lump sum are available. You must enroll in the National Health Insurance, except for the insured person of the office insurance (health insurance, etc.) and dependents and households receiving welfare. Unlike health insurance, insurance benefits are provided regardless of whether they occur during working or not. The percentage of medical treatment benefits, high medical expenses, and lump-sum payments for childbirth and childcare are the same as health insurance. National Health Insurance issued for medical insurance (for medical expenses for people under74 years of age), support premiums (for medical expenses for long-term elderly health care systems), and long-term care insurance premiums (for nursing care expenses, 40 to 64 years old). In addition, each is composed of an income discount (calculated from the income of all National Health Insurance subscribers the previous year), an equal discount (depending on the number of subscribers), and an equal discount (it takes per household). In the year of 2019 for example, if you are a resident of Sapporo City, the combined amount of the following face value will be one year’s medical insurance premium. Income discount multiplied by 9.78%from the previous year’s income minus 330,000 yen. 18120 yen is an equal discount multiplied by the number of subscribers (number of people’s discount). The equal discount is 33010 yen. Income is salary income (salary income – salary income deduction), pension income (public pension income – public pension deduction, etc.), business income (business income). The amount before various income deductions, such as social insurance premium deductions and dependent deductions. The insurance premiums for the support money are the amount of income discount divided by the amount of income less 330,000 yen from the previous year’s income, multiplied by 2.97%and the equal discount. Multiply the number of subscribers to 5530 yen. The sum of the amount multiplied by 10070 yen as an equal discount. Long-term care insurance premiums are the amount of income discount minus 330,000 yen from the previous year’s income multiplied by 2.56% and as an equal discount. The sum of the 5310 yen multiplied by the number of subscribers and the equal discount of 7440 yen. At the age of 75, everyone must withdraw from the health insurance they had previously enrolled in and join the medical care system for the elderly.
