HIA’s Medical Care System for Retired Persons (Special-Case Retired Persons Medical Care System)
Certified by the Minister of Public Welfare of Japan as a specified health insurance society in April 1986, the IBM Japan Health Insurance Association is permitted to offer a Medical Care System for Retired Persons.
Persons qualified to receive old-age (retirement) pension or aggregate old-age (retirement) pension benefits under the employees’ pension plan may use this system if they meet one of the following requirements:
- They were insured persons under the IBM Japan Health Insurance Association for at least 20 years.
- They were insured persons under the IBM Japan Health Insurance Association for at least 10 years during the period starting with the month in which they reached 40 years of age.
Health insurance premiums
Health insurance premiums are calculated by multiplying the special-case retired person’s standard monthly remuneration amount by the insurance premium rate.
Starting with the April 2017 premiums (paid monthly; debited March 27):
410,000 yen × 68.4/1000 = 28,044 yen (monthly amount)
- You must also pay long-term care insurance premiums (4,100 yen/month, starting with the April 2017) through age 64.
- Note that insurance premium rates and standard monthly remuneration are reviewed each year. Any associated changes will also affect your insurance premiums.
- The insured person is responsible for paying in full the amount of the above health insurance premiums.
- Except for prepayments, pay your monthly health insurance premiums automatically by direct debit. If you pay by means other than direct debit, make your payment by the 10th of each month. You can also prepay your health insurance premiums. (Prepayments also result in a discount.)
Insurance benefits/additional benefits
Under this system, you can receive the same insurance benefits and additional benefits as ordinary insured persons. Note that injury and sickness allowance will not be paid.
- The copayment for insured persons is 30% of medical care costs (i.e., 70% paid as benefits).
- The copayment for dependents (family members) is 30% of medical care costs (i.e., 70% paid as benefits).
- Additional benefits will provide reimbursements of any amount beyond 25,000 yen (dependents:50,000 yen), (rounded down to the nearest 100 yen) paid by the insured person.
- *See “Benefits for the Elderly” for more information on benefits and copayments for insured persons and dependents aged 70 or above.
- *See “Health Insurance Systems: Medical Care System for the Advanced Elderly” if your 75th birthday is approaching.
You can use health activities in the same way as ordinary insured persons.
You will lose your eligibility under this system in the following cases:
- You go to work at another company. (Your employer’s health insurance takes precedence.)
- You become eligible for the Medical Care System for the Advanced Elderly (when you reach age 75 or age 65 or above and certified by your municipal government as having a disability because you are bedridden or similarly afflicted).
- Your residence changes to an overseas address (resulting in the cancellation of your certificate of residence in Japan).
- Upon your death
- You begin to receive livelihood protection benefits.
Note that you cannot withdraw from the system once joining the IBM Japan Health Insurance Association’s Medical Care System for Retired Persons except for the reasons given above.See here for the Premium Refund Request/Forfeiture Notice for Voluntarily and Continuously Insured Persons and Special-Case Retired Insured Persons. (sample available)