HIA's Medical Care System for Retired Persons (Special-Case Retired Persons Medical Care System)

Eligibility requirements

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.

See here for detailed information on eligibility to receive old-age (retirement) pension benefits under the employees’ pension plan.

See here for the Special-Case Retired Insured Person Application Form.(with examples)

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 2024 premiums (paid monthly; debited March 27):
410,000 yen × 80.0/1000 = 32,800 yen (monthly amount)

• You must also pay long-term care insurance premiums (8,610 yen/month, starting with the April 2022) 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.

Health activities

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.
• When you have applied for withdrawal for reasons other than the above
  1. *1. The date of loss of eligibility by application will be the first day of the month after the month in which the Health Insurance Association receives the Forfeiture Notice for Voluntarily and Continuously Insured Persons and Special-Case Retired Insured Persons/Premium Refund Request.
  2. *2. Return your health insurance card and other documents by the fifth day of the month of loss of eligibility (the month after the month in which you applied for withdrawal).

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)