Health insurance membership
Employees of employers who are members of the Health Insurance Association are Association insured persons.
Family members who are members of the Association are known as “dependents”.
- When you begin your employment, you become an insured person under the health insurance program.
- Family members must meet certain conditions to be covered under health insurance.
The employee is covered as an insured person
An employee insured under health insurance is known as “an insured person”. Everyone working at an employer to whom health insurance requirements apply must be insured, irrespective of personal preference (excluding those who do not meet certain work-related standards, such as part-time employees).
Health insurance coverage for those working reduced hours (e.g., part-time employees)
Those whose designated number of working hours per week and designated number of working days per month are at least three-fourths those of full-time employees are eligible for health insurance coverage.
However, even those whose numbers of working hours and working days are less than three-fourths those of full-time employees are eligible for health insurance coverage if they meet all five of the following conditions:
- Their designated number of working hours per week is at least 20 hours.
- They expect to be employed for more than two months. (*1)
- Their monthly wages are at least 88,000 yen.
- They are not students. (*2)
- They work for companies that consistently employ more than 100 insured persons (specially eligible establishments) or ones that employ 100 or less but where labor and management have agreed to join health insurance. (*3)
- *1: An employee joins health insurance from the start of the employment period even if the initial employment period is no longer than two months if the employee expects to be employed beyond that period.
- *2: Students attending university, high school, higher vocational school, or other schools (restricted to enrollment in programs requiring at least one year to complete).
However, the following persons are eligible for health insurance membership, even if they are students:
- Those with certificates of anticipated graduation who are employed even before graduation and plan to continue with the same employer following graduation
- Those on leave of absence from school
- Those attending part-time educational programs, such as night classes at universities or high schools
- *3 The company size requirement will be reduced in stages (to more than 50 employees from October 2024)
Period of eligibility
Eligibility for health insurance begins on the first day of employment and ends the day after the employee dies or leaves the employer. If a person becomes an insured person under the Medical Care System for the Advanced Elderly - for example, upon reaching age 75 - he or she will lose eligibility as an insured person under the health insurance program, even if still employed.
- Date of employment
- Becomes an insured person under the Health Insurance Association
- Date of retirement/resignation
- Becomes a Voluntarily and Continuously Insured Person or joins another medical care insurance system
After leaving the employer, you must take appropriate steps based on your individual circumstances such as the following to obtain medical care insurance.
- joining National Health Insurance
- Remaining a member of the Association
- Becoming a dependent of a family member, etc.
In some cases, you may be able to remain in the Association as “a Voluntarily and Continuously Insured Person”, even after leaving the employer.
While you will lose eligibility upon leaving the employer, if you want to remain an Association member, you can join as “a Voluntarily and Continuously Insured Person” if you meet certain conditions.
- Reference link
Family members are covered as “dependents”
Health insurance also provides insurance benefits to family members dependent on the insured person. These family members are known as “dependents”. Becoming a dependent requires meeting certain conditions and certification by the Health Insurance Association.
- Reference link