National Health Insurance (Kokumin Kenko Hoken)
If you live in Japan with a visa valid for over one year or longer, and if you are not enrolled in health insurance program provided through an employer, you must enter the NHI. Please note that your are required to apply for NHI even if you have your own private insurance.
* Those who are covered (themselves or as dependents) by some other public health insurance or those who receive public assistance, or those who have visas for less than one year cannot apply for NHI.

Application
Application is completed at Kokumin Kenko Hoken-ka counter at City Hall. For those who have withdrawn from insurance provided by company, documents to prove you have left the company are necessary other than the Alien Registration Certificates. Students need to bring student ID. An Insurance Certificate is issued right away.

Insurance Certificate and Benefits
After application, a National Health Insurance Certificate (Kenko Hokensho) is issued immediately. When you receive treatment for illness or injury at a hospital or other medical facility where NHI coverage is available, present your NHI certificate at the reception desk before receiving treatment. You will be asked to pay 30% of your medical fee for most treatment. The remaining 70% is covered by the Setagaya municipal government.
* Medical Care Fee Subsidies: Anyone whose individual costs for care at medical facilities have exceeded a set amount during a contiguous 1-month period should submit an application for reimbursement.

NHI Premiums (hokenryo) and Payment
Your NHI premiums are calculated as folows:
(\26,100×number of household members) + (your resident tax×1.87) = annual premium

●Paying with invoices
The invoices are mailed in April, July, November and December. Payment should be made by the end of each month at City Hall, community branch offices (shucchojo), banks or post offices.
● Bank debits
Automatic Payment from your bank account is recommended. Payments are withdrawn on the final day of each month (when it falls on a holiday, on the next business day). Bring your bankbook, seal used on your bankbook along with your NHI certificate or NHI invoices to your bank and fill a fund transfer application which is available there. The procedures can also be made at City Hall or branch offices.

Reporting Changes on your NHI Certificate
In the following cases, please report at the National Health Insurance Section (Kenko Hoken-ka) within 14 days.

Upon moving in to Setagaya (or entering Japan)
Alien registration certificate or copy of alien registration application required (students will also need student ID)
Upon withdrawal from another public health insurance program in Japan
Alien registration certificate and loss of eligibility for health insurance certificate (shikaku soshitu todoke) is required
Upon loss of public assistance benefits
Alien registration certificate and notification of termination of benefits required
After child birth
Alien registration certificate, Mother-Child Health Handbook and NHI certificate required
Withdrawing from NHI
Upon moving out of Setagaya (or leaving Japan) NHI certificate required
Upon joining another public health insurance program in Japan
That program's insurance certificate and NHI certificate required
Upon beginning to receive public assistance benefits
Notification of commencement of benefits and NHI certificate required
Upon an NHI member's death
Documentation to certify the death and NHI certificate required
Other notification
Change of address, name, head of household or nationality
Alien registration certificate and NHI certificate required
Loss of NHI certificate
Alien registration certificate required

* The NHI certificate issued by Setagaya becomes invalid once you have moved from Setagaya (or Japan) or have joined another public health insurance program and must be returned when completing notification procedures for withdrawal.

Inquiries: National Health Insurance Division
Tel.: 5432-1111
Ask an operator for Kokumin kenko hoken-ka