The government has decided at a Cabinet meeting to limit coverage of family dependents under the public health insurance system to those who are residents in Japan, in principle.
A plan to revise the Health Insurance Law, which has set this criterion as a feature, and related rules was approved by the Cabinet on Friday. The decision was made in response to an expected increase in the number of family dependents living overseas after Japan accepts more foreign workers from April. The move is aimed to reduce burdens on the nation's insurance finances. The revision is expected to be enacted in the current Diet session and to be put into effect in April 2020.
Under the draft revision, the government added a requirement that family dependents of workers at large firms who are covered by health insurance societies, or those covered by the Japan Health Insurance Association for small and midsize firms, must have their residence in Japan in order to receive the benefits.
As the current public health insurance system does not set a criterion regarding the residence of subscribers' dependents, the insurance covers out-of-Japan dependent family members of foreign workers in Japan as long as they meet certain conditions. Therefore, medical fees incurred by those families, even at medical institutions overseas, excluding out-of-pocket expenses, have been paid by health insurance societies and the Japan Health Insurance Association.
According to the Health, Labor and Welfare Ministry, 1.46 million foreign nationals were working in Japan as of October last year, up 14 percent from the previous year. A new residence status for laborers with special skills is set to be created under the revised Immigration Control and Refugee Recognition Law, which will take effect in April. The number of foreign workers is expected to further increase. The government has deemed that tougher criteria are needed to limit impact on the nation's medical insurance finances.
The new residence requirement will be applied to Japanese nationals as well. The coverage will be applied exceptionally to dependent family members who have their residence overseas temporarily because they accompany subscribers who either study or are stationed abroad. Details will be set up under a ministry ordinance.
A new requirement will be applied to spouses supported by members of employee pension schemes such as company employees, whereby the spouses must have their residence in Japan for a certain period of time in order to be pensionable. The government aims to revise relevant laws hoping to put them in force in April 2020.
The draft revision also included a rule that will allow the Individual Number Card to be used as a health insurance card so that authorized medical insurance institutions and pharmacies equipped with card readers can check patients' information online. This system is expected to start in March 2021. Once it is enforced, medical institutions can dispense with clerical work related to confirming the identification on patients' health insurance cards, while patients can have medical checkups only with their Individual Number Cards.
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