National Health Insurance Act

A person who has a domicile within the area of a prefecture is an insured person under the national health insurance provided by that prefecture together with the Municipalities within that prefecture.

Notwithstanding the provisions of the preceding Article, any person who falls under any of the following items shall not be classed as an insured person under the national health insurance provided by a prefecture together with the Municipalities within that prefecture (hereinafter referred to as the "national health insurance program provided by prefectures, etc."):

an insured person pursuant to the provisions of the Health Insurance Act (Act No. 70 of 1922); provided, however, that this shall not apply to specially-insured day laborers pursuant to the provisions of Article 3, paragraph (2) of the same Act;

an insured person pursuant to the provisions of the Seaman's Insurance Act (Act No. 73 of 1939);

a member of a mutual aid association pursuant to the National Public Servants Mutual Aid Association Act (Act No. 128 of 1958) or the Local Public Care Service Mutual Aid Association Act (Act No. 152 of 1962);

a subscriber to the Private School Personnel Mutual Aid System pursuant to the provisions of the Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953);

an insured person's dependent pursuant to the provisions of the Health Insurance Act; provided, however, that this shall not apply to a dependent pursuant to the provisions of the same Act of a specially-insured day laborer pursuant to Article 3, paragraph (2) of the provisions of the same Act;

an insured person's dependent pursuant to the provisions of the Seaman's Insurance Act, the National Public Servants Mutual Aid Association Act (including the cases where applied mutatis mutandis pursuant to other Acts) or the Local Public Care Service Mutual Aid Association Act;

a person whose specially-insured day laborer certificate book received pursuant to the provisions of Article 126 of the Health Insurance Act has not run out of blank space to affix additional health insurance stamps, or such person's dependent pursuant to the provisions of the same Act; provided, however, that this shall not apply to any person for whom a period during which said person shall not be eligible as a specially-insured day laborer pursuant to the provisions of Article 3, paragraph (2) of the same Act is running upon the approval obtained pursuant to the provisions of the proviso of the same paragraph or who has returned such specially-insured day laborer certificate book pursuant to the provisions of Article 126, paragraph (3) of the same Act or such person's dependent pursuant to the provisions of the same Act;

an insured person pursuant to the provisions of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982);

a person who belongs to a household which receives public assistance pursuant to the Public Assistance Act (Act No. 144 of 1950) (excluding a household for which public assistance has been suspended);

an insured person of a national health insurance society;

any other person for whom any special reason exists and who is specified as such by Ordinance of the Ministry of Health, Labour and Welfare.

An insured person under the national health insurance program provided by prefectures, etc. shall become eligible as such on the day on which said person acquires domicile within the area of the prefecture or on the first day on which said person no longer falls under any of the items of the preceding Article.

An insured person under the national health insurance program provided by prefectures, etc. shall lose eligibility for said health insurance from the day immediately following the day on which said person loses domicile within the area of the prefecture or from the day immediately following the first day on which said person falls under any of the items (excluding items (ix) and (x)) of Article 6; provided, however, that said insured person shall lose eligibility for said health insurance from the day on which said person loses domicile within the area of the prefecture if said person acquires domicile within the area of another prefecture on the same day.

An insured person under the national health insurance program provided by prefectures, etc. shall lose eligibility as such from the first day on which said person falls under item (ix) or (x) of Article 6.

A Householder must notify the Municipality of particulars regarding the acquisition and loss of eligibility for each insured person belonging to said person's household and other necessary particulars, as provided by Order of the Ministry of Health, Labour and Welfare.

If all or some of the insured persons belonging to the same household as a Householder are in a situation where they are unable to undergo the electronic eligibility confirmation prescribed in Article 36, paragraph (3), said Householder may, as provided by Order of the Ministry of Health, Labour and Welfare, request the Municipality in which said Householder has a domicile to deliver a document stating the particulars specified by Order of the Ministry of Health, Labour and Welfare as information pertaining to the eligibility of the insured persons in that situation, or to provide those particulars by electronic or magnetic means (meaning a method using an electronic data processing system or other method using information and communications technology that is specified by Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter in this paragraph through paragraph (4)). In this case, the Municipality is to, as provided by Order of the Ministry of Health, Labour and Welfare, promptly deliver the document to the Householder who requested the delivery of the document, and provide the particulars by electronic or magnetic means to the Householder who requested their provision by electronic or magnetic means.

A Householder may, for the purpose of confirming the facts pertaining to the eligibility of all or some of the insured persons belonging to the household, as provided by Order of the Ministry of Health, Labour and Welfare, request the Municipality in which said Householder has a domicile to deliver a document stating those facts, or to provide the particulars to be stated in that document by electronic or magnetic means. In this case, the Municipality is to, as provided by Order of the Ministry of Health, Labour and Welfare, promptly deliver the document to the Householder who requested the delivery of the document, and provide the particulars to be stated in the document by electronic or magnetic means to the Householder who requested their provision by electronic or magnetic means.

When any of the insured persons belonging to a household loses eligibility as such, the Householder must, as provided by Order of the Ministry of Health, Labour and Welfare, promptly notify the Municipality thereof.

When a notification is received pursuant to the provisions of Articles 22 through 24, Article 25, Article 30-46 or Article 30-47 of the Residential Basic Book Act (Act No. 81 of 1967) (limited to cases when a supplementary note is appended to the document pertaining to said notification pursuant to the provisions of Article 28 of the same Act), a notification pursuant to the provisions of paragraph (1) or the preceding paragraph shall be considered to have been received for the same reason as that for the above notification.

In addition to what is provided for in each of the preceding paragraphs, necessary particulars concerning notification pertaining to insured persons and confirmation concerning the eligibility of insured persons shall be prescribed by Order of the Ministry of Health, Labour and Welfare.

Each prefecture and Municipality must establish a special account for income and expenses related to national health insurance, as provided by Cabinet Order.

In order to deliberate on matters concerning the administration of national health insurance services (limited to those pertaining to affairs that are to be handled by prefectures pursuant to the provisions of this Act and that are important matters such as the collection of payments for national health insurance services expenses under Article 75-7, paragraph (1) and the formulation of the prefectural national health insurance management policy under Article 82-2, paragraph (1)), a council for the administration of the national health insurance services of the prefecture is to be established in a prefecture.

In order to deliberate on matters concerning the administration of national health insurance services (limited to those pertaining to affairs that are to be handled by Municipalities pursuant to the provisions of this Act and that are important matters such as insurance benefits under the provisions of Chapter IV and the collection of insurance premiums under Article 76, paragraph (1)), a council for the administration of the national health insurance services of the Municipality is to be established in a Municipality.

The councils prescribed in the preceding two paragraphs may, in addition to what is prescribed in the preceding two paragraphs, deliberate on matters concerning the administration of national health insurance services (limited, in the case of the council prescribed in paragraph (1), to those pertaining to affairs that are to be handled by prefectures pursuant to the provisions of this Act, and limited, in the case of the council prescribed in the preceding paragraph, to those pertaining to affairs that are to be handled by Municipalities pursuant to the provisions of this Act).

In addition to what is provided for in the preceding three paragraphs, necessary particulars concerning the councils prescribed in paragraphs (1) and (2) shall be prescribed by Cabinet Order.

Deleted.