The National Health Insurance system has changed since FY2018.

With the enactment of the “Amendment of Part of the National Health Insurance Law, etc. to Build a Sustainable Medical Insurance System” (May 27, 2015), the responsibility for financial management of the National Health Insurance from FY2018 The subject has changed from municipalities to prefectures. Prefectural governments will be responsible for financial management and will play a central role in the operation of National Health Insurance, such as securing stable financial management and efficient business, aiming to stabilize the system.
The management of National Health Insurance after the system reform is as follows.

1. Prefectural governments, together with municipalities in the relevant prefectures, are responsible for the operation of National Health Insurance.
2. Prefectural governments will be responsible for financial management, play a central role in the operation of National Health Insurance, such as ensuring stable financial management and efficient business management, and stabilize the system.
3. Prefectural governments show the prefectural national health insurance management policy as a unified management policy within the prefecture, and promote the efficiency, standardization, and wide area of office work performed by municipalities.

Prefectural governments make estimates of medical care benefits expenses, determine the amount of National Health Insurance operating expenses paid for each municipality, and notify each municipality. In addition, we calculate and announce the standard insurance rate for each municipality.
In Motoichi, based on the National Health Insurance operating expenses payment indicated by Kanagawa Prefecture, the insurance premium rate is determined while referring to the standard insurance rates, etc., and the insurance premium is imposed and collected, and the payment is paid to Kanagawa Prefecture.

As a result of this reform, prefectures have become national health insurance insurers, and have been doing so far for each municipality.
The qualification management of insured persons will be carried out on a prefectural basis.
Therefore, if an insured person transfers Address to a municipal office in Kanagawa Prefecture, there will be no loss of qualification or no new acquisition.
However, since the insured person's card is issued for each transfer of Address, a new insured person's card will be issued at the municipal office of the transferee.

Under the high medical costs system, if high medical costs has received more than 4 payments in the last 12 months (applicable many times)
The co-payment amount will be reduced.
Until now, if you move to another municipality, you will no longer be eligible for National Health Insurance and will be eligible for high medical costs.
I was unable to take over the number of times.
After April 2018, if you move to another municipality in Kanagawa Prefecture, you will not be eligible for National Health Insurance, so you will take over the applicable number of times.
However, if continuity as a household is not recognized, the number of times will not be taken over. The transfer target will be after April 2018.

With this system reform, the structure of financial management will change significantly, but there is no change in the way citizens receive medical care. Please pay the insurance premium to your ward office Insurance and Pension Division as before.
In addition, various applications and notifications are handled by the ward office Insurance and Pension Division of your ward as before.

• Flyer (PDF: 617KB) of summary of National Health Insurance system reform in 2018
• About law to revise a part of the National Health Insurance Law to build a sustainable medical insurance system (Ministry of Health, Labour and Welfare external link) (external site)
• Kanagawa National Health Insurance Management Policy, etc. (Kanagawa external link) (outside site)
• Frequently Asked Questions (PDF: 256KB)