By establishment (May 27, 2015) of "law to revise a part of the National Health Insurance methods to build sustainable medical insurance system", the responsibility main constituent of financial administration of National Health Insurance turned into the metropolis and districts from the municipalities from 2018. The metropolis and districts are made up mainly of responsibility of financial administration and by taking central role in stable financial administration and National Health Insurance administration such as securing of effective business, aim at stabilization of system.
About the way of administration of National Health Insurance after system reform, it is as follows.
The way of administration
- The metropolis and districts take administration of National Health Insurance with the municipalities in the metropolis and districts concerned.
- The metropolis and districts are made up mainly of responsibility of financial administration and carry central role in National Health Insurance administration such as securing of stable financial administration and effective business administration and plan stabilization of system.
- The metropolis and districts show the metropolis and districts National Health Insurance administration policy as unified administration policy in the metropolis and districts, and efficiency, standardization, wide area of desk work that the municipalities take propel becoming.
Flow of National Health Insurance finance
The metropolis and districts make possibility such as medical care benefits costs and decide sum of money of National Health Insurance operating cost payment every municipalities and notify each municipality. In addition, we calculate standard insurance rate every municipalities and announce.
In Motoichi, we set insurance rate based on money of National Health Insurance operating cost payment that Kanagawa shows while taking standard insurance rate into account, and levy collects premium and puts money of payment in Kanagawa.
Main role of the metropolis and districts and the municipalities
Table about main role
The metropolis and districts
・The responsibility main constituent of financial administration
・National Health Insurance operating cost payment every municipalities
We decide money
・Setting, administration of financial stabilization fund
・It is the metropolis and districts for money of National Health Insurance operating cost payment
We are paid by this
・Based on National Health Insurance administration policy, it is desk work
Of this efficiency, standardization, wide area becoming
Promotion (as for ※ 3, 4, similar)
・In imminent relations with local resident,
We manage qualification (identification of person insured, limit
Issuance of sum application certificates)
３．Determination of premium levy, the collection
・By standard calculation methods,
Standard insurance rate every municipalities
We calculate this and announce
・It is premium in reference to standard insurance rate
We decide rate
・Levy, the collection of premium
・Expense necessary for payment in full,
We pay for the municipalities
・Of insurance payment that the municipalities performed
・Decision, supply (medical expenses of insurance payment
High medical costs)
・For the municipalities, we give a necessary advice,
・Grain sai depending on characteristic of person insured
We carry out worth health business (detahe
Main changes accompanied with system reform
１．We manage qualification by the metropolis and districts unit
By this reform, the metropolis and districts became insurer of National Health Insurance, too and went for each municipalities until now
Qualification management of person insured will be carried out by the metropolis and districts unit.
Therefore person insured does not produce the loss of qualification and the new acquisition when Address moves to the municipalities in Kanagawa.
But identification of new person insured is issued in the municipalities of transfer as identification of person insured is issued every Address transfer.
2. Method of high medical costs in total changes
When, in high medical costs system, there is supply of high medical costs more than four times between latest 12 months (multi-several times pertinence)
Self-burden is reduced by this.
Qualification of National Health Insurance disappears once until now when move in other municipalities, gai of high medical costs
We were not able to succeed our number of times.
As qualification of National Health Insurance does not disappear after April, 2018 when we move in other municipalities in Kanagawa, we succeed the applicable number of times.
But the applicable number of times is not succeeded when continuity as household is not recognized. In addition, transfer object is after April, 2018.
３．Payment hakoremadedoridesu of report and premium
By this system reform, structure of financial administration greatly changes, but there is no change in medical how to take of citizens. Please gain in premium mokoremadedori, ward office Insurance and Pension Division of ward to live.
In addition, as for various application or reports, ward office Insurance and Pension Division of ward of koremadedorio house is window.
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