Japan probes concerns over foreigners’ misuse of medical insurance

TOKYO: The Japanese government has begun a survey into public health insurance usage by foreign residents, amid concerns voiced by some lawmakers that people may come from overseas to take advantage of the support for expensive medical treatment.

It is the first time for the Health, Labor and Welfare Ministry to conduct a study into the actual state of insurance premiums paid by foreigners living in Japan and details of the benefits they receive, with the findings to be released by the summer, Kyodo news reported.

The ministry may also consider whether there is a need to review the system itself based on the outcome of survey, according to officials.

In Japan, all residents must enroll in a public health insurance programme and pay premiums.

Foreigners registered as residents and staying in the country for over three months are basically required to enroll in the National Health Insurance program, a system for the self-employed and unemployed, if they have not signed up for any other public health insurance.

The system, among other benefits, enables the refunding of medical expenses that exceed an individual’s limit in a single month. The ceiling varies depending on age and income.

In the fiscal year through March 2024, around 970,000 foreign nationals were enrolled in the National Health Insurance programme, representing 4 percent of the total, according to the ministry.

From March 2023 to February 2024, 980.3 billion yen (US$7 billion) was reimbursed to those who exceeded their monthly cap of medical costs, of which 11.8 billion yen went to foreigners, or 1.21 percent of the total.

A health ministry official said the amounts “cannot be said to be high when compared to the proportion of foreigners enrolled.”

However, politicians have expressed concerns that the system could be misused as foreigners may try to come to Japan to receive expensive medical treatment at lower out-of-pocket money.

Yuichiro Tamaki, head of the minor opposition Democratic Party for the People, has wrote on social media that “people staying for just 90 days can get high-cost medical benefits worth tens of millions of yen. It should be reviewed to make its application stricter.”