Japan probes medical insurance for foreigners amid misuse concerns

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

It is the first time the Ministry of Health, Labour and Welfare is conducting 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.

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

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

Foreigners registered as residents and staying in the country for over three months are required to enrol in the National Health Insurance programme, 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 per cent of the total, according to the ministry.

From March 2023 to February 2024, 980.3 billion yen (S$9 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 per cent of the total.

A Health Ministry official said the amounts “cannot be said to be high when compared with the proportion of foreigners enrolled”.

However, politicians have expressed concerns that the system could be misused as foreigners may try to come