Health Insurance for gaijin wife with peculiar visa.

[Reinie]

Hi. I was wondering if anyone might have any advice for me.

I work on a military base as an American civilian and technically speaking I am legalized here in Japan due to my "work visa," or SOFA. I recently got married and my husband is Japanese. How can I obtain national health insurance so that I can get medical service by Japanese clinics/hospitals? You see, from what I understand, I must possess the alien registration card in order to get the NHI. But in order to get the alien registration card, I would have to void my work visa/SOFA and quit my job which would be too detrimental a move on our finances. Is there any way around this?

My major reason for asking this is because we might possibly have a baby on the way and we would like to know what our options are as far as getting seen at Japanese clinics because I'm not too happy with the service provided on the military base where I work.


Thanks for reading,
Reinie

 

[Mike Cash]

In other words, you're on a SOFA sponsored visa and not a spouse visa.

First thing to do is go to the personnel office and inquire about the implications of switching visa status as regards your continued employment and access to base amenities.

They have definitive answers. All we have are sympathetic butts to pull uninformed conjecture out of.

 

[Glenski]

I agree. SOFA won't let you get NHI, so get qualified for it by switching to a spousal visa. Be absolutely sure what this means as far as your work and accommodations permit, though.

 

[Mike Cash]

The one time I looked into base-affiliated work, they told me I would be required to drop my spouse visa and go on a SOFA sponsored visa....which I wasn't willing to do. Mainly because the pay sucked and the job included ZERO base privileges (housing, commissary, exchange, etc).

It may boil down to your deciding if you want to have your cake or eat your cake.

 

[Glenski]

I think Mike is right. Here are some other people with similar situations (SOFA status and being ineligible for NHI).
Japan Health Insurance?

 

[Reinie]

Thank you all for your advice!

I was afraid it would have to come down to that. Quite frankly, I think SOFA status is a comically dark purgatory. I (being a local-hire) get treated as a second-class citizen as I am not able to receive full benefits on base and at the same time, because I'm under SOFA, don't get full benefits out in town either. It's a catch-22 circus limbo for me and many others as well. And yes, the pay DOES suck. So I think that in the long run (when my husband and I are financially capable), I will definitely be relinquishing my SOFA for a spousal visa. All the trouble I am going through is simply not worth the meager services and accommodations military bases have to offer. The only major downfall we're looking at is (1) the driver's license issue (I have a valid state-side + on base, my husband has an expired state-side and nothing else) and (2) the U.S. post office box. Other than that though, I could care less about the base.

 

[Glenski]

Please let us know what the ramifications are once you do this, ok? That information will help others in similar situations.

As for moaning about a driver's license, just get a Japanese one. You have a valid American one. If you were issued it 3 months or longer before you came to Japan, just take the written and driving tests, and you pass. People complain about how hard it is to get, and that it takes multiple trips to the testing station, but there are those of us who passed on the first try, like me.

Since your husband is Japanese, it's his problem that he never got a Japanese license, and he shouldn't even be driving on an expired license, American or otherwise. (Not saying he has been doing that, just pointing out an obvious fact.) The problem for him is greater because he will have to go to driving school first, which is expensive.

U.S. PO box problem? What are you talking about? If the base affords you that, and you have to move off-base, it's just like moving anywhere else in the world. You leave a forwarding address. Please explain what you mean.

 

[Mike Cash]

APO Boxes have US addresses and mail to them is typically treated as US domestic mail and shipped at US domestic rates, which is fantastic if you order much stuff from the US as you both save a bundle on shipping and have access to merchants who won't ship to foreign addresses.

There is no legal requirement to attend driving school in order for your husband to obtain a Japanese license. It is just that the system is cozily arranged between the schools and the cops so that it looks that way. If he doesn't mind making multiple trips to the testing center it is possible to get a license without having gone to a driving school. They will make him wish he had, but that's strictly because driving schools have financial arrangements with retired officials from the police traffic divisions.

Your license is much more straightforward and is something that you should attend to immediately, if not sooner.

You sound like an intelligent woman and I suspect that you could make a living (and probably a better one) off-base anyway. Don't be one of those people who end up thinking their ability to survive in and remain in Japan depends on suckling Uncle Sam's teat. Lots of the ex-military folks who remain in Japan seem utterly incapable of surviving here if they get out of sight of one of the bases.

 

[FrustratedDave]

One couple more issues. Will your employer pay into the NHI if your ear over the 1,030,000 yen? B/c you won't be eligable for NHI under your husbands insurance if you do earn over that. So if your employer won't pay into the NHI, you will have to cut back your hours as to not earn over that.

 

[Glenski]

Make more than that much, and you might run into tax issues, too.

 

[Reinie]

Thanks for the clarification Mike. I completely agree that many people on base are indeed heavily dependent upon the services offered by the military and its constituents. I grew up as a military child myself and so I understand their mentality but I don't necessarily respect it. Some of these people really give foreigners a bad rep out in town and I hate that.

Other than my mailbox and base driver's license that allows me to drive legally here, I have no real need for the base at all and so I want to steadily separate myself from all things base-related. I'm slowly getting all my ducks in a row to make "the transition" which will probably take place sometime next year. My next short-term goal is to obtain a Japanese driver's license by converting my state-side one. I lived in the states for 2 years prior to coming back to Japan in 2009 so I don't think I'll encounter any problems with regard to that 3-month requirement.

As for health insurance, I'm stuck with my current one from Aetna Global. My husband and I will most likely visit his family doctor and ask what would be the procedure for getting me seen there as well (since I really would like to have just one primary family doctor.) I'm guessing it will involve me filing claim paperwork with my current health insurance. Also, to update my initial post on this thread: there is no baby on the way...so thankfully we have more time to prepare ourselves!

 

[Glenski]

I'm slowly getting all my ducks in a row to make "the transition" which will probably take place sometime next year. My next goal is to obtain a Japanese driver's license by converting my state-side one. I lived in the states for 2 years prior to coming back to Japan in 2009 so I don't think I'll encounter any problems with regard to that 3-month requirement. I'm wondering now what types of valid proof will the Japanese licensing office require? Will my passport be enough?

If your license shows that it was issued >3 months ago, and you were in the U.S. for 3 months during that time, you'll be ok. If it was recently renewed, you may have to ask your DMV to forward you a statement of some sort to say when it was issued, so that it jibes with your passport dates back home.

Just remember that whatever you provide must be translated into Japanese.

Anyway, I'm just not sure yet if I am allowed to possess both the base license AND the Japanese license at the same time. (Again, SOFA has all sorts of nonsensical fine-print policies.) Or am I even allowed to get the Japanese license if I'm under SOFA?

I'm confused. Aren't we talking about you having to move off base anyway?

My husband is actually half Japanese half American. For all intents and purposes, however, he is Japanese.

You just opened a huge can of worms here, and I'm not referring to anything related to his driver's license. Dual nationality is not officially accepted in Japan after the age of 22. To all intents and purposes, if he has hidden his American citizenship from Japan, that's his business (and many do exactly that sort of thing), but he will still be considered Japanese by authorities here. If they find out about his dual citizenship, it is quite likely that he will be asked (not forced) to choose one and disavow the other.

Ok, so there is no baby on the way (yet). Do you still want to get on NHI?

Re: work goals

I would love to work for a Japanese company but actually my real dream is to work from home (I'm an artist and writer). Right now I'm employed as a (*cough* underpaid) graphic designer by the base.

So, with a spousal visa, you can do almost anything and that doesn't require living on base or being tied to SOFA at all. Best I can tell you is to work on setting yourself up for that. Writers and artists live lonely lives and unless they are already established, they cannot always be considered to have steady income, as I'm sure you realize, but that doesn't mean you can't do it and live at home while your husband makes the bulk of the income. This raises the next point: what does your husband do, and is he behind you on all this career thing?

 

[Reinie]

If your license shows that it was issued >3 months ago, and you were in the U.S. for 3 months during that time, you'll be ok. If it was recently renewed, you may have to ask your DMV to forward you a statement of some sort to say when it was issued, so that it jibes with your passport dates back home.

Just remember that whatever you provide must be translated into Japanese.

I'm confused. Aren't we talking about you having to move off base anyway?

You just opened a huge can of worms here, and I'm not referring to anything related to his driver's license. Dual nationality is not officially accepted in Japan after the age of 22. To all intents and purposes, if he has hidden his American citizenship from Japan, that's his business (and many do exactly that sort of thing), but he will still be considered Japanese by authorities here. If they find out about his dual citizenship, it is quite likely that he will be asked (not forced) to choose one and disavow the other.

Ok, so there is no baby on the way (yet). Do you still want to get on NHI?

Re: work goals
So, with a spousal visa, you can do almost anything and that doesn't require living on base or being tied to SOFA at all. Best I can tell you is to work on setting yourself up for that. Writers and artists live lonely lives and unless they are already established, they cannot always be considered to have steady income, as I'm sure you realize, but that doesn't mean you can't do it and live at home while your husband makes the bulk of the income. This raises the next point: what does your husband do, and is he behind you on all this career thing?

Thank you so much for your input, Glenski. My thread was initially about NHI and I guess it went wayward to the topic of driver's licenses, lol. Seeing as that the only way for me to obtain NHI would mean for me to give up SOFA, that process won't happen anytime soon due to financial reasons. So for now, I'll be stuck with my SOFA until we get our stuff together. The current health insurance I have, Aetna Global, isn't too bad. I mean, it is better than nothing, that's for sure. I am definitely aiming to apply for the spousal visa in the future though seeing as that SOFA has too many cons involved and I am simply tired of having to deal with all the rules and regulations associated with the military. And as far as having a baby goes, I think having that NHI would be really nice.

Worm-can-opening was never my intent and for the sake of privacy I won't get into what my husband does. The only relevant thing here is that he is indeed a Japanese citizen who has paid his JP taxes in due and that he is married to an American. I know first hand that the life of a writer and artist is a lonely one but it's who I am and my goal is to make a career out of what I love to do. My husband and I have been together for nearly a decade prior to getting married and so he is well aware of my "career goals." The only real hurdle we face now is dealing with the financial aspects of making it all happen.

Thank you so much for all of your help everyone. I guess I'll be back when I actually have some real updates worth discussing!

 

[Mike Cash]

We'd be happy to have you drop in just to keep in touch and chew the fat. Always glad to do what we can to help with problems, but we'd prefer that not be the only time we see you!

 

[Reinie]

Well, Mike, if you insist... I guess I can chime in here and there!

 

[stuckonsofa]

I feel your pain...

I feel your pain and am in the exact situation. I even tried to go to the immigration and plead my case. I hired an immigration lawyer and still was told that I must have a termination letter in order to change from SOFA to spouse visa. Why is it that people like you and I are stuck in this terrible situation? Unlike many military folks, I WANT status in Japan. I will pay taxes. I want to be put in the line for permanent residence. My company is stubborn too because they can't understand that SOFA is just a darn stamp in the passport. People can still access the base and have an ID without having the stamp. I know many people who got their spouse visa first, then got the job and somehow slipped through the cracks because they have "both." You can get an ID without having a SOFA stamp. But I got the job then got married so until I can come up with a termination letter (which means quitting), I am not able to get spouse visa.

It is really an unfair condition for us. I've never been military and technically SOFA is for Military and DOD civilians not the contractors but we are forced to maintain SOFA or be "let go." What about our families, what about NHI? I need my job and so does my family but it is really like playing roulette with our lives. We get money on one side but we don't get any residence or existence in the country that we live in!!!

If you EVER find a way to get a spouse visa without having to quit your job, please please post it here or contact me. I can speak Japanese and I know the system better than most immigration lawyers but what stands in my way is that one little letter that states that my SOFA status is not active anymore. But being aware of the dangers of immigration issues in this terribly-old-way-of-thinking country, I will wait until the opportunity arises legally to do the switch.

I am sorry to say it but I am happy that there is at least one other person in Japan that has the same situation as me and feels the same way. I wish we could change it.

 

[Glenski]

It is really an unfair condition for us. I've never been military and technically SOFA is for Military and DOD civilians not the contractors

Wait. SOFA is indeed for contractors!

 

[Reinie]

I'm guessing there are more people out there sharing our "unique" situation. But I can relate to finding slight relief in realizing that we are not the only ones enduring this debacle! I just believe that if a foreigner is here in Japan legally and their work status deems them as long-term residents, they *should* have the option of obtaining NHI granted they are willing to pay the premium/taxes involved. Personally, my main concern right now is receiving dental and for the future, maternity care, at a hospital/clinic of my choosing vice being limited to on-base facilities.

With my current health insurance provider, Aetna Global, I have a deductible of $200 and I pay about $150 a month for my premium (obviously my husband is not included on this plan since he has NHI). Speaking from experience, I don't particularly find military health care for civilians worth the money I am paying with each paycheck. And as is, I'm having a hard time finding clinics out in town that will accept my health insurance. I guess I just need to dig a little deeper with all of this because I'm not giving up just yet...


---------- Post added at 09:02 ---------- Previous post was at 08:14 ----------

Note: I should have done this a long time ago but truth be told, I am new to this whole "health insurance" business.

Okay, so I just got off the phone with Aetna Global and according to the gentleman I spoke to, I can technically go to any health care facility in the world under my plan. (Is it just me or does that sound way too good to be true?) Anyway, there's a list of direct-pay facilities that Aetna is contracted with, but I have the option of visiting a non-contracted facility, pay out of my own pocket for the visit, and then file a reimbursement claim. Apparently I have to *first* get a letter of authorization from Aetna and from what I understand, I must give this letter of authorization to the health care facility I'm attending. The facility might or might not accept said letter of authorization but supposedly I am still entitled to receive a reimbursement so long as I file my claim. (That's the part that has me a bit confused, to be honest.) Like I said in my earlier post, I guess I'll have to log on to Aetna, dig deeper within their website, and call them to ask specific questions.

---------- Post added at 09:08 ---------- Previous post was at 09:02 ----------

Wait. SOFA is indeed for contractors!

Yes that's right, contractors are on SOFA as well. I believe all military personnel along with DOD civilians are all under SOFA. I'm wondering what the employees at the US Embassy are under? I look at local job openings there sometimes and I notice it says you must already possess a valid visa.