News Japan investigates foreign residents' health insurance amid misuse concerns

[thomas]

I'm not sure I understand.

In the fiscal year through March 2024, around 970,000 foreign nationals were enrolled in the National Health Insurance program, representing 4 percent of the total, according to the ministry. From March 2023 to February 2024, 980.3 billion yen 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.

Healthcare reimbursements to foreign residents amount to 1.21%. Why probe foreign residents when the potential financial damage and the likelihood of Japanese nationals (98.79%) abusing the system are disproportionately higher?

Yuichiro Tamaki, head of the minor opposition Democratic Party for the People, 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."

But are such visitors considered "residents"?

Japan probes foreigners' medical insurance use amid misuse concerns

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.

english.kyodonews.net

 

[salyavin]

Visitors who come to Japan for lower out of pocket treatment would not be using Japanese insurance right? One would have tourist insurance or pay in cash or in some cases for an emergency some foreign plans may cover . One could be billed and run I suppose but they seem to talk about medical insurance misuse. tourists have no Japanese medical insurance. I agree a visitor is not a resident, they have no resident card. Am I missing something about staying for just 90 days and Japanese medical insurance?

 

[johnnyG]

I also don't understand...

One of our kids (adult), now living in the US, has been to a couple clinics on different trips back here. But they pay the full cost out of pocket**, no insurance, since that's cheaper than the same thing with insurance in the US.

**and let the places know in advance

 

[Majestic]

I think its political theater. "Cracking down on foreigners" seems to be the low-effort, low-hanging fruit of all politicians. It doesn't matter that the cheating foreigners represent some fraction of a percent. "Foreigners are breaking the law" is all that needs to be said, and it sticks in the memory and generates outrage.

 

[Petaris]

Visitors who come to Japan for lower out of pocket treatment would not be using Japanese insurance right? One would have tourist insurance or pay in cash or in some cases for an emergency some foreign plans may cover . One could be billed and run I suppose but they seem to talk about medical insurance misuse. tourists have no Japanese medical insurance. I agree a visitor is not a resident, they have no resident card. Am I missing something about staying for just 90 days and Japanese medical insurance?

That is what I was wondering. Have I been missing something all this time?
I have never once visited a doctor or dentist in Japan. For some reason I just never considered it outside of wondering how expensive it would be if I ever had an emergency need. My US insurance should cover but they do so by reimbursing you to some extent after you have provided an itemized and officially translated bill.

 

[mdchachi]

What you guys are failing to realize is that we are now in a post-facts society. They are called alternative facts. It seems to be a reliable way to drum up votes. Tell people what they want to believe. The more outrageous and untrue the better.

 

[johnnyG]

but they do so by reimbursing you to some extent after you have provided an itemized and officially translated bill

One feature of healthcare here is that the bill is immediate.

If you go to a doctor or clinic, or a hospital, your bill is calculated and presented to you on completion--it's the last thing you do before you leave the clinic/doc's office/hospital/etc.

I've even been in hospital for multiple months. At one place they politely suggested to settle up after the end of each calendar month (and I did). At another place, they just left the clock to run, and the day before checkout, they gave me a slip with what the bill would be (to within a few hundred yen), so that I knew and could be ready to pay on checkout.

So never any waiting a couple months or more for some insurance company to process the claim. And it just happens like that. Everywhere and all the time.

Never any denial of claim. Never any 'negotiation' about what will be accepted or not.

Maybe twice over the years, I've had the clinic/hospital call me afterwards, apologetically saying they had made a mistake, and that I'd get a couple hundred yen back, or that I'd have to make that up to them.

 

[mdchachi]

In the U.S. we've made it more fun. After a medical procedure it's a mystery how much you'll be charged until eventually you get a bill. Everybody likes surprises, right?

My mom spent almost a week in the hospital recently. The bill was $40,000 but the negotiated/actual bill for insurance was $11,000. So far she hasn't had to pay anything but we'll see.

 

[Grandpa Frank]

I'm clueless about medical bills. I thought all I pay was $5 when I go to the doctors. I asked my wife and she tells me we pay $400 a month for the two of us. I thought Medicare was paying for everything , including prescriptions. Gee , now I wished I hadn't asked , LOL.

 

[Lothor]

What you guys are failing to realize is that we are now in a post-facts society. They are called alternative facts. It seems to be a reliable way to drum up votes. Tell people what they want to believe. The more outrageous and untrue the better.

Even so, it's disappointing and worrying to see an attack on foreigners that simply doesn't make sense from a moderate government.

 

[Ukigumo]

We have many 'health tourists' here in the UK due to our NHS.

My partner had an overseas patient (don't you think the word 'foreigner' sounds rude?) who presented to her with a rare haematological condition. She was in the UK as the spouse of a student researching for a PhD in the UK. After a multidisciplinary team meeting, it was decided she should have a treatment that would cost nearly £500,000 (recombinant DNA chemotherapy) as it'd give her the best clinical outcome. It meant a local British citizen would have their treatment delayed as a consequence, since her need wasn't as great. Of course this treatment was free to the patient.

 

[mdchachi]

We have many 'health tourists' here in the UK due to our NHS.

My partner had an overseas patient (don't you think the word 'foreigner' sounds rude?) who presented to her with a rare haematological condition. She was in the UK as the spouse of a student researching for a PhD in the UK. After a multidisciplinary team meeting, it was decided she should have a treatment that would cost nearly £500,000 (recombinant DNA chemotherapy) as it'd give her the best clinical outcome. It meant a local British citizen would have their treatment delayed as a consequence, since her need wasn't as great. Of course this treatment was free to the patient.

That's not really a health tourist. A health tourist is somebody who goes somewhere for the purpose of getting health care. Unless the PhD research was an elaborate ruse to get his spouse into the UK for health care.

 

[Ukigumo]

That's not really a health tourist. A health tourist is somebody who goes somewhere for the purpose of getting health care. Unless the PhD research was an elaborate ruse to get his spouse into the UK for health care.

It seems the place of real expertise for the PhDs area is the USA. So with our sympathetic welfare system and free-health care, the UK was more attractive than the USA.

 

[mdchachi]

It seems the place of real expertise for the PhDs area is the USA. So with our sympathetic welfare system and free-health care, the UK was more attractive than the USA.

Foreign PhD students in the UK, typically on a Student visa, are generally not eligible for most welfare benefits. This is because their visa usually includes a "no recourse to public funds" (NRPF) condition, which prohibits access to most state benefits, tax credits, and housing assistance671.
Key Points:

• 
  
• Most Benefits Excluded: International students cannot claim Universal Credit, Income Support, Housing Benefit, or other income-based welfare benefits167.
• 
  
• Exceptions:There are limited exceptions for certain groups:
  • 
    
  • Students with dependent children or some disabled students may be able to continue an existing claim for specific benefits, but new claims are generally not possible1.
  • 
    
  • Contribution-based benefits (such as "new style" Jobseeker's Allowance or Employment Support Allowance) may be available if the student has worked and paid sufficient National Insurance contributions in the UK, as these are not considered "public funds"56.
• 
  
• After Studies: Once the course officially ends, former students may be eligible to apply for some benefits if they meet the general eligibility criteria and do not have a "no recourse to public funds" condition5.
• 
  
• Hardship Support: If facing unexpected financial hardship, international students are encouraged to seek advice from their university or student support services, as there may be limited institutional or charitable support available, but not state welfare benefits7.

Conclusion:
Foreign PhD students in the UK are generally not entitled to welfare benefits due to visa restrictions. Only in rare, specific circumstances—such as having paid sufficient National Insurance contributions for contribution-based benefits—might they be eligible for limited support. For most financial needs, students should rely on scholarships, stipends, or university hardship funds167.

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Answer from Perplexity

Foreign PhD students in the UK have access to the National Health Service (NHS) on the same basis as UK residents, provided they pay the Immigration Health Surcharge (IHS) as part of their visa application. This surcharge is mandatory for most students on courses longer than six months and entitles them to NHS hospital treatment, GP services, emergency care, and mental health support at no additional cost beyond the IHS payment2578.
Key Points:

• 
  
• NHS Access: After paying the IHS, international PhD students can use NHS services like GP appointments, hospital treatment, emergency care, and maternity services, just like UK residents23578.
• 
  
• Registration: Students must register with a local GP (doctor) upon arrival to access NHS services. Required documents typically include proof of university enrollment, passport, and visa39.
• 
  
• What's Not Covered: Some services, such as dental and optical care, and prescription medicines, may require additional payment. Expensive or elective treatments may also not be fully covered259.
• 
  
• Short Courses: Students on courses shorter than six months may not be eligible for full NHS coverage and should consider private health insurance unless covered by a reciprocal healthcare agreement57.
• 
  
• Dependents: Student dependents who pay the IHS are also entitled to NHS services57.

Conclusion:
Foreign PhD students in the UK, after paying the IHS, receive comprehensive healthcare through the NHS, with some exceptions for dental, optical, and certain prescription costs25789.

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Answer from Perplexity

 

[Ukigumo]

Foreign PhD students in the UK, typically on a Student visa, are generally not eligible for most welfare benefits. This is because their visa usually includes a "no recourse to public funds" (NRPF) condition, which prohibits access to most state benefits, tax credits, and housing assistance671.
Key Points:

Not for him, the student, but his wife.

 

[mdchachi]

Not for him, the student, but his wife.

It's the same conditions for a dependent spouse of a student. The claim that they receive welfare benefits does not seem to be true based on the extensive research I did on this matter.

There are very few examples of PhD students or their dependents successfully claiming welfare benefits in the UK, and these are limited to specific, exceptional circumstances. Here's what the evidence shows:

• Most international PhD students and their dependents are not eligible for welfare benefits such as Universal Credit, Housing Benefit, or Income Support. Claiming these benefits can breach immigration conditions and may jeopardize their visa status34.
• Exceptions exist for certain groups:
  
  • Students with dependent children or disabilities may continue to receive some benefits if they already qualified before starting their course, but new claims are generally not possible178.
  • If a student's partner (the dependent) is not a student and is otherwise eligible for benefits (for example, if they have a different visa status or indefinite leave to remain), they may be able to claim in their own right57. However, this is rare for dependents of international students, as their visas also typically include a "no recourse to public funds" condition.
• UK and EU students (not international students) may be able to claim certain benefits if they fall into excepted groups, such as lone parents, disabled students, or those with ongoing ill health157.

In summary:
There are no standard or routine examples of international PhD students or their dependents receiving UK welfare benefits. Only in rare, narrowly defined cases—such as pre-existing disability benefits or if the dependent has a different immigration status—might benefits be accessible, and even then, strict eligibility rules apply13457.

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Answer from Perplexity

 

[johnnyG]

Way long ago in my uni days, living off of ~$300/month from the GI bill, I qualified for and got food stamps for about a year. I forget how much they were worth, maybe $40-50/month?

I remember getting some looks from cashiers when I'd use them. Foodstuffs only, no napkins or cleaning supplies. Or alcohol.

 

[Ukigumo]

It's the same conditions for a dependent spouse of a student. The claim that they receive welfare benefits does not seem to be true based on the extensive research I did on this matter.

There are very few examples of PhD students or their dependents successfully claiming welfare benefits in the UK, and these are limited to specific, exceptional circumstances. Here's what the evidence shows:

• Most international PhD students and their dependents are not eligible for welfare benefits such as Universal Credit, Housing Benefit, or Income Support. Claiming these benefits can breach immigration conditions and may jeopardize their visa status34.
• Exceptions exist for certain groups:
  • Students with dependent children or disabilities may continue to receive some benefits if they already qualified before starting their course, but new claims are generally not possible178.
  • If a student's partner (the dependent) is not a student and is otherwise eligible for benefits (for example, if they have a different visa status or indefinite leave to remain), they may be able to claim in their own right57. However, this is rare for dependents of international students, as their visas also typically include a "no recourse to public funds" condition.
• UK and EU students (not international students) may be able to claim certain benefits if they fall into excepted groups, such as lone parents, disabled students, or those with ongoing ill health157.

In summary:
There are no standard or routine examples of international PhD students or their dependents receiving UK welfare benefits. Only in rare, narrowly defined cases—such as pre-existing disability benefits or if the dependent has a different immigration status—might benefits be accessible, and even then, strict eligibility rules apply13457.

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Answer from Perplexity

It make you wonder where they get the money to eat, dress, pay for a mobile phone and satellite TV subscription etc. Maybe there is magic a money tree

 

[mdchachi]

It make you wonder where they get the money to eat, dress, pay for a mobile phone and satellite TV subscription etc. Maybe there is magic a money tree

I'd assume they get a stipend or some university if they don't have the funds saved up. But I don't know the doctoral student world.