１ 保健・医療
Health/Medical treatment
定住外国人の方々が地域で安心して生活するため，疾病の予防とともに，保健，医療等について利用し やすい環境づくりを進めています。
In order that foreign residents lead comfortable lives in Hiroshima prefecture, we prepare circumstances under which you could feel free to make use of systems concerning health, medical treatment, and disease preventive measures.
(１) 保健（健康診断，予防接種，感染症対策）
Health(medical examination, vaccination, preventive measures against contagious disease) 健康診断や予防接種，母子健康手帳の交付等の機会や保健衛生等の知識を定住外国人に対し ても周知させるための情報の提供に努めるとともに，感染症について外国語による知識の普及（外 国語によるパンフレット）や相談体制の充実に努めています。
We provide foreign long term residents with information concerning ｍedical examination, preventive injection and issuance of Mother and Child Health Book. We promote knowledge about contagious diseases,( brochures in various languages), we prepare health counseling services.
【問い合わせ先】 市区町役場
地域事務所厚生環境局・保健所 【More information】
保健・医療・福祉関係相談機関 Ward Office
Public Welfare and Sanitation Bureau, Regional Office
Health Center
Counseling organizations for health, medical treatment, and public welfare
(２) 医療 Medical treatment
言葉の違いからコミュニケーションに支障をきたさないよう，各医療機関において外国語による案 内表示，緊急受入体制の整備などを図ります。
languages inside the hospitals or other medical facilities. We prepare systems that meet medical emergencies. 【問い合わせ先】 市区町役場 地域事務所厚生環境局・保健所 保健・医療・福祉関係相談機関 休日・夜間診療所 【More information】 救急医療案内サービス Ward Office
Welfare and Sanitation Bureau,Public Regional office Health Center
Counseling organizations for health, medical treatment and social welfare
Medical facility for nighttimes and holidays Information service for medical emergency (３) 医療保険 Health insurance
医療保険には，勤務先で加入する健康保険と，住んでいる市町で加入する国民健康保険等があり ます。雇用された勤務条件のため，健康保険に加入できなかった外国人であって，外国人登録をし ていて在留期間が１年以上ある者は，国民健康保険が適用されます。
In Japan, there are two types of health insurance. One is Employee’s Health Insurance, which is designed for workers in companies, factories, etc. Workers are obliged to enroll in this plan at their working places. The other is National Health Insurance which the residents are required to enroll in at their living area’s municipal office.
Foreign residents who could not enroll in Employee’s Health Insurance because of the working conditions contracted at the time of their employment, and who have completed Alien Registration and who have been living in Japan more than 1 year will be applied National Health Insurance. また，原則として 75 歳以上(平成 19 年 10 月から。平成 14 年 9 月までは 70 歳，以後段階的に 1 歳ずつ引き上げ)の医療保険加入者に対し，老人保健法による医療給付を行っています。 医療保険は，国籍の区別なく適用されるものですが，この制度の仕組みが十分に理解されていな い状況にあります。このため，社会保険事務所や，市区町の窓口等に外国語によるパンフレットを置 くなどしています。 医療保険の仕組みや手続き，給付の種類，請求，支払いなどについては各担当窓口に相談してく ださい。
In principle, the subscribers of Health Insurance who are 75 years old or over will be given medical allowance under the Preservation of Health for the Aged Law. (This system will start in October
2007.The system is applied to the subscribers of 70 years old until September 2002, and from next year on, each year the age of a person to whom the system will be applied will be added one year.) Health Insurance is applied regardless of nationality, but as the system of this plan is not fully known., we place brochures in various languages at the window of the Social Insurance Office and municipal office.
As for the system of the Health Insurance Plan, procedure of enrollment, allowances, claim and payment and other information, contact the window of the municipal office.
◇◇ 医療保険制度の概要 ◇◇ Outline of health insurance
■ 国民健康保険 National Health Insurance
１ 届出手続き Notification
届出を必要とする本人が属する世帯の世帯主が，住所のある市区町の国 民健康保険担当課で届出手続きをします
The head of a household will submit the necessary documents to
National Health Insurance division of the municipal office of their residence on behalf of the family members who need to notify.
２ 届出必要事項 Notification matters 出国，転入・転出，健康保険加入・脱退，出産，死亡，住所・氏名・国籍・世 帯主変更，被保険者証紛失，等
Departure from Japan, moving-in, moving-out, affiliation with and withdrawal from health insurance, birth, death, address, name, nationality, change of the head of the household, lost of the Health Insurance Certificate, etc.
３ 被保険者証 Health Insurance Certificate １人１枚のカード様式により交付されます（カード様式でない場合は，１世 帯に１枚の様式のものを交付。）保険診療を受ける際に提示してください。 Health Insurance Certificate will be issued either to each individual in a form of a card or to each household in a form of a paper.
An insured person is required to show the certificate to the window of a hospital each time he/she receives medical examination.
４ 保険料（税） Premium (Tax)
世帯主が世帯における国保加入者の人数と収入に応じて支払います。納 付書で支払う方法と，口座振替で支払う方法とがあります。
A head of a household will pay the premium which is determined in accordance with the number of affiliated members in the household and the family income. Premiums are to be paid either through statement of payment or through postal transfer.
■ 健康保険
Employee’s Health Insurance １ 加入手続き Procedure of enrollment 適用事業所で，国籍，年齢，給料の多少に関係なく常時使用される人を採 用した場合，その事業主が社会保険事務所（又は健康保険組合）に届け出 ます。
All fulltime employees in a company must be enrolled in Employee’s Health Insurance Plan regardless of nationality, age, amount of salary.
An employer is obliged to notify to the Social Insurance Office. (or Health Insurance Cooperation)
２ 届出必要事項 Notification matters
事業主（退職，死亡，氏名変更，被保険者証の紛失，等）がそれぞれの必 要事項を届け出ます。
An employer is obliged to notify the employees’ matters. (retirement, death, change of name, lost of Employee’s Health Insurance Certificate, etc.) ３ 被保険者証 Employee’s Health Insurance Certificate 被保険者，被扶養者それぞれ１人に１枚カード様式のものが交付されます （一部カード化になっていない，健康保険組合もあります）。保険診療を受 ける際に提示してください。
An insured person and each of his/her family members will be issued a certificate in a form of card.(Some health insurance cooperation issue certificates which do not have a form of card.). This certificate should be shown to a hospital’s window each time he/she receives medical examination. ４ 保険料 Premium 被保険者の報酬の額に応じて事業主と被保険者が折半で負担し，事業主 が事業主負担分と被保険者負担分を合わせた保険料を保険者に納付しま す。
Premiums are determined in accordance with an insured person’s salary, and are shared equally between the employer and the insured person. The employer delivers the total premium(the sum of employer’s and the employee’s)to the Employee’s Health Insurance.
５ 任意継続被保 険者 （退職後の任 意加入） 健康保険の被保険者期間が継続して 2 ヶ月以上ある人が退職した場合に は，引き続き 2 年間は個人で健康保険に加入することができます。申し込 みは退職後 20 日以内に住所地の社会保険事務所（又は加入していた健 康保険組合）に申請を行います。なお，保険料は全額自己負担です。
Voluntary enrollment after Retirement
When an insured person who had been a participant of Health Insurance Plan over two months continuously has retired from a company, he/she is entitled to continue to be insured as an individual for another two years. If he/she intends to continue to be insured, he/she is obliged to apply for the Health Insurance Office (or the Health Insurance Cooperation in which he/she had participated)within 20days after his/her retirement. In this case, all the premiums should be paid by the individual.
■ 国民健康保険・健康保険の給付の種類
Benefits of National Health Insurance/Employee’s Health Insurance １ 療養の給付 In case of illness or injury 病気やけが（健康保険では，仕事での病気，けがは除かれます。）をしたと き医療費の自己負担分を支払うことにより，必要な治療が受けられます。 自己負担割合は，健康保険加入者及びその家族（被扶養者）は 30％，７０ 歳以上は 10％（一定以上所得者は 20％），３歳未満は 20％で，国民健康 保険加入者も同様です。 自己負担分を除いた残りの医療費は，健康保険又は国民健康保険から支 払われます。
When an insured person falls ill or gets injured, by paying only the portion of the costs one is responsible for, he/she will receive necessary medical treatment.(Employee’s Health Insurance will not be applied to illness or injury caused by the work in the company.)
The ratio of the medical costs one is responsible for is as follows. ・insured person and his/her family member (dependant) -30％ ・person of 70 yeas of age and over- 10％
( those whose income exceeds certain amount – 20 ％) ・child under 3 yeas of age – 20％
（The same ratio will be applied both in National Health Insurance Plan and in Employee’s Health Insurance Plan.)
Health Insurance Plan pays the rest of the costs. ２ 療養費 Medical expenses やむを得ない事情で保険医療機関で保険診察を受けることができず，自 費で受診したときなどの特別な場合に医療費の標準料金から一部負担金 を除いた額が払い戻しされます。（コルセット，生血液の輸血，柔道整復師 等の施術，非保険医による診察，被保険者証を提示しない受診，等） When an insured person could not apply the Health Insurance at
a hospital for unavoidable reasons and paid the whole medical
expenses, the sum that is equivalent to the rest when his/her responsible costs is subtracted from the standard medical fee will be returned.(corset, blood transfusion, treatment by judo bonesetter or other oriental
treatments, treatment by a doctor who does not participate in Health Insurance, treatment without presenting Health Insurance Certificate etc.) ３ 高額療養費
Expensive medical fee
1 ヶ月に医療機関等に支払った自己負担額が下表の額を超えたときその 超えた部分が被保険者の請求により払い戻される制度です。
When the medical fee paid by an insured person to a hospital within one month exceeds the amount of the fee shown by the following list, the amount that exceeds will be returned to the insured person after his/her claim is applied.
70 歳未満及び世帯全体 Under 70 years of age and whole household
自己負担限度額
Amount of the fee that one is responsible for 一般
People in general
72,300 円＋（医療費－241,000 円）×１％ 72,300yen＋（medical fee－241,000yen）×1％ 上位所得者
High income earner
139,800 円＋（医療費－466,000 円）×１％ 139,800yen＋(medical fee－466,000yen×1％ 低所得者
Low income earner
35,400 円 35,400yen
自己負担限度額
Amount of the fee that one is responsible for 70 歳以上
Over 70 years of age 個人単位（外来の み）
Individual (outpatient only)
世帯単位（入院含む）
Household (include inpatient)
一般 People in general 12,000 円 12,000yen 40,200 円 40,200yen 一定以上所得者
Those who get
40,200 円 40,200yen
72,300 円＋（医療費－361,500 円）×１％ 72,300yen＋(medical fee－361,500yen)×
more than certain amount of income
1％
I 15,000 円 (15,000yen) 低所得者
Low income earner II
8,000 円 8,000yen 24,600 円 (24,600yen) ※ 上位所得者とは，診療を受けた月の標準報酬月額が 560,000 円以上の者（健康保 険の場合），その世帯の国民健康保険加入者の所得の基礎控除後の額の合計が 6,700,000 円を超える者。
High income earner means a person whose standard pay monthly basis for the month during which one underwent medical treatment exceeds 560,000yen. (in case of Employee’s Health Insurance) and a person whose income after the fundamental tax deduction exceeds 6,700,000yen(in case of National Health Insurance).
※ 低所得者とは，市町村民税の非課税者・免除者。
Low income earner means a person who is exempted from municipal tax.. ※ 一定以上所得者とは，判定基準所得以上の者がいる世帯に属する 70 歳以上の
者。
A person who earn certain amount of income means a person who is 70 yeas of age or over of a household a member of which earns more than certain standard income.
※ 低所得者 I とは，市町村民税非課税で，世帯員の所得が一定基準に満たない 70 歳以上の者。
Low income earner means a person of 70 yeas of age or over who is exempted from municipal tax and the household to which he/she belongs gets less than certain amounts of income.
※ 低所得者 II とは，市町村民税非課税の世帯に属する 70 歳以上の者。
Low income earner ＩＩ means a person of 70 years of age or over who belongs to a household which is exempted from municipal tax..
４ 出産育児一時金 （家族出産育児一時金） Lump sum allowance for new-born babies
被保険者又はその被扶養者が，妊娠 4 ヶ月（85 日）以上で出 産したとき，１児ごとに 30 万円が支給されます。
When an insured person or his/her dependant gave birth to a baby after more than four months (85 days) of pregnancy,
300,000yen will be given to her for each new born baby. ５ 葬祭費
（健康保険を除く） Allowance for funeral (except the health insurance)
被保険者が死亡したときは，葬祭を行った人に対して一定の 葬祭費が支給されます。
When an insured person died, allowance for funeral will be given to a person who was in charge of the funeral.
６ 埋葬（費）（健康保険のみ） （家族埋葬料） Funeral allowance to
the family of
the deceased (only the health insurance） 被保険者が死亡したときは，埋葬を行なった家族に，故人の 標準報酬月額の 1 か月分（10 万円未満のときは 10 万円），死 亡した被保険者に家族がいない時は，埋葬を行った人に埋葬 料の範囲内で，埋葬にかかった費用が，また，被扶養者が死 亡したときは，家族埋葬料として１０万円が被保険者に支給さ れます。
When an insured person died, one month salary which is equivalent to his/her standard pay monthly basis (when this amount is under 100,000yen, 100,000yen) will be given to a family member who was in charge of the funeral.
When the deceased (who had been insured) had no family, the sum which is equivalent to the funeral expense (within
prescribed amount) will be given to the person who was in charge of the funeral.
When one of the dependants died, 100,000yen will be given to the insured person, as a family allowance of funeral.
７ 出産手当金 （健康保険のみ） Maternity allowance (only health insurance) 被保険者が出産のため会社を休み，事業主から報酬が受け られないとき欠勤 1 日につき標準報酬日額の６割が支給され ます。（出産（予定）日以前 42 日（多胎妊娠の場合は 98 日）か ら分娩の日の翌日以後 56 日の範囲内。）
When an insured person was absent from a company due to childbirth and was not given the salary accordingly, 60 percent of the standard pay daily basis will be given to her for each absent day as maternity allowance. (These days should be during the period between 42 days before the expected date of birth and 56 days[in case of pregnancy of more than two babies at a time, 98 days] after the next day of birth.)
（健康保険のみ） Medical allowance (only health insurance)
酬を受けられない場合に，欠勤１日につき標準報酬日額の６ 割が支給されます。（病気やけがで休んだ期間のうち（４日目） から起算して１年６か月間の範囲。）
When an insured person was absent from a company due to illness or injury and was not given the salary accordingly, allowance of 60 percent of his/her standard pay daily basis will be given for each absent day.
(These days should be during the period between the 4th day after the
beginning of his/her absence due to illness or injury and 1year and 6months after.)
９ その他 入院時食事療養費，特定療養費，訪問看護療養費，移送費，
等
Other allowances
Allowance for inpatient treatment and food expenses in the hospital, Special treatment allowance, Nursing at home allowance,
Allowance for being delivered from a hospital to the other etc. ■ 老人保健法による医療給付
Medical Fee Assistance by Sanitation Law for the Aged
原則として医療費の１割（一定以上所得者は 2 割）を負担することにより医療が受けられま す。
病院診療所等の窓口では，健康手帳，老人保健法医療受給者証及び国民健康保険等の 被保険者証を提示してください。
In principle, an insured person can receive medical treatment by paying 10 percent (Those who have more than certain prescribed income will pay 20 percent )of what the medical treatment really costs.
At the window of a hospital, an insured patient is required to show Health Handbook, Certificate of Medical Treatment Beneficiary by Sanitation for the aged Law, and National Health Insurance Certificate.
【問い合わせ先】 【More information】
国民健康保険
National Health Insurance →
市区町役場 Municipal Office 健康保険
Health Insurance →
社会保険事務所
老人保健法による医療給付 Medical fee assistance by Sanitation Law for the Aged
→ 市区町役場 Municipal Office (４) 医療費の公費負担 Public financial assistance for medical treatment
■ 老人医療費 Assistance for medical expense of the aged
「昭和 11 年 9 月 30 日以前に生まれた人」又は「昭和 11 年 10 月 1 日以降，昭和 14 年 9 月 30 日以前に生まれた人」（いずれも 70 歳以上の人を除く。）で，市町長が一人暮らしと認定した人 が，医療機関で医療を受けた場合の自己負担の一部を公費で負担します。ただし，所得による 制限があります。
なお，市町により，対象年齢の拡大などが行われている場合があります。
Those who were born before September 30th 1936(Showa11) or those who were born during the period between October1st 1936(Showa11) and September 30th 1939(Showa14) [ in either case except those over 70 years of age ] and are acknowledged by mayor as a person living alone will be given medical fee by public expense for a certain part of the medical treatment fee he/she is originally responsible for. In this case, however, the person needs to meet certain condition in terms of his/her income.
There is possibility that in certain specific city or region the beneficiary condition concerning age might be less strict.
【問い合わせ先】 市区町役場
【More information】 Municipal Office ■ 重度心身障害者医療費
Assistance for medical expense of severely disabled or mentally disabled person
身体障害者手帳（１，２，３級）又は療育手帳（ ，Ａ， ）の交付を受けている人が，医療機関 で医療を受けた場合の自己負担相当分を公費で負担しています。ただし，所得による制限があ ります。平成 18 年 8 月から，1 医療機関あたり 1 日 100 円の自己負担が必要となります。（ただ し，入院については，1 医療機関月 14 日までの負担，通院については，1 医療機関月 4 日まで の負担となります。） なお，市町により，対象者の拡大などが行われている場合があります。
When a person to whom is issued the Handbook for the Disabled ( 1 st , 2 nd , 3 rd grade) or Handbook for those rearing the disabled children (A,A,B) received medical treatment in a hospital, he/she will be given the public financial assistance for the sum he/she is originally responsible for. In this case, the benefit can be restricted according
to his/her income. After August 2006,a patient needs to pay 100 yen a day for each medical facility. (However, when hospitalized, the patient should continue to pay 100yen a day only up to 14 days a month for each medical facility. As for outpatient, he/she should continue to pay only up to 4 days a month for each medical facility.) There is possibility that in certain specific city or region, beneficiary conditions might be less strict.
【問い合わせ先】 市区町役場
【More information】 Municipal Office
■ 乳幼児医療費 Assistance for medical expense of infant
対象乳幼児（入院・通院とも就学前児まで）が，医療機関で医療を受けた場合の自己負担の一 部を公費で負担します。ただし，所得による制限があります。１医療機関あたり 1 日 500 円の自 己負担が必要となります。（ただし，入院については 1 医療機関月 14 日までの負担，通院につい ては 1 医療機関月 4 日までの負担となります。） なお，市町によっては，助成内容が異なる場合がありますので，詳しいことは居住地の市区町 役場の窓口へお問い合わせください。
Financial assistance is available for the medical expenses of children up to the time before they start elementary school. (both inpatient and outpatient) The benefit will be restricted according to the income. The patient needs to pay 500 yen a day for each medical facility.
(When hospitalized, however, the patient should continue to pay 500 yen a day up to 14 days a month for each medical facility. As for outpatient, he/she should continue to pay up to 4 days a month for each medical facility.)
For more information, please contact the window of municipal office, for it is possible that the benefit varies according to city or region.
【問い合わせ先】 市区町役場
【More information】 Municipal Office
■ ひとり親家庭等医療費 Assistance for medical expense of the family with a single parent etc. ひとり親家庭の父又は母及び児童（18 歳に達する日以降の最初の 3 月 31 日までの間）並びに 父母のない児童が，医療機関で医療を受けた場合の自己負担相当分を公費で負担します。た だし，所得による制限があります。平成 18 年 8 月から，1 医療機関あたり 1 日 250 円の自己負 担が必要となります。（ただし，入院については，1 医療機関月 14 日までの負担，通院について は，1 医療機関月 4 日までの負担となります。） なお，市町により所得制限などが異なりますので，詳しいことは，居住地の市区町役場の窓口 へお問い合わせください。
When a father or a mother or children ( up to the first March 31st after the day one reaches 18 years of age) of a family with a single parent or an infant without parent received medical treatment, public financial assistance is available for the expense one is originally responsible for. The benefit will be restricted according to income. After August 2006, the patient needs to pay 250yen a day for each medical facility. (When hospitalized, however ,the patient should continue to pay 250yen a day up to 14 days a month for each medical facility.. As for outpatient, he/she should continue to pay 250 yen a day up to 4 days a month for each medical facility.)
As conditions for the benefit such as income etc might vary according to city or region, please contact the window of the municipal office of your residence.
【問い合わせ先】 市区町役場
【More information】 Municipal Office
■ 自立支援医療費 Assistance for medical expense of the handicapped to become self support 心身の障害の軽減を図る自立支援医療に必要な費用の 9 割を保険と公費で負担します。自己 負担部分の 1 割については，世帯の所得水準等に応じてひと月当たりの負担に上限額を設定 し，上限額を超えた部分は公費で負担します。給付の対象になる医療は次のとおりです。 Insurance and public finance will cover 90percent of the medical expense necessary for the handicapped to become self support. As for the 10 percent of the expense one is originally responsible for, monthly maximum fee is prescribed according to the family’s standard income level, and the part of the expense that is over the monthly maximum fee will be covered by the public finance. Benefits are prescribed for the following medical treatments.
（1）育成医療 Medical treatment of the handicapped children
身体に障害のある児童又はそのまま放置すると将来障害を残すと認められる疾患がある児童 であって，確実な治療効果が期待できるものに対して行われる医療。
Medical treatment for the physically handicapped children or the children with the disease that is considered to cause physical disorder in the future if they do not receive the appropriate medical treatment and who can expect to have apparent effects after the medical treatment, they are beneficiary.
【問い合わせ先】 【More information】
保健所（分室）
Health Center (branch) 市保健所
Municipal Health Center
身体に障害を除去し，又は軽減して日常生活を容易にすること等を目的とした医療。
Medical treatment to recover from or reduce physical disorder in order to lead comfortable life.
【問い合わせ先】 市区町役場
【More information】 Municipal Office
（3）精神通院医療 Medical treatment of the mentally disabled outpatient
精神障害者の通院医療を促進し，かつ適正な医療を普及させるために行われる通院医療。 Medical treatment to help mentally disabled outpatient, to prevail appropriate medical treatment.
【問い合わせ先】 市区町役場
【More information】 Municipal Office
■ 結核・感染症医療費 Medical expense of tuberculosis/infectious disease
結核・感染症の適正な医療を普及するため，結核及び感染症患者の治療費は，対象となる医 療費の 95％から全額を保険と公費で負担します。ただし，所得による制限があります。
なお，感染症は知事が入院勧告した一類及び二類感染症（エボラ出血熱，重症急性呼吸器症 候群(SARS)など）が対象となります。
In order to prevail appropriate medical treatment of tuberculosis or other infectious disease, insurance and public finance will cover from 95 percent to 100 percent of necessary medical expense of these diseases. There is limitation of benefit according to the income of the patient. The infectious diseases here indicates those diseases whose patients the governor recommends to be hospitalized, the designated 1st class and 2nd class diseases ( including Ebola, SARS etc.)
【問い合わせ先】 保健所（分室）
市保健所
【More information】 Health Center(branch) Municipal Office
■ 小児慢性特定疾患治療研究事業 Investigation of the specific infantile chronic diseases 20 歳未満（新規は 18 歳未満）の人が，医療機関で小児慢性特定疾患の対象疾患で医療を受 けた場合の，自己負担相当分を公費で負担します。ただし，重症患者，血友病患者，生計中心 者の市町民税が非課税の方及び生活保護世帯の方を除いて，一部自己負担が必要です。 When a person under 20 years of age (as for a newly affiliated person, under 18 years of age) received medical treatment of specific infantile chronic disease, public finance will cover the amount of the expense originally he/she is responsible for. Some persons, however, should pay a part of the expense with the exception of a serious case, a hemophiliac, the person whose family’s householder is exempted from the municipal tax, or the person whose household receive
a livelihood of protection allowance.
【問い合わせ先】 保健所（分室）Health Center(branch) 【More information】 市保健所Municipal Health Center
■ 特定疾患治療研究事業 Medical Treatment Investigation of specific disease
特定疾患に罹患した患者が，医療機関で医療を受けた場合の自己負担相当分を公費で負担 します。ただし，重症患者，生計中心者の市町民税が非課税の方を除いて，一部自己負担額が 必要です。
When a specific disease patient received medical treatment, public finance will cover the expense he/she is originally responsible for. Some persons, however, should pay a part of the expense he/she is responsible for, with the exception of a serious case and a person whose family’s householder is exempted from the municipal tax..
【問い合わせ先】 保健所（分室）
【More information】
市保健所
Municipal Health Center Health Center (branch)
