Japan Health Insurance
Practical, low-cost accidental and medical insurance while in Japan. Solid Japanese insurance for foreign students, teachers, executives, tourists and temporary residents. Medical, life, accidental and rescue insurance all in one policy for non-Japanese citizens. Fully licensed and rated — expatriate company — 60 years in Japan.

Japanese Medical Insurance for the Foreign Community of Japan

Low Rates AND Excellent Coverage
MedOne: Japan Medical Insurance

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MedOne Plan Overview

Who is Eligible?

What is Covered?

What is NOT covered?

How Much Does it Cost?

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Online Application Form for MedOne Insurance

In order to apply for this insurance, you must read, understand and agree to the following policy summary:

Applicant's Selected Plan:
Applicant's Information:
First Name:
Last Name:
Email:
Email (please confirm):
Date of Birth:
(yyyy/mm/dd)

Nationality:
Gender: Male Female
Password:
Password (please confirm):
Applicant's Address in Japan:
Postal Code: ex: 645-1567
Prefecture: ex: Aichi
City: ex: Kobe-shi
Address: ex: Kita-ku, Abe 2-3-17
Bldg Name / Apt No: ex: Sun Mansion 302
Name of person whose name appears on mailbox (if other than you own):      Why is this needed?
Home Tel:
Mobile Phone:
Mobile Phone Email:
Name of Employer: ex: ABC Company
Occupation:
Dependents:
Do you wish to include any dependents in the plan?



Dependent A:
Name:
Relationship:
Date of Birth:
(yyyy/mm/dd)

Gender: Male Female
Premium:
Dependent B:
Name:
Relationship:
Date of Birth:
(yyyy/mm/dd)

Gender: Male Female
Premium:
Dependent C:
Name:
Relationship:
Date of Birth:
(yyyy/mm/dd)

Gender: Male Female
Premium:
Dependent D:
Name:
Relationship:
Date of Birth:
(yyyy/mm/dd)

Gender: Male Female
Premium:
Beneficiary:
(in the event of loss of life) 
Name:
Relationship:
Contact Phone:
Street Address:
City:
State/Province:
Country:
Postal Code:
Requested Effective Date:
On what date would you like your insurance to start? (yyyy/mm/dd):

Please note, the actual Effective Date may vary, based on when your payment is received, when it is approved, and whether you are actually in Japan on that date. When possible, we will try to accomodate your requested start date.
Payment Information:
Payment Method: Convenience Store
Bank Transfer
PayPal
Credit Card (please note that your card will not be charged until we approve your application)
How did you hear of our company?
Statement of Health Condition:

1) Do you have any other insurance having similar coverage or benefit?

Yes No

If yes, please indicate Name of Company, Coverage, and Benefit:


2) Are you engaged in any dangerous or risky occupation like construction, driver, etc?

Yes No

If yes, please indicate details of occupation:


3) Please give details of any disease or ailment or disablement existing now:


4) Have you been operated on for any disease or ailment?

Yes No

If yes, please give details:


5) Will you be engaging in any high risk sports such as skiing, hang gliding, racing or similar activities?

Yes No

If yes, please give details:
Checklist and Agreement:

a) Does the Plan you have selected meet your requirements?

Yes No

b) Do you clearly understand what is covered and what is not covered under this policy?

Yes No

c) Does the policy period, the benefits and limits, premium amount, and payment method meet your requirements?

Yes No

I hereby certify that all statements and answers provided by me on this Application Form are complete and true to the best of my knowledge. In the event of a claim, I agree to authorize any doctor, hospital, clinic, pharmacy, insurance carrier, or other entity having information about my condition of health, to release that information to the underwriters. I understand and agree that if the matters declared are different from the facts, either willfully or by gross negligence, this policy may be cancelled or benefits under the policy may not be payable. I understand and agree that if there are changes in the contract details such as occupation, address, etc., I shall inform underwriters without delay. I acknowledge that I have read, fully understand and agree to the MedOne Terms of Service as well as the Plan Summary at the top of this page. A check mark in the box to the left of this paragraph indicates that I understand and agree to these terms.
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