Essential Guide
Health Insurance in Japan
Japan requires all residents to have health insurance. The system covers 70% of medical costs, making healthcare remarkably affordable. Here's everything you need to know as a foreigner.
Japan requires all residents to have health insurance. The system covers 70% of medical costs, making healthcare remarkably affordable. Here's everything you need to know as a foreigner.
Japan has a universal healthcare system. Which plan you join depends on your employment status.
| Feature | National Health Insurance (NHI) | Employee Health Insurance (Shakai Hoken) |
|---|---|---|
| Who joins | Self-employed, freelancers, students, unemployed | Company employees (30+ hrs/week) |
| Enrollment | Ward office (you enroll yourself) | Employer enrolls you automatically |
| Coverage | 70% of medical costs | 70% of medical costs |
| Premium | Based on previous year's income | ~10% of salary (split 50/50 with employer) |
| Dependents | Each person pays separately | Dependents covered at no extra cost |
| Extras | Basic coverage only | Includes pension, injury/illness leave benefits |
All residents staying in Japan for 3 months or more must enroll in health insurance. If you don't enroll through your employer, you must sign up for NHI at your ward office within 14 days of moving in. Failure to enroll can result in backdated premiums for up to 2 years.
If you're self-employed, freelancing, or between jobs, follow these steps to enroll in National Health Insurance.
Complete your address registration (juminhyo) at your ward office. This is a prerequisite for NHI enrollment.
Go to the NHI counter at your ward office. Bring your residence card, passport, and My Number notification.
Complete the NHI application form. Staff can help with Japanese. Some wards have English forms available.
Your insurance card arrives by mail in 1-2 weeks. You can use the temporary receipt for medical visits in the meantime.
NHI premiums vary by ward and income. Here are typical examples for Tokyo residents.
Japan's healthcare system includes a safety net: if your out-of-pocket medical expenses exceed a certain threshold in one month (typically ¥80,100 for standard income earners), the excess is reimbursed. This means even major surgery or hospitalization won't bankrupt you.
Japanese health insurance covers most medical services. Here's a breakdown.
Doctor visits, hospital stays, surgery, prescription medication, X-rays, MRI, blood tests, dental cleanings, cavity treatment, mental health consultations, physical therapy, and maternity care.
Dental crowns (metal covered, ceramic extra), orthodontics (only for medical necessity), ambulance transport to non-designated hospitals, some advanced treatments with mixed billing.
Cosmetic surgery, LASIK, most dental implants, private hospital rooms (upgrade fee), annual health checkups (employer usually covers), vaccinations (some subsidized separately).
Practical advice to navigate Japan's healthcare system smoothly.
If you leave Japan permanently, visit your ward office to cancel your NHI before departing. You may be eligible for a partial premium refund for months already paid. Failing to cancel can result in continued charges and complications if you return to Japan in the future.
MoveMate can guide you through ward office registration and health insurance enrollment. Get personalized support in English.
Your My Number Card can now function as your health insurance card at most hospitals and clinics — one less card to carry! See our ID Documents guide for the full application process.