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How To Apply For National Health Insurance In Japan

Here is everything you need to know about applying for national health insurance in Japan, whether you are employed or not.

By Aaron Baggett Nov 19, 2024 5 min read

If you’re planning to stay in Japan for more than three months, health insurance is not just recommended—it’s a legal requirement. The Japanese healthcare system is known for its quality, but medical expenses can be steep without coverage. Health insurance in Japan covers 70% of your medical costs, meaning you only need to pay 30% out of pocket for treatments, hospital visits or prescriptions. Here’s a straightforward guide on how to apply for national health insurance in Japan.

Note: Starting December 2, 2024, new conventional health insurance cards will no longer be issued, and the My Number Health Insurance Card will be accepted for medical treatment and pharmacy use. However, either card will be accepted as of this writing.

What is Japan’s National Health Insurance?

How to apply for national health insurance in Japan — Your share of medical expenses is 30%.

Whether you are employed or not, everyone living in Japan for more than three months is legally required to have health insurance. Without it, you could face significant out-of-pocket medical expenses in case of illness or accident.

Japanese health insurance covers a wide range of medical services, including:

Doctor visits (for general check-ups, illness, or injuries)
Hospital stays (including surgeries)
Medications prescribed by a doctor
Dental care (including check-ups, treatments, and surgery)

While dental is covered, it’s important to note that Japan’s national health insurance generally only covers the most common procedures, such as fillings, extractions, and basic treatments. In general, Japanese health insurance covers only non-preventive procedures, such as consultations, surgeries, diagnostic tests, and prescription medications.

For Those Employed Full-Time

office full time employee in Japan — A lot of benefits, but you have to mingle.

If you have a full-time job in Japan, your employer will enroll you in an employer-sponsored health insurance plan called Kenko Hoken (健康保険). One of the benefits of this system is that your company will handle the application process for you. They must enroll you within five days of employment, and it will be deducted from your monthly salary.

The health insurance tax depends on your monthly salary as well as the health insurance rate in your area. For example, in the Tokyo area (as of March 2024), the rate is 9.98%, but it might be lower in other regions. Fortunately, you pay half of that (about 4.99%), and your employer covers the other half.

Your standard monthly salary is based on your average pay over the last three months. However, if you earn more than ¥1,355,000, the tax uses a capped salary of ¥1,390,000.

Once you enroll, you’ll receive a health insurance card, which you must carry with you at all times. That said, starting in December 2024, Japan will link your health insurance to your My Number Card instead of issuing a separate card. Therefore, you’ll need either card when visiting a clinic or hospital.

For Those Who Are Not Employed Full-Time

bike bycicle part time job — A young woman is riding on a bicycle in the street for food delivery.

If you’re not employed full-time, or if your employer doesn’t provide health insurance, you’ll need to apply for Japan’s National Health Insurance (Kokumin Kenko Hoken, 国民健康保険) at your local city hall (市役所, shiyakusho) or ward office (区役所, kuyakusho).

How To Apply

Visit your local city hall or ward office and bring:

Your passport
Your Japanese residence card (with your postal address)
Your hanko (Japanese stamp)
Your My Number card (if you have one; if not, you may need to apply for it at the same time)

After applying, you’ll receive an insurance card and will start paying monthly premiums. The premium amount depends on your age, income and where you live. In most cases, you’ll receive a bill, and you can pay it at a convenience store or via online banking.

FAQ: National Health Insurance in Japan

Below are some common questions and answers about applying for health insurance in Japan.

What Happens if I Don’t Have Health Insurance?

If you don’t have health insurance in Japan, you will be responsible for covering the full cost of your medical bills, which can be very high. Moreover, the Japanese government requires everyone staying in Japan for more than three months to have health insurance. Otherwise, you may find yourself in a difficult financial situation if you need medical care.

What Happens if I Don’t Pay Health Insurance in Japan?

Failing to pay can affect your ability to change your residence status or renew your visa. In some cases, you may receive a National Health Insurance certificate with a shortened validity period. Don’t ignore your bills or try to sneak out of paying. One bad accident, and it’s over.

How Do I Pay for Health Insurance in Japan?

If you are on National Health Insurance, you will receive a bill in the mail. You can pay it at a convenience store, through bank transfers or via online banking. Some areas may allow payments directly from your bank account.

How Do I Apply for Health Insurance If I’m Self-Employed?

If you’re self-employed or freelance in Japan, you need to apply for National Health Insurance like everyone else. National Health Insurance is for the unemployed, self-employed, retired and those under 75.

How Do You Apply for Health Insurance as a Student in Japan?

All international students must apply for National Health Insurance at their local city or ward office shortly after arriving in Japan. In fact, the cost of NHI is based on your income from the previous year. However, in your first year, students typically pay around ¥2,000 per month. Additionally, if you start working part-time, your insurance premium may increase the following year based on your earnings.

How easy was it for you to get health insurance in Japan? Let us know in the comments.