Complete guide to Japanese health insurance for foreigners. Learn about National Health Insurance, employee insurance, costs, coverage, and how to enroll.
Health insurance is mandatory for all residents of Japan, including foreigners. The Japanese healthcare system provides universal coverage through two main systems: National Health Insurance (NHI) and Employee Health Insurance.
This guide explains both systems, helps you understand which applies to you, and walks through enrollment, costs, and usage. Understanding your insurance options ensures you get quality healthcare while managing costs effectively.
| Insurance Type | Who It's For | Premium Calculation | Coverage |
|---|---|---|---|
| National Health Insurance (国民健康保険) | Self-employed, students, unemployed | Based on previous year income | 70% |
| Employee Health Insurance (健康保険) | Full-time employees | Split 50/50 with employer | 70-80% |
| Dependents Coverage | Family of employee insurance holders | Free (covered by primary holder) | 70-80% |
| Annual Income | Monthly Premium | Annual Total |
|---|---|---|
| ¥0 (Student/No income) | ¥2,000-4,000 | ¥24,000-48,000 |
| ¥2,000,000 | ¥10,000-15,000 | ¥120,000-180,000 |
| ¥3,000,000 | ¥15,000-20,000 | ¥180,000-240,000 |
| ¥5,000,000 | ¥25,000-35,000 | ¥300,000-420,000 |
| ¥8,000,000+ | ¥40,000-60,000 | ¥480,000-720,000 |
Employee insurance is provided through your employer and offers better benefits than NHI.
| Monthly Salary | Your Share | Employer Share | Total |
|---|---|---|---|
| ¥200,000 | ¥10,000 | ¥10,000 | ¥20,000 |
| ¥300,000 | ¥15,000 | ¥15,000 | ¥30,000 |
| ¥400,000 | ¥20,000 | ¥20,000 | ¥40,000 |
| ¥500,000 | ¥25,000 | ¥25,000 | ¥50,000 |
Check if you qualify for employee insurance through work
Residence card, passport, My Number, employment proof
Submit application within 14 days of arrival
Usually issued same day or within 1 week
Monthly payments begin immediately
Japanese health insurance covers 70% of most medical expenses. You pay 30% at point of service.
| Service | Coverage | Your Cost | Notes |
|---|---|---|---|
| Doctor visits | ✓ 70% | 30% | All necessary treatment |
| Hospitalization | ✓ 70% | 30% | Includes meals |
| Surgery | ✓ 70% | 30% | Medically necessary only |
| Prescription drugs | ✓ 70% | 30% | Approved medications |
| Dental (basic) | ✓ 70% | 30% | Fillings, extractions |
| Maternity care | ✓ 70% | 30% | Plus childbirth allowance |
| Mental health | ✓ 70% | 30% | Psychiatry covered |
| Preventive care | ✗ | 100% | Health checks not covered |
| Cosmetic procedures | ✗ | 100% | Not covered |
| Alternative medicine | ✗ | 100% | Acupuncture sometimes covered |
Using health insurance in Japan is straightforward once you understand the process.
Private insurance can supplement Japanese health insurance for additional coverage.
| Type | Coverage | Monthly Cost | Best For |
|---|---|---|---|
| Gap Insurance | Covers 30% copay | ¥2,000-5,000 | Reducing out-of-pocket costs |
| Hospital Cash | Daily allowance if hospitalized | ¥1,500-3,000 | Income protection |
| Cancer Insurance | Lump sum for cancer diagnosis | ¥2,000-4,000 | Major illness protection |
| International Plans | Global coverage | ¥10,000-30,000 | Frequent travelers |
Each ward in Tokyo manages health insurance independently. Find English support at these locations:
| English | Japanese | Romaji |
|---|---|---|
| Health insurance | 健康保険 | Kenkou hoken |
| Insurance card | 保険証 | Hokenshou |
| I want to enroll | 加入したいです | Kanyuu shitai desu |
| Premium payment | 保険料 | Hokenryou |
| Coverage certificate | 資格証明書 | Shikaku shoumeisho |
| Dependent | 扶養家族 | Fuyou kazoku |
Yes, health insurance is mandatory for all residents staying longer than 3 months. This includes students, workers, and dependents. You cannot opt out even if you have private international insurance.
NHI costs vary by income and municipality, typically ¥2,000-60,000/month. Employee insurance is about 5% of salary (you pay half). First-year residents often pay minimum rates around ¥2,000-4,000/month.
No, you must enroll in Japanese insurance. However, international insurance can supplement Japanese coverage for services like direct billing at international clinics or coverage while traveling.
For employee insurance, dependents with income under ¥1.3 million/year can be added for free. For NHI, each family member needs coverage but household premiums are calculated together.
Not covered: preventive health checks, cosmetic procedures, fertility treatments (mostly), private hospital rooms, experimental treatments, and some mental health therapies. Normal pregnancy/childbirth has separate support systems.
Health insurance is mandatory for all residents of Japan, including foreigners. The Japanese healthcare system provides universal coverage through two main systems: National Health Insurance (NHI) and Employee Health Insurance.
This guide explains both systems, helps you understand which applies to you, and walks through enrollment, costs, and usage. Understanding your insurance options ensures you get quality healthcare while managing costs effectively.
| Insurance Type | Who It's For | Premium Calculation | Coverage |
|---|---|---|---|
| National Health Insurance (国民健康保険) | Self-employed, students, unemployed | Based on previous year income | 70% |
| Employee Health Insurance (健康保険) | Full-time employees | Split 50/50 with employer | 70-80% |
| Dependents Coverage | Family of employee insurance holders | Free (covered by primary holder) | 70-80% |
| Annual Income | Monthly Premium | Annual Total |
|---|---|---|
| ¥0 (Student/No income) | ¥2,000-4,000 | ¥24,000-48,000 |
| ¥2,000,000 | ¥10,000-15,000 | ¥120,000-180,000 |
| ¥3,000,000 | ¥15,000-20,000 | ¥180,000-240,000 |
| ¥5,000,000 | ¥25,000-35,000 | ¥300,000-420,000 |
| ¥8,000,000+ | ¥40,000-60,000 | ¥480,000-720,000 |
Employee insurance is provided through your employer and offers better benefits than NHI.
| Monthly Salary | Your Share | Employer Share | Total |
|---|---|---|---|
| ¥200,000 | ¥10,000 | ¥10,000 | ¥20,000 |
| ¥300,000 | ¥15,000 | ¥15,000 | ¥30,000 |
| ¥400,000 | ¥20,000 | ¥20,000 | ¥40,000 |
| ¥500,000 | ¥25,000 | ¥25,000 | ¥50,000 |
Check if you qualify for employee insurance through work
Residence card, passport, My Number, employment proof
Submit application within 14 days of arrival
Usually issued same day or within 1 week
Monthly payments begin immediately
Japanese health insurance covers 70% of most medical expenses. You pay 30% at point of service.
| Service | Coverage | Your Cost | Notes |
|---|---|---|---|
| Doctor visits | ✓ 70% | 30% | All necessary treatment |
| Hospitalization | ✓ 70% | 30% | Includes meals |
| Surgery | ✓ 70% | 30% | Medically necessary only |
| Prescription drugs | ✓ 70% | 30% | Approved medications |
| Dental (basic) | ✓ 70% | 30% | Fillings, extractions |
| Maternity care | ✓ 70% | 30% | Plus childbirth allowance |
| Mental health | ✓ 70% | 30% | Psychiatry covered |
| Preventive care | ✗ | 100% | Health checks not covered |
| Cosmetic procedures | ✗ | 100% | Not covered |
| Alternative medicine | ✗ | 100% | Acupuncture sometimes covered |
Using health insurance in Japan is straightforward once you understand the process.
Private insurance can supplement Japanese health insurance for additional coverage.
| Type | Coverage | Monthly Cost | Best For |
|---|---|---|---|
| Gap Insurance | Covers 30% copay | ¥2,000-5,000 | Reducing out-of-pocket costs |
| Hospital Cash | Daily allowance if hospitalized | ¥1,500-3,000 | Income protection |
| Cancer Insurance | Lump sum for cancer diagnosis | ¥2,000-4,000 | Major illness protection |
| International Plans | Global coverage | ¥10,000-30,000 | Frequent travelers |
Each ward in Tokyo manages health insurance independently. Find English support at these locations:
| English | Japanese | Romaji |
|---|---|---|
| Health insurance | 健康保険 | Kenkou hoken |
| Insurance card | 保険証 | Hokenshou |
| I want to enroll | 加入したいです | Kanyuu shitai desu |
| Premium payment | 保険料 | Hokenryou |
| Coverage certificate | 資格証明書 | Shikaku shoumeisho |
| Dependent | 扶養家族 | Fuyou kazoku |
Yes, health insurance is mandatory for all residents staying longer than 3 months. This includes students, workers, and dependents. You cannot opt out even if you have private international insurance.
NHI costs vary by income and municipality, typically ¥2,000-60,000/month. Employee insurance is about 5% of salary (you pay half). First-year residents often pay minimum rates around ¥2,000-4,000/month.
No, you must enroll in Japanese insurance. However, international insurance can supplement Japanese coverage for services like direct billing at international clinics or coverage while traveling.
For employee insurance, dependents with income under ¥1.3 million/year can be added for free. For NHI, each family member needs coverage but household premiums are calculated together.
Not covered: preventive health checks, cosmetic procedures, fertility treatments (mostly), private hospital rooms, experimental treatments, and some mental health therapies. Normal pregnancy/childbirth has separate support systems.