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Health Insurance for Foreign Residents

health Last updated: 2024-12-12

Complete guide to Japan's health insurance system. Understand NHI vs. company insurance, costs, and how to use your coverage.

🗣️ Key Vocabulary

健康保険 Health insurance けんこうほけん kenkō hoken
国民健康保険 National Health Insurance (NHI) こくみんけんこうほけん kokumin kenkō hoken
保険証 Insurance card ほけんしょう hokenshō
負担 Burden/co-payment ふたん futan
診察 Medical examination しんさつ shinsatsu
処方箋 Prescription しょほうせん shohōsen

Who Needs Health Insurance

Everyone registered as a resident in Japan for more than 3 months must have health insurance. This includes:

- Employees (enrolled through your company) - Self-employed and freelancers (National Health Insurance) - Students on visas longer than 3 months - Dependents of insured residents

There is no "opt out." The system assumes everyone participates.

The Two Main Systems

Company Insurance (Shakai Hoken) If you work for a company with 5+ employees, you're automatically enrolled. Premiums are split with your employer (roughly 50/50). Higher earners pay more, but coverage is the same.

National Health Insurance (Kokumin Kenkō Hoken) For self-employed, part-time workers, students, and unemployed residents. You enroll at your ward office. Premiums are based on last year's income plus a flat per-person rate.

Both provide the same 70% coverage — you pay 30% of medical costs.

Enrolling in National Health Insurance

If you need NHI, go to your ward office within 14 days of moving in:

Step 1: Go to the insurance counter

Look for signs saying 国民健康保険 or ask at information.

💬 What to Say

国民健康保険に加入したいです
Kokumin kenkō hoken ni kanyū shitai desu
I want to enroll in National Health Insurance

Step 2: Bring required documents

Residence card, My Number card or notification, and passport. Some wards require a bank book for payment setup.

Step 3: Fill out the application

Staff will help. You'll receive your insurance card in 1-2 weeks by mail.

Step 4: Understand your premiums

First-year residents from abroad often get lower rates since there's no Japanese income history. Expect ¥15,000-40,000/month depending on income.

Using Your Insurance

At the Clinic/Hospital 1. Present your insurance card (hokenshō) at reception 2. See the doctor 3. Pay 30% of the bill at the window 4. Take your prescription (shohōsen) to any pharmacy

Getting Medicine Pharmacies are separate from hospitals. Hand them your prescription, pay 30% of medicine costs. Generic options (jenerikku) save money — ask for them.

What's NOT Covered - Most dental work beyond basics - Vision correction - Cosmetic procedures - Annual health checks (some companies cover these separately)

✅ Checklist

🔗 Resources