Japan has a universal healthcare system. If you live in Japan for more than three months, you are generally required to enroll in either Employee Health Insurance or National Health Insurance (NHI).
This guide explains how National Health Insurance works and how foreigners can apply.
What Is National Health Insurance (NHI)?
National Health Insurance (Kokumin Kenkō Hoken) is a public health insurance system managed by local municipalities.
If you are:
- Self-employed
- A student
- Unemployed
- Working part-time without employee insurance
You will likely need to enroll in National Health Insurance.
If you are employed full-time, your employer usually enrolls you in Employee Health Insurance instead.
Do Foreigners Need to Enroll?
If you have completed your Address Registration at your local city or ward office and plan to stay in Japan for more than three months, enrollment is generally mandatory.
You will also need your My Number for the procedure.
Failing to enroll may result in back payments being charged later.
Required Documents
Bring the following to your local municipal office:
- Residence card
- Passport
- My Number card or notification
- Proof of previous insurance (if applicable)
- Bank account details (for premium payments)
If you have not opened one yet, see our guide on how to open a Bank Account in Japan.
How to Apply Step-by-Step
- Visit your local city/ward office.
- Inform them you want to enroll in National Health Insurance.
- Submit required documents.
- Choose your payment method (bank transfer recommended).
- Receive your insurance certificate (or digital registration confirmation).
The entire process usually takes 30–60 minutes.
How Much Does It Cost?
Premiums depend on:
- Your previous year’s income
- Number of household members
- Municipality
If you had no income in Japan last year, your premium may be reduced.
On average, many low-income residents pay between ¥15,000–¥30,000 per month, but this varies significantly.
What Does NHI Cover?
National Health Insurance typically covers:
- 70% of medical expenses
- Doctor visits
- Hospitalization
- Prescription medications
You pay 30% at the clinic.
For emergencies, keep emergency contact information accessible and ensure your Address Registration is up to date.
When to Notify the City Office
You must notify your local office if:
- You move to a new address
- You leave Japan
- You switch to Employee Health Insurance
- Your household status changes
See our moving guide in:
How to Rent an Apartment in Japan as a Foreigner
What Happens If You Don’t Pay?
Unpaid premiums can result in:
- Late fees
- Reduced insurance benefits
- Difficulty renewing visas
Back payments may be collected when renewing your residence status.
Important Notes
- Premium calculations vary by municipality.
- Always confirm details directly with your city office.
- Keep all payment receipts.
Disclaimer
This article is for informational purposes only and does not constitute legal or financial advice. Health insurance regulations and premium calculations may change and vary by municipality. Always confirm official procedures with your local city or ward office.
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