How Does Japan’s Health Insurance Work? A Simple Guide for Foreigners
1. Introduction
"Did you know that if you live in Japan, you must have health insurance?"
Japan is known for its high-quality and relatively affordable healthcare. One of the key reasons for this is the Universal Health Insurance System.
This system ensures that everyone living in Japan, including foreigners, is covered by public health insurance. As a result, most medical costs are covered, and patients only need to pay a small portion.
But did you know that your out-of-pocket cost depends on your age?
For example, working-age adults pay 30%, while young children and seniors pay only 10%–20%.
In this guide, I’ll explain how Japan’s health insurance works, how much it costs, and how to use it in a simple and easy-to-understand way!
(Source: Government Public Relations Online)
2. What is Japan’s Health Insurance System?
In Japan, all residents must enroll in health insurance, including foreigners who have a visa for more than three months.
Short-term visitors, such as tourists, are not eligible. However, if you are working or studying in Japan, you must join the system.
With public health insurance, you only pay 10%–30% of medical costs, while the insurance covers the rest.
This means that even if you need surgery or hospitalization, your medical expenses will be significantly reduced.
3. How Much Do You Pay? (Copayment by Age)
The percentage of medical costs you pay depends on your age.
For example, children under 6 years old pay 20%, while those aged 6 to 69 pay 30%.
If you are over 70, your copayment is 20%, but if you have a high income, you may have to pay 30%.
For people aged 75 and older, the standard rate is 10%, unless they have a high income, in which case it can be 30%.
Japan’s system reduces costs for seniors, as they tend to require more medical care.
(Source: Government Public Relations Online)
4. What Are the Types of Health Insurance?
There are two main types of health insurance in Japan.
The first is Employee Health Insurance (Shakai Hoken), which is for people who work at a company. If you are employed, your company will pay half of your insurance premiums, making it a more affordable option. Additionally, your spouse and children can be covered under your plan.
The second type is National Health Insurance (NHI), which is for freelancers, self-employed individuals, students, and working holiday visa holders. The premium is based on your previous year’s income, so people with lower incomes pay less.
For foreign students, the cost is usually around ¥5,000–¥10,000 per month if they have no income. However, if they work part-time, the premium may increase to ¥15,000–¥20,000 per month.
5. How Much Does It Cost?
Monthly Premiums
For health insurance, you must pay a monthly premium. The amount varies based on your income and type of insurance.
Employee Health Insurance: ¥15,000–¥30,000 per month (the company pays half)
National Health Insurance (for freelancers & students): ¥5,000–¥20,000 per month (depends on income)
Medical Costs (Out-of-Pocket Expenses)
With insurance, you don’t have to pay the full cost of medical treatment. You only need to pay 10%–30% based on your age.
Additionally, Japan has a "High-Cost Medical Expense System", which means that if your medical bills exceed a certain amount, you don’t have to pay beyond a set limit.
For example, let’s say you undergo surgery and hospitalization that costs ¥1,000,000.
With insurance, you only need to pay about ¥87,430 (depends on your income), and the remaining ¥900,000+ is covered.
(Source: Government Public Relations Online)
6. How Do You Join and Use Health Insurance?
If you are employed in Japan, your company will automatically enroll you in Employee Health Insurance, so you don’t need to do anything.
However, if you are a freelancer, student, or self-employed, you must apply for National Health Insurance at your city or ward office. To register, you need your passport and residence card, so be sure to bring them with you.
Once you receive your insurance card, using it is simple. Just show it at the hospital’s reception, and your medical fees will be reduced to the insured rate (10%–30%).
7. Summary
Japan’s health insurance system is designed to make healthcare affordable for everyone, including foreigners.
Understanding how it works can make your life in Japan much easier and less stressful when it comes to medical expenses.
Final Thoughts
If you’re planning to live in Japan for a long time, it’s important to know how the health insurance system works.
By being enrolled, you can reduce your medical costs and have peace of mind in case you need medical treatment.
If you have any questions about Japan’s healthcare system, feel free to ask in the comments!