Your health is the most important resource you have. No matter your salary, location, or background, access to quality health care is one of the most important factors when choosing a country to live in. But this can vary widely across the globe and a sudden change in health can either be manageable or devastating.

Luckily for us, Japan’s National Health Insurance service covers just about any malady and makes it easy to enjoy a healthy lifestyle. But as a foreigner, how do you get health insurance in Japan and what is National Health Insurance for foreign residents? Don’t worry, we’ve got you covered. 

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Photo of a hospital

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What is National Health Insurance?

The current Japanese National Health Insurance system is a somewhat more complicated single-payer system born out of social welfare reforms after WWⅡ as a way to ensure all citizens of Japan were not overly burdened by medical bills. All citizens not covered by their employer are covered by the National Health Insurance system and enrollment in some kind of insurance is mandatory. 

Foreigners are eligible for National Health Insurance (NHI) if they are working in Japan with proper visa documentation and not covered by their place of work. Payment for the NHI is on a sliding income scale and maximum premiums encompass a wide range with the absolute top being ¥580,000 per year, with a co-pay ceiling of ¥150,000+[(Total Medical Expenses – ¥500,000) x1%]. This also covers both dental and vision-related medical expenses.

By registering yourself with the municipality of your residence, your local government system pays for your medical fees. Failure to pay will result in penalties of a temporary card of having your wages garnished until the outstanding debt is paid for.

Photo of the National Health Insurance Card

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Who takes National Health Insurance in Japan:

All public doctors and hospitals take the NHI. Indeed, it would be far stranger to find a doctor who doesn’t take it. The exception remains for some English-speaking doctors, often in areas where a high percentage of clients are diplomats or special-case short term residents who use their country’s own care system rather than the NHI.

If you aren’t sure whether the English speaking doctor you’re hoping to see takes NHI, a quick ring is always helpful if it’s not stated on their website. This single universal system makes it easy to pick a doctor, dentist, and optometrist that’s right for you, as well as any specialists you may require.

If you’re getting more than just primary care, there are a few medications or medicals services that the NHI does NOT cover, so check with your doctor or the Ministry of Health, Labour and Welfare for more information. 


Consulting a Doctor

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How to get Public National Health Insurance:

In Japanese, Public National Health Insurance is known as kokumin kenkou hoken, quite literally, ‘countryman’s health insurance’. This service can be received by going to your municipal or ward office and filling out a kokumin kenkou hoken form, which will either be given to you on the spot or (most often) mailed to you within a week. Note: If something happens to you in the interim of applying for your card and receiving it, you can tell the hospital and any overpayments will be returned to you. You will need to do this when you first move in, and also if you leave your municipality or return to your home country, so you won’t continue being charged. Everyone can get coverage, from seniors to babies, and you must always show your insurance card at the doctors in order to use your health insurance benefits. 

Is everyone eligible for National Health Insurance?

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Are there other options besides NHI?

Yes, there are! Tourists, for example (or residents under a four-month stay), can apply for private health insurance or travel insurance through outside companies. Some citizens also choose private insurance to help with conditions not covered through the NHI, as both can coexist for double coverage. These prices can range, but don’t fret too much, as even under private insurance, costs are constantly reviewed by the Ministry of Health to ensure a fair and even rate across the board.

There is also what’s known as just kenkou hoken, or health insurance. This is paid by your employer, where they take care of the paperwork and pay your insurance premiums each month. Other than who pays, not much is different between the NHI and employees health insurance, as both will receive the same benefits and/or co-pays on medical treatments and health services. Kenkou hoken and kokumin kenkou hoken cannot happen simultaneously–either you register and pay your premiums directly (often with a handy dandy packet you can take to a local convenience store), or your employer pays your premiums. 

Overall, it’s an easy system to navigate, and all residents of Japan (foreign or not) are required to have medical insurance. It’s the simplest and often most efficient system, with just about every hospital or doctor you would like to see covered under one simple system. From crowns to chiropractors, the NHI has your back. 

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