Health insurance in Japan isn’t optional — it’s mandatory for all residents, including foreigners. If you’re living in Japan on a visa longer than three months, you’re required to enroll. The system can seem confusing at first, but it’s actually one of Japan’s greatest strengths: comprehensive coverage at remarkably affordable rates. Here’s everything you need to know.
Japan’s healthcare facilities are world-class and accessible to all residents.
The Two Main Systems
National Health Insurance (NHI / Kokumin Kenko Hoken)
This is for self-employed people, students, freelancers, and anyone not covered through their employer. You enroll at your local city or ward office (shiyakusho/kuyakusho) after registering your address.
Premiums based on your income from the previous year
New arrivals often start with lower premiums
Covers 70% of medical costs (you pay 30%)
Employee Health Insurance (Shakai Hoken)
If you work for a company with 5+ employees, you’ll typically be enrolled in Shakai Hoken automatically. Your employer handles registration.
Premiums are split 50/50 between you and your employer
Also covers pension contributions
Same 70/30 cost coverage as NHI
Additional benefits like maternity leave pay and injury/illness allowance
What’s Covered?
Japanese health insurance covers an impressive range of services:
Doctor visits and consultations
Prescription medications
Surgery and hospitalization
Dental care (basic procedures)
Mental health services
Maternity check-ups (with additional municipal subsidies)
Rehabilitation and physical therapy
Not typically covered: cosmetic procedures, advanced dental work (orthodontics, implants), some cutting-edge treatments, and annual health check-ups (though employers must provide these).
How Much Does It Cost?
NHI Premiums
NHI premiums vary by municipality and income. As a rough guide:
Low income / new arrival: ¥2,000-5,000/month
Average income (¥3-5M/year): ¥15,000-25,000/month
Higher income (¥7M+/year): ¥40,000-60,000/month
Shakai Hoken Premiums
Roughly 5% of your monthly salary (your share). Your employer pays another 5%. So on a ¥300,000 monthly salary, you’d pay about ¥15,000.
The High-Cost Medical Expense System
Japan has a brilliant safety net: if your out-of-pocket costs exceed a monthly cap (typically ¥80,100 for average earners), the excess is reimbursed. This means even major surgery or extended hospitalization won’t bankrupt you.
How to Enroll
For NHI
Register your address at your local city/ward office within 14 days of moving
Go to the National Health Insurance counter at the same office
Bring your residence card, passport, and My Number notification
Fill out the enrollment form (staff will assist)
Receive your health insurance card (hokensho) — usually on the spot or by mail within a week
For Shakai Hoken
Your employer handles enrollment. You’ll receive your insurance card within a few weeks of starting work.
With health insurance, doctor visits become affordable and routine.
Using Your Insurance
Present your insurance card (hokensho) at any clinic or hospital
Pay 30% of the bill at the reception desk
No referral needed for specialists (though hospital visits without referral may incur extra fees of ¥5,000+)
Prescriptions are filled at pharmacies (yakkyoku) separate from the clinic
Practical Tips
Always carry your insurance card — Without it, you’ll pay 100% upfront (you can get reimbursed later, but it’s a hassle)
English-speaking clinics exist — Search AMDA International Medical Information Center or your city’s international association
Don’t skip enrollment — If you enroll late, you’ll owe back-premiums from when you should have joined
Keep receipts — Medical expenses over ¥100,000/year can be deducted from your taxes
Get a health checkup — Many municipalities offer free or discounted annual checkups (kenko shindan) for NHI members
FAQ
Q: Is health insurance really mandatory for foreigners?
A: Yes. All residents staying longer than 3 months must enroll. Failure to do so can affect visa renewals.
Q: What if I can’t afford the premiums?
A: You can apply for premium reduction at your local city office. Low-income residents may qualify for significant discounts or exemptions.
Q: Can I use my Japanese insurance abroad?
A: Partially. You can apply for reimbursement for emergency medical care received overseas, but only up to what the equivalent treatment would cost in Japan.
Q: I’m leaving Japan. Do I need to do anything?
A: Yes. Visit your city office to cancel NHI before leaving. Pay any outstanding premiums to avoid issues if you return.
Japanese clinics are known for their efficiency and cleanliness.
Getting Connected
Navigating Japan’s healthcare system is much easier when you have a community to lean on. Join international exchange events to connect with other foreign residents who can share their experiences and recommend English-friendly clinics. Also make sure your bank account is set up for direct debit premium payments.
Opening a bank account in Japan is one of those essential tasks that every foreign resident needs to tackle early on. Whether you need to receive your salary, pay rent, or set up utility payments, a Japanese bank account is practically non-negotiable. The good news? It’s gotten much easier in recent years.
Japanese ATMs are reliable and available at most convenience stores.
Which Bank Should You Choose?
Major Banks with English Support
Japan Post Bank (Yucho Ginko) — Most foreigner-friendly. Over 24,000 ATMs nationwide, easy application, no minimum balance.
MUFG Bank — Japan’s largest. English staff at select branches in Tokyo/Osaka.
Shinsei Bank — Fully English online banking, no ATM fees at convenience stores. Popular among expats.
Sony Bank — Online-only with excellent multi-currency accounts and English interface.
Digital Banks
Wise — Multi-currency account with JPY balance and debit card. Entirely online in English.
Revolut — App-based, multi-currency, English interface.
Personal Seal (Inkan) — Some banks still require it (¥500-2,000 at any hanko shop)
My Number Card — For tax reporting
The 6-Month Rule
Most major banks require 6 months of residency. Workarounds: Japan Post Bank often accepts newcomers; your employer may help; digital banks like Wise have no such requirement.
Step-by-Step Process
Choose your bank based on needs (English support, ATM access, international transfers)
Find a branch with English-speaking staff
Visit during weekday hours (9:00-15:00)
Fill out the application form (staff will help)
Wait for your cash card (1-2 weeks by mail)
Set up online banking
Your Japanese bank card will become one of your most essential items.
Understanding Japanese Banking
ATM Hours and Fees
Bank ATMs: 8:00-21:00. Convenience store ATMs (Seven Bank, Lawson) have longer hours but charge ¥110-220 outside business hours.
Key Features
Furikomi (振込) — Bank transfers for rent and bills
Direct Debit (口座振替) — Auto-pay for utilities
International Transfers — Expensive via banks (¥3,000-6,000). Use Wise for better rates.
Practical Tips
Bring a Japanese-speaking friend if no English support available
Get a passbook (通帳) — useful for tracking and as ID
Set up convenience store ATM access for after-hours
Keep registered info updated when you move or renew visa
Consider multiple accounts: main bank + digital bank for transfers
FAQ
Q: Can I open an account without speaking Japanese?
A: Yes. Shinsei Bank, Sony Bank, and Wise offer English services. For traditional banks, bring a Japanese-speaking friend.
Q: I just arrived. Can I open an account immediately?
A: Japan Post Bank may allow it. Your employer can often assist. Use Wise while waiting for the 6-month mark.
Q: Do I need a personal seal (hanko)?
A: Fewer banks require it, but it’s still common. A simple seal costs ¥500-1,000.
Q: Can I send money abroad?
A: Yes, but traditional wires are expensive. Wise and Revolut offer much better rates.
Having your documents prepared in advance makes the process much smoother.
