- Health insurance system
- Type of health insurance
- Use of health insurance
- Cases not covered by health insurance
- Assistance for high medical expenses
Health insurance system
The health insurance system is for protecting people from unexpected high medical costs when sick or injured.
Payments for seeing a doctor or purchasing medicines can be reduced by paying "insurance premiums" every month.
All residents in Japan must be enrolled in a health insurance program through their employer or the municipality where they live.
Foreigners who live in Japan for more than three months also must be enrolled in a health insurance program.
However, those foreigners from countries that have a special agreement with Japan called "International Social Security Agreement" may not be required to be enrolled.
What is the Japan Pension Service Social Security Agreement (English)
Type of health insurance
There are two types of health insurance programs in Japan: “Employees’ Health Insurance” and “National Health Insurance.”
[Employees' Health Insurance ]
“Employees’ Health Insurance (健康保険)” is an insurance program for those who work for companies.
There are conditions such as working 20 hours or more per week and having a monthly salary of 8,8000 yen or more.
Dependent family members who live in Japan can also be enrolled.
The employer takes care of the enrollment procedure.
Employees’ Health Insurance premiums are paid half by the employee and the other half by the employer.
The insurance premium amount is based on an employee’s salary.
The employer deducts insurance premiums from the employee’s salary.
[National Health Insurance]
“National Health Insurance (国民健康保険)” is an insurance program for those who do not work for a company.
Those family members who are in the same household and do not have health insurance coverage will join the National Health Insurance together.
The enrollment is processed at the local municipal office.
National Health Insurance premiums are determined by the family size and income (money earned through work, etc.) of the household.
Insurance premiums can be paid in one of the following ways:
- Direct debit (a payment method that automatically draws money from your bank account)
- In-person payment at the counter of the municipal office, banks, post offices, convenient stores, etc. while using the “payment slip” sent by the municipal office.
If you are under financial difficulty because you have suffered damage in a disaster or lost your job, you can consult with your local municipal office.
You may be qualified for the program of insurance premium reduction or exemption.
Use of health insurance
When using health insurance at hospitals or pharmacies, you need either a “My Number Health Insurance Card [マイナ保険証] ”or a “Health Insurance Eligibility Certificate [資格確認書] ” to verify your health insurance enrollment.
[ My Number Health Insurance Card -マイナ保険証
A My Number Health Insurance Card is your My Number Card combined with your health insurance card.
You can register to link your My Number Card with your health insurance through “My Number Portal” or at hospitals and pharmacies.
My Number Health Insurance Card Guide for Foreign Residents in Japan (15 languages) - Ministry of Health, Labour and Welfare (Japanese/English)
[Health Insurance Eligibility Certificate -資格確認書]
Those who do not have a My Number Health Insurance Card can use a “Health Insurance Eligibility Certificate” instead. People who have not registered for a My Number Health Insurance Card can receive a Health Insurance Eligibility Certificate from their health insurance provider (employer or municipality).
About Health Insurance Eligibility Certificates (How to receive medical care without using a My Number Health Insurance Card) | Ministry of Health, Labour and Welfare (Japanese)
When you present either your My Number Health Insurance Card or Health Insurance Eligibility Certificate, the amount you pay at the hospital or pharmacy counter will be only 30% of the medical consultation and medication costs. (You pay different percentages for small children and the elderly.)
If you visit a hospital or pharmacy without your My Number Health Insurance Card or Health Insurance Eligibility Certificate, you will be required to pay 100% of the costs. However, you can later apply for a refund of the excess payment through the appropriate procedures.
Your My Number Health Insurance Card or Health Insurance Eligibility Certificate is an important document that proves your health insurance enrollment. Only you may use it. Do not lend it to others.
*Traditional health insurance cards will no longer be valid from April 2026. Those not using a My Number Health Insurance Card must either apply for one or use a Health Insurance Eligibility Certificate.
【Using your MyNumber Card as a Health Insurance Card】
After registration, you can use your My Number Card as a health insurance card (Myna Insurance Card) at hospitals and pharmacies.
My Number Card as your Health Insurance Certificate (Information for Foreign Residents) (Japanese & English)
About using My Number Card as Health Insurance Card - Ministry of Health, Labour and Welfare (Japanese)
Cases not covered by health insurance
The health insurance does not cover the following cases:
- Pregnancy and childbirth
- Health checkups
- Vaccinations
- Straightening teeth
- Staying in a private room (room for one person) during the hospitalization
- Injuries in a traffic accident
In this case, the person who caused the injury pays.
- Injuries at work
In this case, the worker's compensation insurance will cover.
Assistance for high medical expenses
[High-cost medical expenses]
If the total amount you paid to medical institutions or pharmacies in a month exceeds the set amount, you can request a reimbursement of exceeded amount.
The out-of-pocket limit per month and reimbursement amount depend on your age and income.
