National Health Insurance for Foreigners in Japan: Enrollment, Premiums & Usage
- Foreigners staying in Japan for more than 3 months are generally required to enroll in National Health Insurance (Kokuho).
- Once enrolled, you pay only 30% of medical costs out of pocket (the remaining 70% is publicly covered).
- Apply at your local city/ward office, generally within 14 days of registering your address.
- If you get a job and join your employer's social insurance, you will need to complete the procedure to withdraw from National Health Insurance.
Foreigners living in Japan (residence over 3 months) must enroll in the National Health Insurance (Kokuho). It covers 70% of medical costs; you pay only 30%.
① How to Enroll
Apply at your local city/ward office within 14 days of registering your address.
Enrolling in National Health Insurance requires resident registration (moving-in notification) first.
Required documents:
- Residence Card
- Passport
- My Number Card/Notice
- Personal seal
② Premium Estimates
| Annual Income | Monthly Premium (approx) |
|---|---|
| Up to ¥1M | ¥2,000–5,000 |
| ¥2M | ¥15,000–25,000 |
| ¥3M | ¥25,000–35,000 |
National Health Insurance premium rates and the per-capita (flat) portion are set by each municipality and reviewed every fiscal year, so the FY2026 (Reiwa 8) rates also depend on your local government. Please check the exact amount at your city/ward office.
③ At the Hospital
Show your insurance card at reception. Pay only 30% of medical costs.
When you join a company, you switch to social insurance; see social insurance enrollment for details. Under Kyokai Kenpo (the health insurance mainly for small and medium-sized companies), the FY2026 (Reiwa 8) health insurance rate varies by prefecture and averages about 9.9% nationwide, split evenly between employer and employee; those aged 40–64 also pay a nationwide long-term care insurance rate (1.62% in FY2026). Your insurance also covers visits to pharmacies and prescriptions, health checkups and cancer screening, dental care, and mental health consultations. If hospitalisation or surgery leads to high costs in a month, the High-Cost Medical Expense Benefit may refund the amount above a set ceiling — reviewing it in advance can be helpful.
If you are enrolled in health insurance (NHI or employees' insurance), you can receive the Childbirth Lump-sum Grant (¥500,000 per child).
If you work as a company employee, your health insurance premium is deducted from your salary. See how it appears on your payslip on our sister site Zainichi Money Navi: How health insurance premiums appear on your payslip.
Frequently Asked Questions
Do foreigners also have to enroll in National Health Insurance?If your period of stay exceeds 3 months, you are in principle required to enroll in National Health Insurance.
What happens when you enroll in National Health Insurance?The government covers 70% of medical costs, leaving you with only a 30% co-payment. It applies automatically when you show your insurance card at the hospital.
About how much are National Health Insurance premiums?It depends on your previous year's income and household size. For an annual income of 2,000,000 yen, the guideline is about 15,000-25,000 yen per month.
What happens to my National Health Insurance if I get a job at a company?Since you will join the company's social insurance (health insurance), you need to complete procedures to withdraw from National Health Insurance. This can be done at your local government office.
Ask our AI Concierge
Chat with our AI about this topic.
More practical guides for life in Japan
Browse all guides →