A Layman’s Guide to Japan’s Health Insurance System

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Health Insurance in Japan can sometimes seem like a real pain in the neck, but it doesn’t have to be!

First and foremost, allow me to answer the big question that you might have. Yes, it is mandatory for all Japanese citizens, permanent residents, and anyone residing in Japan for three months or longer to be enrolled in a health insurance system here. No, there’s no escaping it. It’s essential for anyone working and living in Japan to be insured. However, it’s also highly beneficial, as Japan has one of the best health care systems in the world.

If you’re looking to move to Japan some day, you’ll want to make sure you understand how the health care system works and which kind of health insurance is best for you. That’s where we come in with this easy-to-follow beginner’s guide! Think of this as an introduction to Japan’s two main health insurance plans, a primer on what you definitely want to know before you join the millions of others insured by the same system.

Now, let’s discuss your options:

Social Insurance (shakai hoken)

Shakai hoken (社会保険), or Social Insurance, combines Health Insurance (kenkou hoken, 健康保険) and Pension Insurance (kosei nenkin, 厚生年金) into one system.

However, it’s important to note that this type of insurance cannot be applied for as an individual; it must be done for you by your employer. They will be the ones responsible for submitting all the paperwork necessary to sign you up for it.

The insurance fee varies depending on your salary and the monthly premium is split 50-50 with your employer, with your half being directly deducted from your paycheck. Social Insurance covers a wide range of medical and drug costs, including dental treatment.

National Insurance (kokumin kenkou hoken)

Kokumin kenkō hoken (国民健康保険) or National Health Insurance, is the more basic, standalone insurance system. It is intended for those who are self-employed, unemployed, or retired. If you are not enrolled in Social Insurance, you must enroll in National Insurance if you will be residing in Japan for longer than 90 days.

To get enrolled in this type of insurance, you must go to your local city hall and request to be signed up for it. The fee will also vary depending on your circumstances and monthly income. For instance, if you are a student or have any form of disability, you can expect to pay less for it than someone working a part-time job, for example.

Note that, for this type of insurance, you will also have to pay into the National Pension system (kokumin nenkin, 国民年金) separately. Enrolling in this system can also be done through your town or city hall.

The Right Insurance For You

Now that you know the difference between the two, let’s talk about how they work, and which one is best for you.

After you have finished your application (or your employer has processed the forms for you), you will receive an insurance card that you must carry with you at all times and present at the reception before you receive any treatment. Depending on your address and workplace, you might get stuck with a temporary card for a while before you receive the real thing, but they work the same. Along with your residence card, this card acts as an important form of ID, so it’s essential that you keep it safe and handy when necessary.

Insurance Card – https://www.yutorism.jp/entry/HealthInsurance

Both the shakai hoken and the kokumin kenkō hoken cover 70% of your medical bills. You will be expected to pay the remaining 30% before you leave any medical facility.

For those working at a company and planning to stay in Japan long-term (at least 3-5 years or more), Social Insurance is a great system to enroll in. It has a wide range of benefits, and managing health & pension as one package is particularly convenient for full-time salaried workers. Be advised though, you will be paying more per month and paying into both systems at once, so it is the more expensive of the two.

For students, lower-salaried temporary workers or those planning a shorter stay, the National Insurance system is perfectly reasonable. Private insurance in Japan does exist, but it is generally supplemental, to cover specific conditions. So if you are not being enrolled in Social Insurance, make sure you take some time to visit your city hall and sign up for National Insurance soon after moving in.

And that’s it! You now know the basics of what the health insurance system is like in Japan. Hopefully this article has answered some of your questions. But again, this is just a basic overview, so we highly recommend doing more in-depth research for all who are about to enter (or re-enter) the Japanese health care system. Good luck on your journey to Japan. I hope to see you soon!

Images for this article were provided by Irasutoya. Cover photo provided by pixabay.com



Leticia Iglesias

From Brazil
Has had several years of experience around Japan!