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As of September 2025, this article has been updated to reflect recent changes in the system.
The health insurance scheme is required by the government in Japan for all Japanese citizens, permanent residents, and any foreign residents residing in Japan with a visa for three months or more, including students. Kokumin kenkō hoken (国民健康保険), or National Health Insurance (NHI), is available for those without Employees’ Health Insurance. Let’s learn more about Japanese health insurance system.
Premiums
The premiums are based on income so students with little or no income will have low payments. The rates are calculated based on jūminzei (住民税), or residence tax from the previous calendar year, which is determined in June. Annual National Health Insurance premiums are divided into 10 installments.
The monthly bills for Japan’s health insurance can easily be paid at any convenience store in Japan.
Registration
To enroll, applicants should visit their local city/ward/village office with their Japanese IDs to fill out an application. It may be easiest if you enroll for the national health insurance on the same day as you register for your zairyū card.
People are required to join within two weeks of becoming eligible, which includes a change in employment status or a move from one municipality to another. Those that do not register when they become eligible can be charged for up to two years of back payments.
Benefits
The National Health Insurance covers 70% of medical bills, while the insurer is responsible for the remainder. Your insurance applies whenever you become ill, injured, or require dental care.
You can also receive reimbursements for:
- Medical treatment from a healthcare provider that doesn’t accept National Health Insurance.
- Massage therapy, acupuncture, or moxibustion with doctor’s written consent or medical certificate.
- Expenses for crutches or other medical equipment or appliances.
- Blood used in a blood transfusion.
In these situations, you pay the full amount and then make a claim to NHI. If NHI decides to provide the reimbursement, you will receive between 70-90% of the approved amount.
You may also receive reimbursement for:
- Expenses for emergency transport or hospitalization of a critical patient — the cost of transport is covered if it is deemed necessary by a doctor and approved by NHI.
- Emergency treatment by an overseas healthcare provider for illness or injury — NHI members can receive a 70-90% refund of the estimated cost of the treatment of the same illness or injury in Japan.
You will receive a Certificate of Health Insurance Eligibility card by post after registering for the National Health Insurance program. Patients must show the card in order to receive benefits.
Some schools offer an affordable add-on insurance that covers the 30% not covered by NHI of their students’ medical expenses if an accident happens in Japan.
Exceptions for usage
- Failure to follow doctor’s instructions regarding treatment.
- Intentionally inflicted injury or illness resulting from crime or suicide.
- Injury or illness resulting from a fight or drunkenness.
- Treatment unrelated to illness (health examinations, preventative injections, cosmetic surgery, orthodontic work, normal child delivery/abortion for economic reasons, etc.).
- Private or semi-private room upgrade charges during hospitalization.
- Injury during work (should be covered by worker’s compensation or employer).
It’s also important to note that National Health Insurance does not cover contraceptives such as the birth control pill and others.
Health insurance & My Number card
Health insurance is now linked to your My Number card, and there are a few important things to know. As of November 2024, the real Health Insurance card has been halted and the Certificate of Health Insurance Eligibility has replaced it. Important to note is that the new “certificate” is still a card that looks very similar to the previous Health Insurance card. The title of the card has changed, the company (if it was issued through a company) name is no longer on it, and the color of the card varies according to location.
Students will first receive a Certificate of Health Insurance Eligibility because the My Number card takes some time to be delivered. This certificate expires with your visa expiration date and it will be reissued if you renew your visa. If you do not link your health insurance to your My Number card, you will need to carry your Certificate card at all times, especially when visiting any medical clinics or hospitals.
If you want to use your My Number card as a Health Insurance card, you need to go through the process of registering and linking your My Number card with your Certificate card. It will not be automatically done for you when you obtain the official plastic My Number card.
Please note: with the My Number system, you will first receive a notification letter and then will need to apply for the My Number card yourself. Once you submit your My Number application, you will need to go back to the ward office to pick it up once it’s ready. It will not be sent automatically to you. This is the official My Number card that you will need to link to your health insurance.
Consequences of not being insured
It is important to note that if you are staying longer than three months in Japan, it is mandatory to enroll in a health insurance system in Japan — either in the national scheme or a company scheme.
Without enrollment into the national health insurance system, patients are responsible for 100% of medical bills, which may be costly. There have been many cases of students who forwent enrolling in the system and suffered great losses from the necessity of emergency care, consequently not being able to stay in Japan thereafter.
All long-term students should enroll in the National Health Insurance system as soon as they arrive in Japan. All students that come to Japan through Go! Go! Nihon will be reminded to get proper insurance to ensure all students feel safe and secure during their time in Japan.
Non-NHI insurance
Short-term students studying in Japan aren’t able to join the NHI, however they can still get medical insurance before coming to Japan. Go! Go! Nihon is partnered with a travel insurance company called WorldTrips (part of the Envisage Global Insurance Group) — Health and Travel Insurance for Japan — which can provide the necessary coverage.
If you are using Go! Go! Nihon to study in Japan long or short term, or you are coming with one of our Study Trips, please ask your student coordinator since we will have a special deal on insurance for you.
Contact us for more information or if you have any questions.
