Health insurance in Japan, explained: company plan or National Health Insurance

Which one you're on, what it costs, what changes when you switch jobs or quit, and the gap month that catches people out. Everyone living here for more than three months must be on one.

Last updated 4 October 2026

Which one are you on?

If you're	You're on
Employed full-time (and most part-timers above set hours)	Your employer's plan (社会保険, shakai hoken / 健康保険). Taken from your salary; your employer pays about half.
Freelance, a student, unemployed, or retired	National Health Insurance (国民健康保険, kokumin kenkō hoken) through your city. You join at the ward office and pay it yourself.
The dependent family of someone on a company plan	Usually covered through them, without paying, if your income is under the limit.

Either way, you pay 30% of medical costs at the clinic (less for young children and older people), and big monthly bills are capped by the high-cost medical expense benefit.

What National Health Insurance costs

It's based on last year's income in Japan, so in your first year it's usually low, and it can jump in your second year.
The bill arrives around June, split into monthly slips (or direct debit).
Income dropped or lost your job? Ask about reductions. People who lost their job involuntarily often qualify for a big one.

Changing jobs or quitting: the gap

1When you leave a company, your company coverage ends the day after your last day. Return the company's insurance details as they ask.
2Starting a new job right away? The new employer enrols you. Nothing for you to do but give them your details.
3A gap between jobs, or going freelance? Join National Health Insurance at the ward office within 14 days. Bring the certificate showing your company coverage ended (資格喪失証明書, shikaku sōshitsu shōmeisho) from your old employer.
4Or ask about continuing your company plan for up to two years (任意継続, nin'i keizoku), if you'd been on it at least two months. Sometimes cheaper, sometimes not: compare.

Joining late doesn't save money. National Health Insurance is charged back to the day your old coverage ended, and medical bills in the gap may not be covered.

Your insurance card now

Paper insurance cards are no longer issued. Register your My Number card as your insurance card (マイナ保険証) and scan it at clinics. If you don't use one, your insurer sends you a paper 資格確認書 (shikaku kakuninsho) to show instead. Seeing a doctor in Japan.

Leaving Japan

Filing your moving-out notice ends National Health Insurance from the day you leave. Pay what you owe up to then. Leaving Japan: the checklist.

Keep reading

Seeing a doctor in Japan: clinics, hospitals and what you'll pay

Clinic or hospital, what to bring, what you'll pay, and who to call at night.

The Japanese pension for foreigners: pay, pause, or claim back

Which pension you're in, pausing it properly, the ten-year rule, and claiming it back when you leave.

That letter from the city: what it is and what to do

Tax, insurance, pension, overdue notices: which letters need you, and how to pay at the konbini.

Sources

Facts checked against these official sources. Rules change and differ by city: if something here looks out of date, tell us at support@progaijin.com.

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