How does Japanese Health Insurance work?
There are several different insurance providers in Japan. The three most common types are introduced below. If you have specific questions not answered here please contact us.
National Health Insurance (NHI)
Non-Japanese residents with residence cards (Zairyu Card) who will stay more than 3 months can join National Health Insurance. Japanese hospitals and clinics do not accept insurance from overseas. Even if you have insurance from your own country, joining NHI is recommended.
NHI is mainly aimed at students, freelance workers and the self-employed. Full-time company employees are generally offered to join their employer’s Health Insurance instead. Each person in a household must enroll in NHI as an individual member. The premiums are then charged to the head of the household.
Under NHI, patients need to pay 30% of the total cost of care at clinics and hospitals. More than 90% of Japanese hospitals and clinics, including dental clinics, accept National Health Insurance. NHI also provides benefits for high medical costs associated with surgery and hospitalization. It also contributes to birth costs and, in some cases, will cover overseas medical expenses.
To apply for these benefits, please contact us. We can help you throughout the process.
Premiums are charged monthly. Costs will vary depending on your annual income and the area you live in. Premiums may be discounted depending on your financial situation.
When you move to a new area you need to submit a copy of your income statement to your new city hall/ward office. If you forget to do so, NHI may charge you higher premiums.
To join, visit the NHI department at your local city hall or ward office. They are usually open Monday through Friday, 9 am to 5 pm. They are generally closed on Saturdays, Sundays and public holidays.
An appointment is not necessary. Bring your residence card (Zairyu Card) and passport. Payment is not needed at the time of enrolment; you will be billed later.
If you do not join NHI as soon as you move to Japan, you will be charged back payments for this period when you do join. For example, if you move to Japan in August and join NHI in October, your first payment will include premiums for August and September in addition to the first regular monthly payment.
If are treated at a hospital or clinic but forget to bring your insurance card, you will need to pay the full costs. You can claim it back from NHI but it can take a few months to process the reimbursement.
Social Health Insurance/Employees’ Health Insurance
Full-time employees are usually enrolled in Social Health Insurance (SHI) through their employers. (Please note, there are some exceptions. Check with your company). The family of the covered employer can join as dependents.
Like NHI, under SHI patients are required to pay 30% of the total cost of care at clinics and hospitals. More than 90% of Japanese hospitals and clinics, including dental clinics, accept Social Health Insurance.
SHI also provides benefits for the high medical costs of surgery and hospitalization, birth allowances, and covers some costs of care overseas under certain circumstances. To apply for these benefits, contact the person in charge of the insurance scheme in your company. If they cannot help we are happy to assist with your application.
The premiums will be charged monthly through your employer. Your company is responsible for paying half of the price of the premiums.
The largest difference to NHI is that family members do not have to pay their portion of the premiums. The total premiums for a family are charged as one amount to the head of the household. However, if the income of any of the dependents exceeds 1,300,000 yen per year, they will lose dependent status and must enrol in NHI or SHI themselves.
When joining SHI, a person in charge in your company will file the application on your behalf. Often this person is a member of your company’s HR Department.
If you are treated at a hospital or clinic but forget to bring your insurance card, you can get reimbursement from SHI. However, it will take a few months to process the reimbursement.
International Travel Insurance
Most Japanese clinics and hospitals do not accept private health insurance and do not provide medical services without cash payment. If seeking care under travel insurance, you will need to make full payment for treatment upfront and file a refund application yourself.
Private insurance companies often require a medical certificate and receipt for the refund, so it is best to contact your insurance company before visiting a hospital.
Some international travel insurance companies do not have information on Japanese healthcare providers. We can provide clinic or hospital information and assist you with arranging and attending your visit if necessary. Please contact us to discuss your requirements.