Two kinds of health insurance
If you work full time for a company, you are enrolled in employee health insurance (shakai hoken). The premium is shared with your employer and taken from your salary, and your family can usually be covered as dependants.
Everyone else, such as the self-employed, students and those working part time, joins National Health Insurance (kokumin kenkō hoken) at the city office, usually when they register their address. The premium is set by the city and based on last year's income in Japan, so it is often low in your first year.
What you pay at the doctor
With insurance you usually pay 30% of the bill at clinics, hospitals and pharmacies. Young children pay 20%, and many cities cover children's bills further. If your bills are very high in a month, the high-cost medical expense benefit (kōgaku ryōyōhi) caps what you pay.
Bring your My Number Card, or your certificate of eligibility, every time you see a doctor.
The pension
Residents aged 20 to 59 must join the public pension. Company employees are in the Employees' Pension through their employer. Everyone else pays into the National Pension (kokumin nenkin), which costs ¥17,920 a month in the 2026 fiscal year. Students and people on low incomes can apply to delay or reduce payments.
Leaving Japan
If you leave Japan for good after paying into the pension for at least six months, you can claim a lump-sum withdrawal payment (dattai ichijikin) within two years of leaving. It covers up to five years of payments. Japan also has social security agreements with many countries, which may let your years in Japan count towards your pension at home instead.
Tips
- Join National Health Insurance at the same visit as your address registration. Coverage starts from the day you moved in, and late joiners still owe premiums back to that date.
- Check whether your home country has a social security agreement with Japan before claiming the lump sum. Claiming it cancels those years of contributions.
- Keep receipts for medical bills. If your household pays more than ¥100,000 in a year, you may be able to claim a tax deduction.
Words you will see
- 国民健康保険 kokumin kenkō hoken
- National Health Insurance
- 社会保険 shakai hoken
- employee social insurance
- 国民年金 kokumin nenkin
- National Pension
- 厚生年金 kōsei nenkin
- Employees' Pension
- 高額療養費 kōgaku ryōyōhi
- high-cost medical expense benefit
- 脱退一時金 dattai ichijikin
- lump-sum withdrawal payment
Sources: Ministry of Health, Labour and Welfare; Japan Pension Service (premium for fiscal 2026). Rules and fees can change and vary by city. Check with your city office or the official service before you go.