Health & Medical Care

Health Insurance in Japan: The Basics

Public health insurance covers most of the cost of medical care in Japan, and most residents are required to join. This guide explains which plan you belong to, how much you pay at the counter, and the support available for large bills and childbirth.

Who must join

Plan	Who joins	Where
健康保険kenkō hoken · employee health insurance	Company employees, including part-time workers who meet the conditions on hours and pay	Through your employer
国民健康保険kokumin kenkō hoken · National Health Insurance	Registered residents under 75 who are not in employee health insurance	Your city office

Some people are not covered by National Health Insurance, for example those staying three months or less. People aged 75 and older join a separate system for older people.

What you pay at the counter

With health insurance, you pay only part of the medical cost (jiko futan, 自己負担).

Age	Your share
Under 6, before starting school	20%
School age through 69	30%
70 to 74	20% (30% with an income like a working person's)

Proof of insurance

At a clinic or pharmacy, you can show your My Number card registered as a health insurance card (maina hokenshō, マイナ保険証). If you have not registered your My Number card for health insurance, you receive a certificate of eligibility (shikaku kakuninsho, 資格確認書) for free, without applying.

Help with large medical bills

The high-cost medical expense benefit (kōgaku ryōyōhi, 高額療養費) sets a monthly limit on the medical costs you pay yourself. The limit depends on your age and income. The amount over the limit is covered.

Having a baby

The childbirth lump-sum grant (shussan ikuji ichijikin, 出産育児一時金) pays ¥500,000 per child in principle to help with the cost of giving birth. Through the direct payment system, your insurance can pay the hospital directly, so you pay only the difference.

Japanese words you'll see

Japanese	Reading	Meaning
保険料	hokenryō	Insurance premium.
自己負担	jiko futan	The share of the cost you pay.
加入	kanyū	Joining, enrollment.
脱退	dattai	Leaving a plan.
高額療養費	kōgaku ryōyōhi	High-cost medical expense benefit.
出産育児一時金	shussan ikuji ichijikin	Childbirth lump-sum grant.

Questions families ask

Do I have to join health insurance?

Most registered residents must. If you work for a company and meet the conditions, you join employee health insurance through your employer. Registered residents under 75 who are not in employee health insurance must join National Health Insurance at their city office. There are exceptions, such as stays of three months or less.

How much do I pay at the doctor?

30% of the cost for most people aged 6 through 69. 20% for children under 6 who have not started school and for people aged 70 to 74 (30% for those with an income like a working person's).

What if my medical bill is very large?

The high-cost medical expense benefit sets a monthly limit on what you pay. The limit depends on your age and income, and the amount over it is covered.

How much is the childbirth grant?

¥500,000 per child in principle, paid by your health insurance.

Sources

This guide is based on information published by Japan's Immigration Services Agency and Ministry of Health, Labour and Welfare. Premiums and limits depend on your city and income, so ask your city office or employer for your own amounts.

Practice the Japanese you need at the hospital in Japanese Talk: Hospital.