National Health Insurance

Overview

Japan's national medical insurance is divided into two main programs: the National Health Insurance Program (NHI) and employer-sponsored health insurance. All Japanese citizens are required to join one of the two programs. Foreigners who have permission to stay in Japan for at least one year are also required to join one of these programs even if the student is covered overseas under their parents' or private insurance. In most cases, as students, you will be applying for NHI.

NHI is designed to reduce the burden of medical treatment costs through a cooperative system of paying premiums. When you visit a doctor or dentist, you must show your NHI certificate to receive a 70% discount. You are responsible for only 30% of the treatment costs. For students, the premiums are very affordable because the NHI premium is calculated based on income for the previous year. Calculation of insurance premiums differs slightly depending on the municipality, and those whose previous year's income was below a certain fixed amount will have their premiums reduced.

For example, a minimum premium is around 35,100 yen per year in Tokyo and you may apply for a 70% discount from this price. Please be aware that you will need to apply for the discount fee during the application process and cannot request it after you have already applied for insurance. If you worked the previous year in Japan the tax form will be necessary to determine the fee. You need to apply for the discount every year around February-March and you must show your tax form (gensenchoshusho) from each company you worked. Students over 40 years old will be charged a "care insurance fee" or "kaigohokenryo." NHI covers most medical and dental care needs. Eye glasses and contacts are not covered under insurance, but are affordable.


Applying for National Health Insurance

To apply for National Health Insurance (NHI), visit the ward office in your town.
It is recommended to apply for NHI when you visit the ward office to apply for your alien registration card. You will need the following:

  1. Alien registration card (or receipt showing application)
  2. Passport
  3. Address in Japan

*Be sure and ask for the discount insurance for low income persons when you apply for NHI.

You will need to cancel the insurance before leaving Japan
Visit your respective ward office with an airline itinerary or airplane ticket showing your return flight home. Please cancel within 30 days before you leave (the fee will be charged until the last day you are in Japan). The ward office will cancel your insurance and adjust your account. You will need to return the NHI Certificate (Hoken-sho) at this time or you may request permission to mail it to them from the airport in order to keep insurance until the last day of your stay in Japan.

Yearly Renewal Plan
Students need to renew their NHI premium discount every year. Students who applied January 1st do not need to renew it in the same year.

When to apply for renewal: During city ward office hours from February through March.

Place to apply: The ward office where you registered your alien registration card as of January 1st in the same year, even if you moved after January 2nd.

Who is eligible to apply: There are basically three main premium discounts available:

  1. Earned income less than 330000 yen = 70% off
  2. Earned income less than 575000 yen = 50% off
  3. Earned income less than 680000 yen = 20% off

What to bring: To apply for discount (1) you will need your alien registration card, National Health Insurance Card, and passport. To apply for discount (2) or (3), your payment slip from last year may be required in addition to the items needed for discount (1).

For more details of the application process, please contact Tokyo Metropolitan Government, National Health Insurance section; Tel: 03-5320-4166 (English available).

For more information about the NHI program itself, please check their website, or call the Tokyo Social Insurance Bureau; Tel: 03-5322-1615.


National Pension Plan

Students may also receive national pension information, which is a different program from Japanese health insurance described above. Information to sign up for pension is sent automatically when a person turns 20 years old. Visa sponsored students need to apply for a waiver at the ward office to avoid participation in this program. For more information about the national pension plan, please see each ward office's webpage and ask at the office when you visit.


FAQ

Q1.
If I don't join the National Health Insurance system, what will happen?
A1.

Your status as a TUJ student will not change. However, Japan requires that you join the National Health Insurance System so it is important that you follow and respect this governmental regulation.



Q2.
What happens when I don't have insurance?
A2.

You risk having insufficient or no insurance coverage in the event of illness or injury during your stay in Japan. If you do seek medical attention, you will be required to pay the amount in full upon completion of your treatment each visit. Also, if you return to Japan in the future, you will be asked to pay the past fees when you register for an alien registration card.



Q3.
Even if I live in Japan less than one year, do I need to join the National Health Insurance Program?
A3.

Yes. Foreigners who have permission to stay in Japan at least one year or more are required to join it even if they have private insurance or live in Japan less than one year.



Q4.
Do all physicians and dentists in Japan participate in the National Health Insurance system?
A4.

Many of the English-speaking doctors and dentists in Tokyo that cater to the foreign and expatriate crowds do not participate in the system. However, several of them do accept private insurance plans.



Q5.
If I join the system and don't pay my premiums, what will happen?
A5.

You can expect late fees and collection letters.



Q6.
How do they calculate the health insurance premiums?
A6.

Premiums are calculated on a monthly basis based on your income from the prior year. Because premiums are calculated on a monthly basis, it is best to enter the system towards the beginning of the month. (For example, if you apply on August 31st, you will be charged for the entire month of August). Depending on the ward in which you live, you will be billed quarterly, semi-annually, or yearly.



Q7.
How much are the insurance premiums?
A7.

The yearly fee depends on the city in which you reside as well as your income in Japan during the prior year. Some cities may charge students 32,500 yen per year (while others may charge as little as 15,000 yen per year). If your income from the previous year is less than 330,000 yen, you may be granted a discount on the yearly charge up to 70%. Please ask them to give you a discount application form for low income earners. You need to apply for the discount every year between February and March.



Q8.
What are the payment methods?
A8.

You will need to confirm this at the ward office. However, you can typically pay these premiums at the nearest convenience store (7-11, Lawson, Sunkus, etc.)



Q9.
How do they check my income from the previous year?
A9.

The ward office receives tax information around April of each year. You also need to file your income every February through March. Please keep all income information you receive from a company where you work. If an adjustment is necessary, the ward office will inform you.



Q10.
What if I forget to cancel my health insurance before leaving Japan?
A10.

You will be charged premiums until you cancel the insurance. Please contact your ward office as soon as possible via telephone or mail.



Q11.
Can I cancel it from overseas?
A11.

No. You need to cancel it while you are still in Japan.



Q12.
If I move to a different city or ward, what should I do?
A12.

Within 14 days of changing your address, please go to your new ward's office and register this change with the alien registration and insurance departments.



Q13.
If my visa status changes what should I do?
A13.

You need to change your alien registration card first, and then seek information about health insurance from your new visa sponsor.