Working in Japan

Health insurance in Japan – overview, how to apply, premium and coverage

Health insurance in Japan – maybe this topic is not easy to gather information if you are not very good at reading Japanese, but it is significantly vital issue if you want to go and live abroad. So, today we’d like to introduce you all the info you need to know about health insurance in Japan such as types of health insurance, coverage, premium (cost), how to apply and tips about dental treatment.

Before we go to the point, health insurance is an essential topic because it is mandatory to enroll in Japan for anyone regardless your nationality as long as you stay in Japan for more than 3 months.

Overview of Japanese health insurance

Basically the self coverage of the health insurance is 30% in Japan for all types of health insurance. For example if you go to hospital and it costs 9.000 JPY, then you must pay 3.000 JPY on your own. Whether the coverage ratio is good or not depends on the condition in your country.

Now let’s see what kind of health insurances in Japan. there are two types that you should know.

  • Health Insurance (HI) as one of the social insurance schemes
  • National Health Insurance (NHI)

Health Insurance as social insurance schemes (健康保険)

Japanese social insurance consists of five types: health insurance, pension insurance, nursing insurance, industrial accident compensation insurance. These are mandatory to apply for all who is full-time employees, contract employees, or part-time employees if…

  • working time is more than 20 hours a week
  • monthly wage is more than 88.000 JPY
  • working period is more than 1 year

But this social insurance is something that your company, so your employer, must take care of. They will organize your application, and basically you don’t need to do nothing. Of course you are the one who pays the monthly premium, however the company will deduct the cost automatically from your monthly salary.

How much you have to pay is depending on where you live, your income and which health union you belong to. By the way, your share for the premium payment is only 50%, your employer pays the rest of premium.

I will give you a practical example:

Monthly Salary 200.000 JPY
Salary grade 17 (195.000 – 210.000 JPY)
Premium in % 9.87%
Total premium in JPY 19.740 JPY
Your share 9.870 JPY

You can check the whole payment-table published by Japan Health Insurance Association. Again, your amount share will be only 9.870 yen for your health insurance in this case as employer have to pay the half of your social insurance premium in Japan.

National Health Insurance (国民健康保険)

National health insurance is for whom that stays longer than 3 months in Japan. If you for example come to Japan to visit language school, study at an university, do working holiday for a year or self-employed (freelance) for more than 3 months, then you must apply for national health insurance.

The fee is depending on where you live. But I will give you a rough image with a table based on a simulation. The condition is your are under 40 years old and the insurance is just for one person.

Setagaya-ku (Tokyo) 52.800 Yen / year – 4.400 Yen / month
Yokohama-shi (Kanagawa) 44.640 Yen /year – 3.720 Yen / month
Saitama-shi (Saitama) 38.000 Yen / year – 3.170 Yen / month
Funabashi-shi (Chiba) 35.950 Yen / year – 3.000 Yen / month
Osaka-shi (Osaka) 71.847 Yen / year – 5.990 Yen / month

Coverage ratio is the same, and you have to pay 30% when you visit hospitals.

How to apply for the health insurances

How to apply is also a topic that shouldn’t be forgotten. Here you will find vital points of both types of health insurances. Before we go to details, what you have to be aware of is that you have to complete the procedure of enrolling in national health insurance within 14 days after you come to Japan. Exactly said, 14 days is counted from the date of entry, transfer, or the date of disqualification of the health insurance you have been enrolled in.

How to apply for HI as social insurance schemes

As already mentioned above, application is what your employer have to take care of. So, your company will ask you to fill out some application forms. That means you have to provide:

  1. personal information
  2. residence card
  3. passport
  4. my number card

But don’t worry, you are guided by the company what to do. It’s far easier than you do everything by yourself from research to applying.

How to apply for National Health Insurance

Search for a city office or ward office near your home. No appointment is required. If you enter the word “city office” or “ward office” in google map, you can find the answer in a second.

  • city office (市役所)
  • ward office (区役所)

If you go there you can get advices at the reception. The opening hour is usually from 9:00 to 17:00 (Monday to Friday). The 2nd and 4th Saturday can be opened as well (check the website).

In case you are student, you are asked to submit:

  • passport
  • residence card
  • student card
  • my number card or notification letter

In case of working holiday visa, you are asked to submit:

  • residence card
  • passport
  • my number card or notification letter

Is dental treatment covered, too?

Good for you, the both Japanese health insurances cover your dental treatment as well. The coverage ratio is also 70% which means that you pay only 30% of the total cost when you visit dentist and get treatment.

As a general rule, the treatment that use social HI and NHI is limited to “therapeutic purposes”. Therefore, insurance is applied to those performed as part of the treatment of tooth decay and periodontal disease, but insurance is not applied to those for aesthetic purposes such as tooth whitening. The following is a treatment cost overview after deduction of 70% support from HI or NHI (what you have to pay from your pocket).

Dental checkup 3.000 Yen
1 dental caries treatment (mild) 1.500 – 3.000 Yen
1 dental caries treatment (moderate) 2.000 – 10.000 Yen
1 dental caries treatment (severe) 7.000 – 20.000 Yen
Wisdom tooth extraction (straight growing) 1.500 – 3.000 Yen

Here some more examples that won’t be supported by HI and NHI:

  • Orthodontics
  • Tooth whitening
  • Ceramic or gold stuffing and coverings (Insurance coverage is silver, palladium, plastic, etc.)
  • Aesthetic cleaning

What about cleaning?

The question is whether HI and NHI are applied to dental checkup and cleaning. If both are for the treatment of tooth decay and periodontal disease, you can get support from insurances. On the other hand, these doesn’t cover your cost if it is for purely preventive purposes.

However, at most dental clinics, dentist gives you a quick cleaning and polishing of any dirt on your teeth after the treatment like removing tartar. And in this case, the cleaning is covered by HI and NHI.

Summary of important points

I hope you’ve got an clear overview about Japanese health insurance system. Last but not least I will repeat and pick up some important points.

  • Enrollment in health insurance is mandatory for everyone regardless your nationality
  • No choice of health insurance programs. If you are employee, social health insurance. If you are not employee, national health insurance
  • The coverage is the same for both insurance: 70%
  • You need to apply for NHI within 14 days after your entry
  • Dental treatment is basically covered

If you want to know more about the common insurances in Japan, jump to this article.

Yuki Nagahori
BA in German / Japan Country Manager at editorial company → Sales → currently sales planner based in Hamburg, Germany