Category
Health Insurance in Japan for Foreigners
Health insurance is mandatory for everyone in Japan. This page explains the two systems, how to enroll, what you pay at the hospital, and how to find English-speaking doctors.
What is here
- Shakai Hoken vs National Health Insurance explained.
- The 30% co-pay rule and high-cost medical care benefit.
- How to find English-speaking doctors.
New to Japan?
See the full setup guide before you make the next move
If you are still sorting out essentials like SIM, banking, utilities, or insurance, use the checklist page to keep the overall order clear.
Key facts
What foreigners need to know about healthcare
Health insurance is mandatory
Everyone living in Japan — including foreigners staying 3+ months — must enroll in health insurance. There are no exceptions.
30% co-pay at hospitals
With health insurance, you pay 30% of medical costs. The remaining 70% is covered. This applies to doctor visits, prescriptions, surgery, and hospital stays.
High-cost medical care benefit
If your monthly medical costs exceed a certain threshold (varies by income, roughly ¥80,000–¥260,000), the excess is refunded. This protects against catastrophic medical bills.
Two systems: Shakai Hoken vs NHI
Employees at companies with 5+ workers get Shakai Hoken (employer-based). Everyone else — freelancers, students, job seekers — enrolls in National Health Insurance (NHI) at the city office.
How it works
Enrolling in health insurance
1. Check your type
Employees get Shakai Hoken automatically. Everyone else enrolls in NHI at the city office.
2. Get your card
You'll receive a health insurance card (hokenshō) — bring it to every medical visit.
3. Visit a doctor
Show your card, receive treatment, and pay 30% at the window.
Shakai Hoken vs National Health Insurance
Shakai Hoken is automatically enrolled by your employer. Premiums are split roughly 50/50 between you and your employer, deducted from your salary. It also includes pension contributions.
National Health Insurance (NHI / kokumin kenkō hoken) is for everyone not covered by Shakai Hoken. You enroll at the city or ward office. Premiums are based on your previous year's income and are billed separately.
How to visit a doctor in Japan
Bring your insurance card (hokenshō) to any clinic or hospital. You'll pay 30% at the window after treatment. No referral is needed for clinics, but large hospitals may charge an extra fee without a referral letter.
For English-speaking doctors, check AMDA International Medical Information Center, JNTO's medical institution search, or hospital websites that list multilingual staff.
Related guides
How to Understand Health Insurance in Japan as a Foreigner
Japan has universal health insurance, and foreigners are required to enroll. This guide explains the two systems, what they cover, how much you pay, and how to actually use the system when you need care.
New to Japan
Use this when you want the overall order of the setup steps.
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FAQ
Healthcare FAQ for foreigners
Common questions about health insurance and visiting doctors in Japan.
Is health insurance mandatory for foreigners in Japan?
Yes. Everyone living in Japan for 3+ months must enroll in either Shakai Hoken (through your employer) or National Health Insurance (at the city office).
How much do I pay at the hospital?
With health insurance, you pay 30% of medical costs at the window. The remaining 70% is covered by insurance.
What is the high-cost medical care benefit?
If your monthly medical expenses exceed a certain threshold (varies by income), the excess is refunded. This prevents catastrophic medical bills.
What's the difference between Shakai Hoken and NHI?
Shakai Hoken is employer-based insurance where premiums are split with your employer. NHI is for everyone else — freelancers, students, job seekers — with premiums based on last year's income.
How do I find an English-speaking doctor?
Use the AMDA Medical Information Center hotline, JNTO's medical institution search, or check hospital websites for multilingual staff listings.
What happens if I don't enroll in health insurance?
You may face back-dated premiums when you eventually enroll, and you'll pay 100% of medical costs out of pocket until then. Enrollment is legally required.