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Health Insurance in Japan — Which Type Do You Need?

Japan has universal healthcare — everyone living here for 3+ months is expected to have health insurance. The system covers 70% of medical costs for most treatments, meaning you only pay 30%. But which type of insurance applies to you?

Type	Who	Premium	Coverage	Employer Pays
National Health Insurance (NHI / 国保)	Self-employed, students, unemployed	¥5,000-30,000/month (income-based)	70% covered	No — you pay 100%
Employee Health Insurance (社保 / Shakai Hoken)	Company employees	~10% of salary	70% covered	Yes — employer pays 50%

💡 Which one do I have?

If you work for a company: Your employer enrolls you in Shakai Hoken automatically — you do not need to do anything at city hall. If you are self-employed, a student, or between jobs: You need to enroll in NHI yourself at city hall within 14 days of arrival.

How Much Will I Pay?

NHI premiums vary significantly by municipality and income. As a rough guide:

Annual Income	Approx. Monthly NHI Premium
New arrival (no previous income)	¥2,000-5,000
¥2,000,000	¥8,000-15,000
¥3,000,000	¥12,000-22,000
¥5,000,000	¥20,000-35,000

Note: Premiums vary by municipality. Use our Insurance Premium Calculator for a more accurate estimate.

What Does Insurance Cover?

Both NHI and Shakai Hoken cover the same treatments: doctor visits, hospital stays, surgery, prescription medication, and most dental work. You pay 30% at the counter. Not covered: cosmetic procedures, advanced dental (braces, implants), some preventive care, and room upgrades at hospitals.

Steps

Visit the National Health Insurance (NHI) counter at your municipal office. This is usually on the same floor as the resident registration counter. If you are registering your address for the first time, you can sign up for NHI at the same time.

📄 Residence Card

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Fill out the NHI enrollment form (国民健康保険加入届). Staff will calculate your estimated premium based on your income. For new arrivals with no previous Japanese income, the premium is typically ¥2,000-5,000/month.

📄 Residence Card📄 My Number Card

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Receive a temporary insurance certificate on the spot. Your official NHI card (保険証) will arrive by mail in 1-2 weeks. You can use the temporary certificate at hospitals and clinics in the meantime.

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Pay monthly premiums (varies by municipality and income).