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#11

A Comprehensive Guide to Health Insurance in Japan : What You Need to Know

by Rachel Anne

Understanding Japan’s health insurance system is crucial for everyone living in the country—whether you're a Japanese citizen, a foreigner, or a retiree. Japan boasts a universal healthcare system that ensures all residents have access to high-quality medical care at affordable rates. Whether you’re a working professional, a retiree, or a student, understanding how to navigate Japan's health insurance landscape is essential to staying healthy and managing your healthcare costs.

In this blog post, we’ll break down the ins and outs of Japan’s healthcare system, providing a guide that covers the essentials for everyone living here.

1. Japan’s Health Insurance System : A Quick Overview

Japan’s healthcare system is one of the most efficient and high-quality in the world. What makes it unique is its universal health insurance system, which covers all residents of Japan—citizens and foreigners alike. The government mandates health insurance, ensuring that everyone can receive necessary medical treatment.

There are two primary forms of public health insurance in Japan :

Employee Health Insurance (EHI) : For employees and their dependents, typically through their workplace.
National Health Insurance (NHI) : For self-employed individuals, students, retirees, and others who are not covered by their employer’s plan.

Regardless of which plan you’re enrolled in, Japan’s health insurance system typically covers 70% of medical expenses, leaving the patient responsible for only about 30%. This makes healthcare costs relatively affordable for all residents.

2. Major Update : My Number Card Integration

As of December 2, 2024, Japan has stopped issuing new health insurance cards, transitioning health insurance functionalities into the My Number personal identification card. This move aims to streamline social security and taxation processes.

Existing health insurance cards will remain valid until December 1, 2025.
Residents are encouraged to apply for a My Number card and register it for health insurance use.
Registration can be completed online, at medical facilities, or via ATMs in select convenience stores.
Employers should assist their employees in this transition to avoid disruptions in healthcare access.

While this integration is meant to improve efficiency, concerns over data security and system errors have been raised. It is advisable to complete the registration process early to avoid potential complications.

Photo Courtesy : https://images.app.goo.gl/4egpXBn3Sju2iKFB6

3. Employee Health Insurance (EHI) : For the Employed Population

If you’re working in Japan, you will likely be enrolled in Employee Health Insurance (社会保険, Shakai Hoken). Your employer deducts insurance premiums directly from your paycheck and pays a portion of the premiums on your behalf.

How It Works :

For Employees : If you're employed, you automatically enroll in EHI through your company, covering you and your dependents.
What’s Covered : Doctor visits, surgeries, hospital stays, prescription medications, and more.
Premiums : Based on your income, shared between you and your employer.
Transitioning : If you leave your job (retirement, career change, etc.), you must switch to another coverage, such as National Health Insurance.

4. National Health Insurance (NHI) : For Self-Employed, Retirees, and Non-Employed Residents

For those not covered by Employee Health Insurance—such as the self-employed, students, and retirees—National Health Insurance (国民健康保険, Kokumin Kenkō Hoken) is the alternative.

How It Works :

Enrollment is mandatory and managed by local municipalities.
Retirees under 75 must register with NHI if they are no longer working.
Self-employed individuals and freelancers must also enroll in NHI.

Coverage and Premiums :

Covers doctor visits, hospital stays, surgeries, and prescriptions.
The standard 70% coverage applies, with patients paying 30%.
Premiums depend on annual income but may be reduced for retirees with lower income.

5. Medical Care for the Advanced Elderly : Special Coverage for Seniors 75+

Once you reach 75 years old (or 65 with disabilities), you qualify for Medical Care for the Advanced Elderly (後期高齢医療制度, Kōki Kōreisha Iryō Seido).

What’s Different:

Lower Copayment : Seniors pay only 10%-20% of medical costs.
Additional Care : Covers long-term care services.
Automatic Enrollment : Begins at 75 (or 65 with disabilities).

6. Private Health Insurance : For Extra Coverage and Peace of Mind

While Japan’s public health insurance is comprehensive, private health insurance can help cover additional services not included in the national plans.

Why Consider Private Insurance?

Supplemental Coverage : Covers treatments or services not fully covered by public insurance.
International Coverage : Useful for frequent travelers.
Faster Access to Care : Some plans provide quicker access to specialists.

7. For Foreign Residents : Navigating the System

Foreign residents must enroll in Japan’s public health insurance system. If staying for more than three months, they must register for Employee Health Insurance (if employed) or National Health Insurance (if self-employed, retired, or unemployed).

Key Considerations :

U.S. Retirees : Medicare does not cover medical expenses in Japan.
Language Assistance : Many municipalities offer assistance in English to help with enrollment and understanding coverage.

8. How to Enroll and Get Started

Steps to Apply :

Register Your Residence at your local municipal office.
Apply for Health Insurance : Through your employer (EHI) or local government (NHI).
Pay Your Premiums : Payments are usually made quarterly.
Use My Number for Health Insurance: Register your card to access medical services seamlessly.

Health Insurance for All Residents of Japan

Japan’s health insurance system ensures everyone has access to affordable, high-quality medical care. Whether you’re a working professional, retiree, or foreign resident, understanding your options helps you make informed decisions for your healthcare.

With the My Number card integration, residents should take steps to register and transition smoothly into the new system. By securing the right coverage, you can enjoy a stress-free and healthy life in Japan!

This guide aims to clarify Japan’s healthcare system, making it easier for all residents to understand their health insurance options and how to access medical care.

Posted 21 February 2025