Haven’t Paid Your National Health Insurance? The First 3 Things to Know! | Guidable - Your Guide to a Sustainable, Wellbeing-centred Life in Japan

Haven’t Paid Your National Health Insurance? The First 3 Things to Know!

By Aika Kaise Aug 9, 2018

Do you have a national health insurance card in Japan?

Even if you are covered by your company social insurance now, there may be a time in the future where you have to change to a national insurance card.

We would like to explain why you need to apply for national health insurance, and the first 3 things you need to do if you forget or ignore the insurance fee payment.

1. Who Needs to Apply for National Health Insurance?

First things first, if you stay in Japan for more than 1 year, you may have to apply for national health insurance.

You will need to apply for national insurance if the following applies: you are over 20 years old, you are not a student, you are not covered under social insurance (because you do not have a job or you are dependent to your family).

Even if you have a job, you need to apply for it in the case your working condition does NOT correspond to all of the following conditions.

  1. You work for over 20 hours per week.
  2. You are presumed to continue working for more than 1 year.
  3. Your income is over 88,000 yen.
  4. You are not a student.
  5. There are more than 501 workers in your company.

If you are a company employee and your working conditions match those presented above, you should apply for social health insurance, you do not need to apply for a national health insurance.

If you are a student, there is a special payment system which enables you to forgo the national health insurance payment, after application. It will be necessary for you to submit your application at your local city hall. Be aware that even if you are a student, you be will expected to pay the national health insurance premium if you forget.

If you do not have social insurance and you are not a student, it is your duty to apply for national health insurance in Japan.

Please note that you will face a hefty fee when you go to see a doctor after you are injured or sick because without insurance you will be billed for the entire expense.

2. What Happens If You Refuse the Payment?

Because it is an obligation to apply for national health insurance if you are not covered by social insurance, you will face many difficulties if you forget or refuse to pay…

2-1. You will get a demand letter after 1 month from the due date for the payment.

2-2. If you continue to ignore the payment after the due date written in the demand letter, you will receive a renewed national health insurance card whose expiration date is much shorter.

2-3. If you do not complete the payment after 1 year since the first obtained due date, you will receive a ‘certificate of national health insurance’ which is different from national health insurance card. With this certificate, if you go to see a doctor and show it to a clerk at the window, you will be obligated to pay 100% of the medical bills by yourself, and it will not be refund unless you make a procedure at a city hall.

2-4. If you still keep ignoring without consulting it to a staff at a city hall, your property may be seized.

Payment in arrears happens from the next day of the first payment due date to 1 month later, and you are billed 2.7% of the insurance fee as payment in arrears.

After 1 month passes, you will be claimed 9.0% of the insurance fee as payment in arrears.

Therefore, you should take care not to forget and ensure the payment is completed by the due date written on the invoice.

3. How Can You Pay the Offending Bills?

3-1. You should go to your local city hall.

First of all, we advise a trip to city hall where you inform the staff that you have been unable to pay your national health insurance fee.

The staff will guide you as to what procedures you need to make for the remaining payments.

3-2. You may ask for an extension of the payment.

If you do not have an enough income because you are undertaking job hunting, or if work is difficult because you are sick or injured, you should explain your situation because sometimes you can get an extension of the payment.

3-3. You can ask to pay it installments.

It is also possible to get a reduction of the billing amount in some regions if you explain you do not have an enough income now, so please confirm it to a city hall near your home.

Furthermore, if it is difficult to pay as a lump sum, it might be possible to pay in installments if you ask. If you explain your situation, you may be able to pay it installments of as low as 1,000 yen per month.

It is very rare for the insurance office to force the payments after you explain your income troubles, so it is strongly recommended that you to go to a city hall and talk about your situation.

In conclusion, you should not ignore national health insurance payment because you will face huge problems later on. You will be billed for the payment with arrears, and will have to pay much more than the first billing amount.

To avoid that, please go to the city hall first if you have any questions about the payment, or if you face some difficulties for the payment due to your life situation.

The city hall staff will surely give you some advice depending on your situation, so please do not hesitate to visit there and explain your situation honestly.

I hope this information helps to prevent you from facing the difficulties of national health insurance payments in Japan!


Aika Kaise / Japan