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5 tips to utilise the Insurance System in Japan

By Guidable Writers Oct 26, 2017

This post is also available in: Italian

When it comes to living in a foreign country, the most serious concern will be how to do when you become sick or get injured. Especially you might be worried about the medical/treatment expense which will cost you.

In Japan, we have national health insurance system, and no matter what kind of insurance you had applied for in your own country, every foreigner must join this health insurance system, with the cost of approximately 4,000 yen per month, if staying in Japan for 3 months or more

(If you are employed by a company, social insurance shall be alternative of national health insurance. Hence no need to proceed the participation of national health insurance by yourself).

Here, we’d like to introduce some brief tips regarding national health insurance system in Japan (for details, you can ask the city office in your city).


1. First of all, what is “national health insurance system” in Japan?

National health insurance is one of the social security systems in Japan, by which the claimed medical expense shall be paid from the insurance fee when the joinee becomes sick, gets injured, gives a birth or passes away.

The coverage is not 100%, so you have to pay some amount at the hospital counter. Some large hospitals can accept credit card, but most local private clinics still accept the cash payment only. It’ll be better to put some cash in your wallet when going to the hospital.

In case you will be pregnant in Japan and have your own insurance card here, you can get around 350,000 to 420,000 yen (the amount depends on the city you live in), for the delivery cost, as a lump-sum allowance for childbirth and nursing.

And in case the cardholder passes away, 50,000 yen shall be supplied as funeral cost.


2. Who can join national health insurance system in Japan?

In Japanese national health insurance system, no matter what kind of insurance you had applied for in your own country, every foreigner must join this insurance system, if staying in Japan for 3 months or more. You can get your own national health insurance card at the city office where you have done your resident registration. In the occasion of the application, please do not forget to take your residence card. The application procedure shall be done in the national health insurance window at the city office. Recently, more and more English/Chinese speaking staff (or with even more foreign languages ability) are available at the city office, so do not worry, they will surely support your case.


3. How much must we pay?

The fee amount varies depending on your income amount of the previous year in Japan.

Therefore, the fee amount will be widely changed in case that you are a student or a worker. The detailed fee amount can be calculated at the national health insurance window at the city office on your request. However, there is the limit of the fee, so it doesn’t necessarily mean that the higher salary you get, the more you have to pay.

In my case, just for an example, I have been working outside of Japan for these 2 years (no previous income in Japan), and not currently employed due to pregnancy, the insurance cost is approximately 4,000 yen per month.



4. If the claimed medical expense is too expensive, what can we do?

When a national health insurance card holder gets sick or injured, and the medical expense to be paid by her/himself national health insurance exceeds the limitation, the exceeded amount can be paid back later. Please be careful that this is “terms and condition applied”. If you default on the fee, for example, it might be difficult to claim this payback. Also, in case that you already know that your medical expense will be much expensive due to long-term hospitalization etc, you can submit the expense limitation certificate at the hospital, by which the payment amount will be limited up to your limitation.


5. Is it possible to save some amount for the payment?


Understanding the system itself and the payment calculation method, there are some ways to reduce the payment amount.


First, if you live with someone at the same residence with independent/separate households, try to put them together into a single household.

Second, moving to another city. In some cases, you might save much amount. Even within Tokyo, for example, approximately 100,000 yen gap a year can be observed between 23 wards and others.

Third, use “Nanaco” for the payment. Nanaco is an electronic money supported by Seven-eleven. By paying the insurance fee by this electronic money, some points can be added to your nanaco card. You can also pay the fee by credit card, but be careful if this payment method can be acceptable at your residential city. Besides, in some cases, commission fee can be deducted at the time of payment.

Forth, the advanced payment. When paying the whole year fee payment at once, you might get approximately around 1% discount. This discount amount varies in each city. Please ask your city office for details.



Well, how about it? Though the payment can be the issue in some cases, health problems can happen anytime for anyone. To reduce the everyday concerns in a strange country, please do join the national health insurance system as long as you stay in Japan.


Sonia Insomnia/JAPAN