May 2020


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Public Medical Insurance

Everyone who lives in Japan must enroll in a public medical insurance program through their company or municipality. This type of insurance provides support if you are sick or injured.

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Public Medical Insurance System

What is public medical insurance?

If you get sick or injured, seeing a doctor and buying medicine costs money. Public medical insurance is a system which provides coverage to ensure you don’t have to pay large amounts of money for this care.

To enroll in public medical insurance, you pay insurance premiums, and the cost of these premiums is determined based on your income (earnings from working at a company or running a store, etc.). In return, you can use this insurance to cover some of the costs for seeing a doctor and purchasing medicine if you get sick or injured.

Everyone living in Japan is enrolled in public medical insurance through their company or municipality. All foreigners living in Japan for 3 months or more are required to enroll.
However, in some cases, people from countries with special agreements with Japan are not required to enroll.

Types of public medical insurance

There are two different types of public medical insurance.

  • Health insurance: Insurance programs for people who work at companies and organizations.
  • National health insurance: Insurance program for people who don’t work at companies.

Using your public medical insurance

If you enroll in a public medical insurance program, you will receive an “insurance card.” If you bring this card with you when you go to a hospital or pharmacy, you pay only 30% of the total cost for seeing a doctor or buying medication.
If you go without this card, you will be required to pay 100% of these costs. You can submit an application for a refund of the 70% covered by insurance at a later date. Ask for information at the reception desk of the facility you visit.
Your insurance card is an important document that proves your enrollment in the public medical insurance program. Only you can use it. It cannot be given or lent to anyone else.

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When you can’t use public medical insurance

Be aware that there are also times when public medical insurance cannot be used. Here are some examples.

  • Pregnancy and childbirth
  • Receiving a physical (a general check of your health condition)
  • Receiving vaccinations (shots to prevent diseases)
  • Orthodontic treatment
  • Fees for hospitalization in a private room (for a single patient)
  • Injuries caused by traffic accidents
    (In this case, the person who caused the accident pays.)
  • Injuries and illnesses at work or when going to/from the workplace
    (In this case, there is a separate system called “worker’s compensation insurance” which is used instead. Ask for details at your workplace.)

Health Insurance

What is health insurance?

Health insurance programs are for company workers.
The application procedure is completed at your employer.
Family members you support with your earnings can also be enrolled in the same insurance programs along with you. However, they must also live in Japan to enroll. Ask for details at your workplace.

Payment methods for health insurance premiums

Insurance premiums (fees for insurance enrollment) are paid half and half by you and your company.
The amount you pay is determined based on your wages.
Your company will deduct the insurance premiums from your paychecks.

National health insurance

What is national health insurance?

National health insurance is for people who don’t work at companies.
The application for enrollment is completed at the ward office or city hall which serves your local area. Bring your residence card and passport with you to the reception desk

In addition, if you do not have any family members living in the same house as you, you can enroll in the national health insurance program by yourself.
If you have family members living in the same house as you who are not enrolled in health insurance programs, these family members can also enroll in the national health insurance program. The application procedure is carried out by the head of the household. Ask for details at your local ward office or city hall.

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Insurance premium payment methods

Insurance premiums (cost for insurance enrollment) are determined based on the following factors.

  • The place where you live
  • Your income (earnings from running a store or working freelance)
  • The number of people in your family

Insurance premiums are paid using one of the methods below.

  • Payments will be automatically withdrawn from your bank or post office account.
  • You will receive a “payment slip” in the mail. This is a paper used to pay your insurance premium. Bring it to the ward office or city hall insurance desk, or a bank / post office / convenience store to make your payment.

Always make sure to pay your insurance premium by the deadline shown.

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