my place in japan

How to move into Japan

Get covered! Health insurance in Japan. Registering Series Pt. 2

Ahoy there!

  Welcome back to the second part of our 'Registering at city hall series' !  

  Nothing is more important that getting covered under the Japanese national health insurance if you intend on spending any significant time in Japan or will be doing any kind of activity where you might get injured or sick.  Read on to find out a bit more!

  National Health Insurance (NHI or often called “Kokuho” in Japanese.  Short for Kokumin kenkou Hoken) – NHI is basically the health-insurance system that covers all of its citizens in Japan.  Once you obtained the NHI, the co-pay for medical expenses will be drastically reduced whenever you received a medical treatment at a hospital or clinic.  You can also obtain the NHI at a city or town hall when registering.

  The NHI fee will vary depending on your annual income from the previous working year.  The more annual income you earned, the higher the NHI fee will be.  For example, if you are single and making about 4,000,000 yen a year(about 333,000 Yen a month which is about 3,000 USD), your NHI fee will be around 26,000 yen a month (Roughly 230 USD).  

  In general, Kokuho will pay 70% of most fees incurred when you visit Kokuho will cover a wide variety of non-cosmetic medial expenses like many fees incurred at hospitals, clinics, and dentists.  Things like glasses, or getting a private room at a hospital instead of sharing with other patients are not covered.  Many supplementary 'extras' aren't covered either, but usually are not something that one could expect insurance to cover in Japan.

  From my personal experience to give you a few examples, I got sick and needed medicine.  I went to a clinic, got a check up and diagnosis, and the whole process only cost me about 2,500 yen out of pocket.  I also got a two-week prescription for two medications available to pick up at a local drugstore and that only cost me 2,000 yen as well.  Overall, a painless affair besides the illness I walked in with!

  Another time, my wisdom tooth was in great pain and I needed that sucker out immediately!  I made the appointment and it was an emergency and they took me in as soon as they had time to admit me.  I was given anesthesia and the tooth was pulled and when all was said and done, I only owed about 3,000 yen total.  Having some experience with dentistry in America, I was blown away by the cheap price I paid for what I assumed would be a drastically expensive procedure.

  There is another type of insurance called “social insurance (often called “Shaho” in Japanese, short for Shakai Hoken)”. If you work for a company or corporation, in many cases, the company or corporation will cover your social insurance fee, and it will be deducted directly from your salary.  If that’s the case, you don’t have to obtain NHI. Please remember to check with your company or corporation if they cover for your insurance because sometimes some small companies can’t afford to pay for the social insurance.  Unless the company is a certain size, it may not be mandatory for them to offer this coverage to you. 
  This can be a large point of contention among many employees in Japan who want shakai hoken, due to its benefits regarding pension (To be discussed in another article) and some of the extra benefits it can offer to employees who are covered.  In general, it is very similar to NHI, but offers a few extra benefits regarding time off, bereavement, child birth, and paid leave after a child is born to name a few.  Each company has a slightly different policy, so check with you employer for the details.

  For the NHI, your NHI card will be mailed to your residence after you apply for it at the city or town hall where you live.  And please make sure to bring your NHI card with you whenever you visit a hospital or clinic, otherwise, you may have to pay 100% of medical expense there and have to bring a receipt to a city or town hall to get some of the money reimbursed at a later date.  Although an annoying extra step, the fact that you can apply for reimbursement later is quite a convenience compared to cases where you have to pay full price and get nothing later.

  Please beware that if you sign up for national health insurance, that you will be expected to pay for it! Of course this is the case.  And if you leave your town or city, make certain to let them know that you are moving, or you may be paying double when you register in your new town.  They will continue to bill you and expect the money back even if you 'forget' about it.  For people who are 'never sick' sometimes NHI can feel like a burden, but when you are in a pinch, there is nothing more helpful then having backup for those times when you are ill or injured.

    Hopefully this article gave you some insight on the benefits of being insured in Japan! Feel free to let us know what you think by shooting an e-mail to us at!

 Set sail to a new life, may ships take you on the seas, through the skies, and over the land towards my place in Japan.

Until next time, from all of of here at take care!

Kei & Phil