Health Insurance Guide for Foreign Residents in Japan [Enrollment Obligation, Switching, and How to Use Your Insurance Card]
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Foreign residents in Japan are **obligated to enroll in health insurance** regardless of their residence status. Those employed by a company enroll in health insurance (social insurance), while the self-employed or freelancers enroll in National Health Insurance. If you visit a medical institution without being enrolled, you will be responsible for the full cost of medical care, so it is necessary to complete the procedures immediately after arriving in Japan.
1. Two Types of Health Insurance
- Eligible: Employees of a company
- Enrollment Procedure: Company handles it
- Premiums: Split with the company (approx. 5% each)
- Dependents can also enroll without additional premiums
- Includes sickness and injury benefits, maternity benefits
- Eligible: Self-employed, freelancers, unemployed individuals
- Enrollment Procedure: You handle it yourself at the municipal office
- Premiums: Full self-payment (based on previous year's income)
- No dependent system (family members also need to enroll separately)
- No sickness and injury benefits
Not being enrolled in health insurance or failing to pay premiums is one of the factors that can lead to a negative evaluation during residence status renewal screening, indicating "problems with residence status." Please complete the enrollment procedures promptly after arriving in Japan and ensure you pay your premiums on time.
2. Enrollment Procedures
National Health Insurance Enrollment Procedures
You can complete the procedures at the municipal office at the same time as submitting your moving-in notification. Please bring your Residence Card and the receipt for your moving-in notification. The general rule is to complete this within 14 days of arriving in Japan.
| What to bring | Notes |
|---|---|
| Residence Card | Required |
| Passport | If necessary |
| My Number Card (or Notification Card) | Bring if you have one |
3. Switching Insurance Upon Job Change or Retirement
| Situation | What to do | Deadline |
|---|---|---|
| Period between leaving a job and starting the next one | Switch from Social Insurance to National Health Insurance (at municipal office) | Within 14 days from the day after your resignation date |
| Changing jobs and starting at a new company | New company handles enrollment in Social Insurance | As soon as possible after joining the company |
| Becoming a freelancer | Switch from Social Insurance to National Health Insurance | Within 14 days from the day after your resignation date |
4. Estimated Insurance Premiums
The health insurance (social insurance) premium rate is approximately **10% of your standard monthly remuneration (split 5% each with the company)**. For a monthly income of 300,000 yen, your self-payment would be around 15,000 yen.
National Health Insurance premiums are calculated based on the previous year's income and vary by municipality. Please check with your local municipal office or their official website for details.
5. How to Use Your Health Insurance Card / My Number Health Insurance Card
When you present your health insurance card (or My Number health insurance card) at a medical institution, you will generally be responsible for **30% of your medical expenses**. If you visit without an insurance card, you will be responsible for 100% (the full amount).