Health Insurance in Japan: A Financial Guide
What is Health Insurance in Japan?
Health insurance (健康保険 - kenko hoken) in Japan is mandatory for all residents. Upon arrival in Japan, you must enroll in health insurance either via your employer, or yourself at the city/ward office in which you reside.
There are two main types: the National Health Insurance (国民健康保険 - kokumin kenko hoken) for self-employed and unemployed individuals, and Employee Health Insurance (社会保険 - shakai hoken) for company employees.
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How much does health insurance in Japan cost?
Premium calculations vary based on your insurance type, income level, and where you live. Below we've outlined a common estimate for each type of insurance.
| Insurance Type | Premium Calculation | Cost Sharing |
|---|---|---|
| National Health Insurance | Based on previous year's income, plus a fixed amount | Individual pays 100% |
| Employee Health Insurance | Generally ~9-13% of monthly salary | Employer pays 50% |
In general, Employee Health Insurance is cheaper than the National Health Insurance, because your employer must pay 50% of the premiums for you.
Example Monthly Premium Calculation for ¥300,000 Monthly Salary:
- Insurance rate: 11% (varies by prefecture/provider)
- Total premium: ¥33,000 (¥300,000 × 11%)
- Employer portion: ¥16,500 (50% of total)
- Employee portion: ¥16,500 (50% of total)
What percent of costs does health insurance in Japan cover?
The Japanese health insurance system covers 70% of medical costs, with patients responsible for the remaining 30%. However, there are some exceptions to this depending on financial circumstance and age.
- Standard Co-payment: 30% for most adults (ages 18-69)
- Reduced Co-payment: 20% for children under 18
- Senior Co-payment: 10-30% for those 70 and older (income-dependent)
- High-Cost Medical Care Benefit: Caps monthly medical expenses based on income level
Are there caps on how much you have to pay?
The high-cost medical care benefit system (高額療養費制度 - kogaku ryoyohi seido) sets maximum monthly payments:
| Annual Income Level | Maximum Monthly Payment |
|---|---|
| Under ¥3,700,000 | ¥57,600 |
| ¥3,700,000 - ¥7,700,000 | ¥80,100 + 1% of expenses above ¥267,000 |
| Over ¥7,700,000 | ¥252,600 + 1% of expenses above ¥842,000 |