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National Health Insurance (国民健康保険 / NHI)
All residents of Japan — including foreign nationals with a residence card — are legally required to enroll in health insurance within 14 days of arriving. The National Health Insurance scheme (NHI / Kokumin Kenko Hoken) covers the self-employed, students, and those not enrolled in employer insurance.
- Enrollment at your local ward office (kuyakusho) is mandatory; failure to enroll results in backdated premium liability
- Premiums are calculated based on the previous year's income and vary by municipality — typically ¥15,000–¥30,000/month ($100–$200)
- Covers 70% of all covered medical costs — you pay 30% out of pocket at the point of care
- Includes: GP visits, specialist consultations, surgery, inpatient care, prescription medicine, and basic mental health care
- The High-Cost Medical Expense System (高額療養費) caps monthly out-of-pocket at approximately ¥80,100 + 1% of costs above ¥267,000 — protecting against catastrophic bills
- New arrivals with no prior income history in Japan often pay minimum premiums in their first year — typically ¥5,000–¥15,000/month ($33–$100)