Author: M.Kok

About Japanese medical insurance

Health care has become a polarizing topic in recent years. In Japan, the decision to have health insurance is easy- because you do not get to choose. If you live in Japan, you are required to have health insurance. Here is a quick guide to what it is, how it works and how to use it.

The options

There are three options. This sentence deserves an asterisk. Most foreigners, meaning almost everyone who works in Japan, uses the first option- the work insurance or the Kenko Hoken(健康保険).
The second one is called Kokumin Kenko Hoken(国民健康保険) or the National Health Insurance. The only feasible way for someone from overseas to use this is when they are a student or a dependent of someone who uses the first option.
The third option is the others. Most of the people living in Japan use the first two options. There are unique cases where someone might be privately insured. Or have a special agreement between Japan and their country of origin. But this is somewhat uncommon and warrants an article of its own.

The Kenko Hoken is what you get when you start working for a Japanese company. The company does all the paperwork for you and pays half. How much you have to pay depends on your income. The average cost is said to be somewhere around fifteen-thousand yen.

The insurance covers 70 per cent of your medical costs. You have to pay the rest yourself. However, prolonged costly medical expenses have a cap. Which, again, depends on your age and income, but the average is about eighty-thousand yen per month. Everything that is above the ceiling the insurance covers.


Kokumin Kenko Hoken. For the unemployed, the students and those who work less than thirty hours a week. It is much the same as the Work insurance. The main difference is that you don’t get sick pay.

The exception

Mostly private insurance. But in some unique cases, some overseas transfer workers have special agreements where their requirement for the mandatory insurance is waivered and replaced by whatever they are covered by in the country of origin.

There are also alleged cases where individuals avoid paying for health insurance. But this is, depending on how well you can read Japanese law, illegal or borderline legal.

How to use

If you are on the Kenko Hoken, your company will apply for you. If you have the National one, you have to do it yourself. You can get your school or someone nice from the local administrative office to help you get it right.
After the application is processed, you will receive your insurance card.
You take the card with you when visiting the doctor.


The Japanese healthcare system is not ideal. But the reality is that a perfect system does not yet exist. What Japan currently has is one of the better systems in the world, with only a handful of European countries besting it. Seems odd to think of a functioning healthcare system as an added perk to working in Japan, but maybe that is why the topic has become this controversial.

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