Healthcare
Japan — Healthcare: Public Healthcare (National Health Insurance)
Japan has a universal healthcare system funded through mandatory public insurance across three schemes (3,000+ individual funds): employer-based health insurance, residence-based National Health Insurance (NHI, for self-employed, freelancers, students, part-time workers, those between jobs, and dependents not covered under a company plan), and insurance for those over 75. NHI is administered municipally — the local city/ward office manages enrollment, calculates premiums, and issues the insurance card. Enrollment is compulsory regardless of citizenship for anyone resident in Japan 3+ months. Public insurance covers 70% of most medical costs, with the insured paying the remaining 30% out of pocket. Since 2024, Japan has been phasing out the paper insurance card in favor of the My Number card as the health insurance credential; as of late 2025 most clinics accept (and many prefer) it. From 2026, MHLW has strengthened coordination between ward offices and the Immigration Services Agency, linking visa/residence status more closely to NHI enrollment records.
Key facts
- Universal system: employer-based insurance, municipal NHI, and over-75 insurance — 3,000+ individual funds.
- Enrollment is compulsory for all residents (any nationality) staying 3+ months.
- Coverage: 70% of most medical costs paid by insurance, 30% out-of-pocket copayment.
- My Number card is replacing the paper insurance card as the primary credential (since 2024, widely accepted/preferred by late 2025).
Costs
- Standard patient copayment: 30% of medical costs
Timelines
- Residency threshold triggering compulsory enrollment: 3+ months
Required documents
- My Number card (health insurance credential)
- Residence card
Common mistakes
- Assuming enrollment in NHI is optional for foreigners — it is compulsory for any resident of 3+ months regardless of nationality.