Health insurance in Japan.
If you live in Japan, joining public insurance is the law. A private plan can only sit on top. Digital nomads are the exception.
The rules
What Japan asks of you.
Checked against official sources on 23 October 2026. Rules change, so the broker confirms them again before you apply.
- Mandatory for residents
Foreign residents staying more than 3 months must join public health insurance. It is not optional.
Source: city.nagoya.jp - Employer plan or NHI
If you work for a Japanese employer, you join its health insurance. Everyone else, such as freelancers and students, joins National Health Insurance at the city office, usually within 14 days.
Source: osaka-u.ac.jp - You pay 30%
Most people pay 30% of the bill and insurance pays 70%. Young children pay 20%.
Source: city.yokohama.lg.jp - A private plan does not replace NHI
A foreign health plan or travel insurance does not let a resident skip NHI. It can only be added on top.
Source: city.nagoya.jp - Digital nomad visa: 10 million yen
The digital nomad visa needs private medical insurance with at least 10 million yen of treatment cover for the whole stay of up to 6 months. Family members need the same.
Source: moj.go.jp
Once enrolled, residents get the same public cover as Japanese citizens, with a monthly cap on very high bills. If you join late, the city can charge premiums back to the day you became a resident.
Source: global.support.ritsumei.ac.jpLocal or international
We compare both. You keep the one that fits.
Residents must join Japan’s public insurance. A local private plan can pay the 30% you owe, and an international plan adds care outside Japan.
- Local plans
Plans sold in Japan. Often cheaper, sometimes required for your visa. Filed by a broker licensed in Japan.
- International plans
Plans that cover you in Japan and beyond, and stay with you if you move again. Filed by our international broker partner.
What it costs
Published prices in Japan.
List prices from insurers and official schemes. Your quote depends on your age, health and the cover you pick.
- NHI medical part, Sumida City, 2026
47,600 yen per person a year, plus 7.51% of last year’s income after a 430,000 yen deduction. This part is capped at 670,000 yen. Each city sets its own rates.
Source: city.sumida.lg.jp - NHI elderly and child support parts, Sumida City, 2026
On top: 17,600 yen per person plus 2.80% of income for elderly support, and 1,873 yen plus 0.27% for child support.
Source: city.sumida.lg.jp - Long-term care part, ages 40 to 64, Sumida City, 2026
17,800 yen per person plus 2.43% of income, capped at 170,000 yen. Under 40, you don’t pay this part.
Source: city.sumida.lg.jp
What to look for
Choosing a plan in Japan.
Ankyro checks each of these on every plan, so you don’t have to read the fine print.
- Top-up, not replacement
Residents already have public cover. Look for a plan that pays the 30%, private rooms and care outside Japan.
- Nomad visa wording
For the digital nomad visa, the policy must show at least 10 million yen of treatment cover for your full stay.
- Family on the policy
A spouse and children on the nomad visa need their own proof of cover, or to be named on yours.
Step by step
Getting covered in Japan.
- 01Register your address within 14 days. Go to the city or ward office with your passport and residence card within 14 days of moving in. Missing the deadline can cost a fine of up to 200,000 yen.
- 02Join NHI at the same counter. If you are not on an employer plan, enrol in National Health Insurance on the same visit. Family members living with you join too.
- 03Or join your employer’s plan. If you work for a Japanese employer, it enrols you in its own health insurance. You then skip NHI.
- 04Set up your My Number Card for clinics. Your 12-digit My Number arrives by post. Register the card as your insurance card through MynaPortal or a Seven Bank ATM, or show your eligibility certificate instead.
- 05Pay premiums from June to March. NHI is billed in 10 monthly payments from June to March. The amount is based on last year’s income in Japan.
- 06Add a private plan for the 30%. A private plan can pay your 30% share or care abroad. It sits on top of NHI, never in its place.
Common mistakes
3 we see all the time.
- 01Thinking an international plan lets you skip NHI. For residents it does not.
- 02Joining NHI late and getting a bill for back premiums.
- 03Leaving NHI premiums unpaid. Japan has said it plans to link unpaid premiums to visa renewals.
Real published prices, and the 6 things that move yours.
Just visiting?For a holiday or a short trip, travel insurance is enough. See what Japan asks of visitors, and what care costs.
Questions
People also ask.
Do foreigners have to join National Health Insurance in Japan?+
Yes, if you live in Japan for more than 3 months and are not on an employer plan.
How much does health insurance cover in Japan?+
Most people pay 30% of the bill and insurance pays 70%. Young children pay 20%.
Can I use international health insurance instead of NHI?+
Not as a resident. A private plan can only be added on top of NHI.
What insurance do I need for the Japan digital nomad visa?+
Private medical insurance for your whole stay, with at least 10 million yen of treatment cover.
Other countries
Going somewhere else?
Most UK visas don’t ask for private insurance. You pay a yearly surcharge instead, and it opens the NHS. Here is what the surcharge buys, and what you still pay for.
02AustraliaMost visitors can’t use Medicare, and many visas carry condition 8501. Here is what each visa asks for, who gets Medicare, and what to check.
03Dubai and the UAEIn Dubai, no insurance means no visa. Your employer covers you, but not always your family. Here are the rules, and what the basic plan leaves out.
04PhilippinesThe retiree visa asks for a medical certificate, not a policy. The new nomad visa does ask for cover. Here is what each visa needs, and how PhilHealth works for foreigners.
05NetherlandsIf you live or work in the Netherlands, Dutch basic insurance is the law. A few people are exempt. Here is who must sign up, by when, and what it costs in 2026.
06CanadaEach province runs its own health plan, and some make you wait. The super visa has strict insurance rules. Here is how Ontario and BC differ, and what the super visa needs.
07Saudi ArabiaIn Saudi Arabia, no insurance means no iqama. Your employer pays for you and your family, and visitors need a policy too. Here is who pays, and what each policy covers.
09GermanyEveryone in Germany must be insured, and a residence permit needs cover equal to the public system. Here is how to choose, and what gets rejected.
10SingaporeThe national plan is for citizens and PRs. Hospital bills for foreigners are high, and families are often left out. Here is what to check.
11ThailandRetirement visas have hard minimums, the DTV has none, and public care is not free for foreigners. Here are the rules, and what to check.
12SpainSpain has the strictest visa insurance rules in Europe: a Spanish-authorised insurer, no co-pays, no waiting periods. Here is what passes.
13MalaysiaPublic hospitals charge foreigners full price, and work schemes only cover injuries at work. Here is what each pass asks for, and what to check.
14QatarMost visitors need a QAR 50 a month policy before Qatar issues a visa. The law covers expats too, but that part is still rolling out. Here are the rules.
15FranceThe public system is open to residents, but not on day 1 if you don’t work, and it only pays part of each bill. Here is how to cover the gaps.
16PortugalThe visa asks for travel medical cover. The public system opens once you are a resident. In between, and after, here is what to check.
17MexicoNo visa asks for it, so many expats skip it. Then a private hospital asks for payment first. Here is how cover really works in Mexico.
18ItalyWorkers join the public system for free. Retirees and nomads need private cover for the visa, then pay at least €2,000 a year to join. Here are the rules.
19South KoreaStay more than 6 months and you must join the national plan. Before that, and for your share of each bill, you need your own cover.
20VietnamOnly long local contracts come with public cover, and most expats use private hospitals anyway. Here is what the rules say, and what to check.
21Bali and IndonesiaMost Indonesian visas don’t ask for insurance. But hospitals ask for payment first, and serious cases fly to Singapore. Here is what to check.
22GreeceThe consulate takes travel cover for the visa. The residence permit then asks for full health cover. If you don’t work for a Greek employer, that means a private plan.
23ColombiaNomads and retirees need a private policy with exact wording. Residents who work must join the public EPS system. Here are the rules.
24Costa RicaResidents must pay into the Caja, whatever private plan they have. Nomads need their own cover for the visa. Here is how it fits together.
25USAThe US has no public plan you can simply join. Some visas set minimum cover. Others leave it to you. Here is what a J-1 needs, who can use the Marketplace, and what plans cost.
26SwitzerlandBasic health insurance is compulsory for everyone who lives in Switzerland. You have 3 months to sign up. Here is how it works, and what to check.
27IrelandNon-EEA students must hold private medical insurance. Everyone else gets public care once they count as living in Ireland for 1 year. Here is what to check.
28Dominican RepublicThe residence visas for retirees and rentistas ask for a medical certificate, not an insurance policy. Public care is limited. Private care is good but costly.
29New ZealandStudent visas require insurance. A work visa of 2 years or more may open public health care. ACC covers accident injuries. Here is what to check.
30IsraelIn Israel, the public system is for residents. If your life is centred there, you join a health fund (kupat holim). If not, you need private cover.
31Hong KongPublic hospitals in Hong Kong are cheap for eligible persons. Many foreigners are not on that list. Here is who is, what the rest pay, and what to check in a plan.
32ChinaIf you work in China on an employment permit, your employer must enrol you in social insurance. That includes basic medical cover. Here is how it works, and what to check on top.
33ArgentinaEmergency care is open to everyone. For other care at national hospitals, foreigners without permanent residence must show insurance or pay first. The rules are new, so check them.
34IndiaWe found no official rule that ties health insurance to an Indian work visa. We also could not confirm a public scheme for foreign residents. So the plan is yours to choose. Here is what to check.
35TurkeyA residence permit application needs valid health insurance for the whole permit. Most new expats buy a private policy. The public SGK system opens later, after 1 year of residence.
36BrazilThe digital nomad visa needs health insurance valid in Brazil. The public system is open to migrants by law. Many expats add a private plan for speed.
37PanamaThe Pensionado visa asks for a health certificate, not an insurance policy. The public system is tied to the Caja. Private care is the main option for most expats.
38South AfricaStudy and exchange visas ask for proof of cover from a registered medical scheme. Public clinics offer free primary care. Here is what to check.
39KenyaKenya’s public fund is run by the Social Health Authority (SHA). A foreigner who lives in Kenya for more than 12 months pays into it. Shorter stays need travel health insurance instead.
40TaiwanTaiwan has one national health insurance. Foreigners with a residence certificate can join. If you have a job, you join through your employer. If not, there is a wait.