Part 4 of our series on Japanese insurance

In my opinion, 健康保険 (kenkou hoken), or Health Insurance is one of the most familiar insurances in Japan because it covers most people in Japan. Let’s get familiar with Health Insurance in Japan.


  • Most people in Japan are enrolled in either of Employee’s Health Insurance or National Health Insurance
  • Employee’s Health Insurance is paid by you and your employer
  • National Health Insurance is paid only by you

What is Health Insurance?

As explained in part 1, there are two types of Health Insurance: Employee’s Health Insurance and National Health Insurance. Most people in this country are enrolled in either of the two insurances, which makes Health Insurance very familiar to Japanese people.

Employee’s Health Insurance is part of the Social Insurance System, and National Insurance is not.

Both the insurances cover 70 percent of your medical costs, including prescriptions and treatments. The insurances also cover your family members’ medical costs. This is why Health Insurance is very important; without it, you would need to pay the full costs of medical procedures and emergencies.

For example, if your medicine costs ¥3,000 with Health Insurance, it would cost ¥10,000 without the insurance. In this case it would be more than three times as expensive!

Employee’s Health Insurance

In addition to 70 percent coverage of the medical cost, Employee’s Health Insurance provides sick benefits and maternity benefits. For example, if you get sick and cannot go to work for at least three days straight, you can receive two thirds of your daily wage as part of your sick benefits.

The premium of the insurance is paid evenly by you and your employer. The amount you are responsible is taken from your monthly wages.

The insurance can cover your family members too. Moreover, you may not have to pay extra premiums for your dependent family members who are enrolled in the insurance. For more information, please visit the Japan Pension Service’s page

Who needs to enroll?

If you fulfill all the five criteria below, you may be obligated to enroll in Employee’s Health Insurance:

  • You work for at least 20 hours per week.
  • You earn at least ¥88,000 per month.
  • You are expected to work for at least a year.
  • You are not a full-time student.
  • You work for a company with more than 500 employees OR your work for a company with less than 501 employees and it is agreed that its employees enroll in the Social Insurance.

I encourage you to check your employment contract and payment slips to see if you fulfill all the five criteria.

National Health Insurance

Below are some of the things that make National Health Insurance unique from Employee’s Health Insurance.

  • Those who are unemployed, self-employed or work for a company with fewer than five employees can be enrolled in National Pension Insurance. Basically, people who do not fulfill the criteria for Employee’s Health Insurance enroll in National Health Insurance.
  • National Health Insurance does not provide sick benefits or maternity benefits. Even though you can receive some financial assistance for delivery, there is no maternity benefit.
  • You pay for the whole premium of National Health Insurance. Unlike Employee’s Health Insurance, whose premium is paid by you and your employer.
  • The amount of the premium is calculated by considering how many people in your family are enrolled, in addition to other things. Unlike Employee’s Health Insurance, which lets you have your dependent family members enroll without paying more, your premium for National Health Insurance gets higher as the number of your family members enrolled in the insurance increase.

In order to apply for the insurance, you can go to a local city office and submit a form at the National Health Insurance section. You will need your passport and residence card.

Expensive, but…

The premium of Health Insurance is expensive, and paying the premium every month can be a burden for your livelihood. However, one day the insurance may help you a lot, and you may think “I’m blessed to have this insurance.” Insurances are there to protect and support you. 

In Japanese culture it is important to be a responsible citizen. Unlike Western culture, Japanese people care more about responsibility as a group than as an individual. For example, so many Japanese companies emphasize success and harmony as a team.

In the same way, you cannot choose not to pay your insurance premiums just because you do not want to. You are responsible to pay the premiums as a member of a team, such as your company, family, and this country. By paying for all of these insurances, you are being responsible to you, your family, company, and Japan.

Part 1: the Social Insurance System
Part 2: Employment Insurance
Part 3: Workers’ Compensation Insurance