Alyssa Lane
Japan has a universal healthcare system, where the government covers 70% of all costs. All residents, including foreigners, are required to have health insurance coverage, whether provided by their employer or purchased privately. This can be done through the National Health Insurance program (NHI), also known as Kokuho, or through an employer-provided scheme. Most people in Japan also carry supplemental private insurance to help pay for the remaining 30% of medical fees that the universal program doesn't cover.
| Characteristics | Values |
|---|---|
| Type of coverage | Universal healthcare |
| Cost coverage by government | 70% |
| Insurance for foreigners | Available |
| Mandatory insurance | Yes, for all residents |
| Insurance providers | Public and private |
| Public insurance plans | Japanese National Health Insurance (NHI) and Japanese Health Insurance |
| Private insurance | Supplemental to public insurance |
| Insurance for students | Personal Accident Insurance for Students Pursuing Education and Research ("Gakkensai") |
| Insurance for travel | Available |
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What You'll Learn
Japan's public healthcare system
Japan has had universal health coverage since 1961, and foreigners can be a part of the system. The government pays for 70% of medical fees under the current healthcare system, with the remaining 30% covered by the individual. This payment is funded through two plans: the Social Health Insurance (SHI) and the National Health Insurance Program (NHI). SHI is the program that all full-time employees of medium and large-sized companies are automatically enrolled in. Those who are self-employed or work for small businesses contribute to the NHI. Enrollment in either an employment-based or residence-based health insurance plan is required, and those staying in Japan for more than 90 days must register for the NHI right away.
Japan's statutory health insurance system is funded primarily by taxes and individual contributions. Benefits include hospital, primary, specialty, and mental healthcare, as well as prescription drugs. In addition to premiums, citizens pay 30% coinsurance for most services, and some copayments. Young children and low-income older adults have lower coinsurance rates, and there is an annual household out-of-pocket maximum for healthcare and long-term services based on age and income. There are also monthly out-of-pocket maximums.
Each of Japan's 47 prefectures has its own residence-based insurance plan, and there are more than 1,400 employment-based plans. The national and local governments are required by law to ensure a system that efficiently provides good-quality medical care. The national government regulates nearly all aspects of the SHIS, setting the fee schedule and giving subsidies to local governments, insurers, and providers. Japan's prefectures implement national regulations, manage residence-based regional insurance, and develop regional healthcare delivery networks with their own budgets and funds allocated by the national government.
Although the majority (more than 70%) of the population holds some form of secondary, voluntary private health insurance, private plans play only a supplementary or complementary role. Private insurance has historically developed as a supplement to life insurance, providing additional income in case of sickness, usually as a lump sum or in daily payments over a defined period. The number of supplementary medical insurance policies in force has gradually increased, from 23.8 million in 2010 to 36.8 million in 2017.
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Private health insurance
Japan has provided universal healthcare to its citizens since 1961, with the government covering 70% of all costs. The remaining 30% is covered by the individual, although young children and low-income older adults benefit from lower coinsurance rates. All residents are required by law to have health insurance coverage, either provided by their employer or purchased privately. Most people in Japan carry supplemental private insurance to help pay for the remaining 30% of medical fees that the universal programme doesn't cover. This private insurance also covers things that aren't included in the public system, such as orthodontics.
The most popular type of private health insurance in Japan is for people with long-term illnesses or foreigners on a temporary stay. However, it is important to note that there are no private hospitals in Japan, and some public hospitals and clinics have been known to deny the use of private health insurance. Additionally, private coverage does not provide a significant advantage in terms of coverage or access to doctors. Therefore, most residents use private health insurance as a supplement to life insurance, providing additional income in case of illness.
For foreigners travelling to Japan, it is recommended to purchase travel insurance before arriving in the country. Medical services in Japan are advanced, but treatment can be expensive. Some credit card companies offer travel insurance coverage, so it is advisable to check with your card provider for details on insurance coverage. Since 2021, foreigners with unpaid medical expenses in Japan may be restricted or refused entry to the country.
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Foreigners and health insurance
Japan has provided universal healthcare to its citizens since 1961, and foreigners can be a part of this system. Foreign nationals staying for more than three months are eligible for health insurance. Within two weeks of moving to Japan, you are required to enrol in a health insurance plan. There are two types of health insurance available to those living in Japan: Employee Health Insurance (EHI) and the country's National Health Insurance (NHI). The type of insurance you enrol in depends on whether or not you work for a Japanese employer and whether or not they offer health insurance benefits. If you are self-employed or work for a small business, you will contribute to the National Health Insurance Program (NHI).
Under the current healthcare system, the government pays for 70% of medical fees, with the remaining 30% covered by supplemental private insurance. Many immigrants opt to purchase International Health Insurance. Private medical insurance can be purchased instantly online. It is also possible to purchase insurance after arriving in Japan. The Japan Tourism Agency operates a dedicated website for safe travel where you can easily purchase travel insurance. Some credit card companies also offer travel insurance coverage.
If you are planning to have children and want them to go to public daycare, it is important to be on health insurance, as this is how they verify your qualification. If you are an expat moving to Japan, it is important to note that the majority of healthcare workers only speak Japanese. However, the AMDA International Medical Information Center website offers advice and translation services, and your insurance provider may also offer emergency translation services.
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Travel insurance
There are a variety of different travel insurance policies available, offering protections from lost baggage to emergency medical evacuation. Some policies cover round-trip flights or transport from your home to the airport, while others won't. It's important to know what your insurance covers and how they will pay you. For example, some providers offer a "cashless service" where they pay out to medical providers directly on your behalf. If your insurance does not offer this, you will need to pay upfront and then sort out reimbursement with your insurer when you return home.
If you have a chronic disease, this will affect your travel insurance coverage. Make sure you know if your insurance covers your planned activities, as some dangerous activities may not be covered. Check if your insurance provides compensation for damages or injuries to third parties. If you become injured or feel ill, it's helpful to know who to call. The number to dial for an ambulance in Japan is 119, but the type of medical institution you need differs depending on the hour of the day, the level of severity, and whether it is an emergency. Not speaking Japanese may complicate things and in some cases, delay you from getting help. While some medical facilities offer services in foreign languages, not all do. The AMDA International Medical Information Center website offers advice and translation services.
There are many places to find various levels of travel insurance for a trip to Japan. Some premium travel credit cards include travel protection perks for cardholders, like trip cancellation, lost baggage protection, and trip delay coverage. This option usually only covers travel expenses purchased using the card and might have coverage limits. Private medical insurance can be purchased instantly online, and some companies allow you to purchase insurance after you've arrived in Japan. Travel insurance for Japan can cost anywhere between ¥170 and ¥1,000 per day, depending on factors like the length of your trip, your age, where you’re from, and what you want to be covered.
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Regional insurance plans
Japan has had universal health coverage since 1961, and foreigners can be a part of the system. The government pays for 70% of medical fees, with the remaining 30% covered by the individual. This payment is funded through two plans, known as SHI and NHI. Social Health Insurance (SHI) is the program that all full-time employees of medium and large-sized companies are automatically enrolled in. Those who are self-employed or work for small businesses contribute to the National Health Insurance Program (NHI). Even if they are eligible for SHI or NHI, many immigrants opt to purchase International Health Insurance.
Each of Japan's 47 prefectures, or regions, has its own residence-based insurance plan. Japan's prefectures implement national regulations, manage residence-based regional insurance, and develop regional healthcare delivery networks with their own budgets and funds allocated by the national government.
The role of private health insurance is supplementary or complementary to the universal coverage. More than 70% of the population holds some form of secondary, voluntary private health insurance. Private insurance provides additional income in case of sickness, usually as a lump sum or in daily payments over a defined period. The provision of privately funded healthcare has been limited to services such as orthodontics.
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Frequently asked questions
Japan has had universal health coverage since 1961, with the government covering 70% of medical fees. The system is funded by taxes and individual contributions. All residents are required to have health insurance, which can be provided by their employer or purchased privately.
There are two main public schemes: Japanese National Health Insurance (NHI), which is available to unemployed people, those working less than 30 hours a week, and students; and Japanese Health Insurance (SHI), which is available to full-time employees. There is also the option of purchasing private health insurance, which most residents use to supplement their public insurance.
If you are a foreigner staying in Japan for three months or more, you must subscribe to the NHI. You can register at the municipal office after completing resident registration. If you are employed full-time, your employer will set up your SHI.
Benefits include hospital, primary, specialty, and mental healthcare, as well as prescription drugs. Young children and low-income older adults have lower coinsurance rates, and there are out-of-pocket maximums based on age and income.
