Confused by the Japanese healthcare system? We explain the difference between National Health Insurance (NHI) and Employees' Health Insurance (Shakai Hoken).

Japan has a universal healthcare system, and enrollment is mandatory for all residents, including foreigners. But which system do you join?

1. Shakai Hoken (Employees' Health Insurance)

• Who joins: Full-time employees (and some part-timers) at companies.
• Cost: Approx. 5% of your salary (your employer pays the other 5%). Deducted automatically.
• Benefits:
  • Covers 70% of medical costs.
  • Includes Pension (Kosei Nenkin).
  • Covers dependents (spouse/kids) for FREE.

2. Kokumin Kenko Hoken (National Health Insurance - NHI)

• Who joins: Students, freelancers, unemployed, and part-timers not covered by Shakai Hoken.
• Cost: Based on your previous year's income. You receive payment slips in the mail.
• Benefits:
  • Covers 70% of medical costs.
  • Does NOT cover dependents for free (you pay per person).

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How to Use It

1. Show your card: Present your "Hokensho" at the reception of any clinic or hospital.
2. Pay 30%: You pay 30% of the bill in cash.
3. High-Cost Cap: If your surgery costs 1,000,000 JPY, the "High-Cost Medical Expense Benefit" caps your monthly payment (usually around 80,000 JPY based on income).

Warning

If you don't pay your premiums, they can seize your bank account. Also, you cannot renew your visa if you have unpaid taxes or insurance.