Introduction
Once you register your address in Japan, the next essential step is to join the public health insurance and pension system. Without them, you may face extremely high medical costs and legal obligations.
At the bottom, you’ll find links to related guides so you can continue building your life step by step.
What is Health Insurance & Pension?
In Japan, there are two main types of health insurance:
- Employer’s Social Insurance (社会保険 / Shakai Hoken)
This is provided through your employer. If you are a full-time company employee, your company handles all enrollment procedures for both health insurance and pension. In this case, you don’t need to do anything yourself—contributions are deducted directly from your salary. - National Health Insurance (国民健康保険 / Kokumin Kenko Hoken)
This is for people who are not covered by Employer’s Social Insurance, such as freelancers, part-time workers, students, or unemployed residents. You must apply for this at your City or Ward Office.
💡 From this point forward, this guide focuses on National Health Insurance (国民健康保険) and National Pension (国民年金), since people with Employer’s Social Insurance don’t need to handle these procedures on their own.
National Health Insurance & National Pension Overview
Japan operates under a universal health insurance and pension system. All residents with a stay of more than 3 months are required by law to enroll.
- National Health Insurance (国民健康保険 / Kokumin Kenko Hoken)
Covers about 70% of your medical costs. Enrollment is mandatory unless you’re already covered by Employer’s Social Insurance. - National Pension (国民年金 / Kokumin Nenkin)
A basic pension system for everyone aged 20–59, including foreigners. Even if you don’t plan to stay long, you may be eligible for a Lump-Sum Withdrawal Payment when leaving Japan.
Where to Go & What It’s Called
Both procedures are handled at your City or Ward Office (市役所 / 区役所), usually at the Health Insurance & Pension Section (国保年金課).
💡 If you just finished your Resident Registration, the staff will often direct you straight to this section—so it’s efficient to complete everything in one visit.
👉 Related: Resident Registration in Japan: A Complete Guide↗
What to Bring (Checklist)
- Residence Card (在留カード)
- Passport
If you have:
- Proof of residence (住民票)
- My Number (マイナンバーカード)
- Bank account info
- Student ID or employment contract
💡 Don’t forget your My Number—it’s increasingly required for both health insurance and pension enrollment.
How to Enroll: Step-by-Step Process
- Take a number ticket at the Health Insurance & Pension Section.
- Say: 「国民健康保険に加入したいです」 / “I’d like to join National Health Insurance.”
- Fill out the form with your name, address, household information, etc.
- Staff checks your Residence Card, Passport, and My Number.
- You’ll receive your Health Insurance Card (保険証) either immediately or by mail within 1–2 weeks.
- Pension enrollment (if age 20+): Staff explains contributions (currently about 17,000 JPY/month). You’ll be asked to set up bank withdrawal or payment slips.
- Students or short-term residents may receive additional explanations, but in principle, enrollment is mandatory.
Costs & Payments
Understanding the cost is essential:
- National Health Insurance (国民健康保険 / Kokumin Kenko Hoken)
The insurance premium depends on your previous year’s income (taxable income) and the municipality you live in. For example:- Annual income around 3,000,000 JPY → Insurance premium is usually around 20,000 JPY/month.
- If you just arrived in Japan and had no income in the previous year, the premium is usually minimal (around 6,000 JPY/month).
※ Premiums vary depending on the municipality.
- National Pension (国民年金 / Kokumin Nenkin)
A flat monthly contribution, currently about 17,000 JPY (2025).
Payments can be made via:- Automatic bank withdrawal
- Payment slips at convenience stores
- Credit card (upon application)
Common Mistakes (to Avoid)
- Double Enrollment → Trying to join National Health Insurance when you already have Employer’s Social Insurance.
- Assuming short stay = no need → If you have a stay of more than 3 months, enrollment is still mandatory.
- Ignoring pension → Unpaid contributions can cause issues later (and you may lose eligibility for Lump-Sum Withdrawal).
After Registration: What will you do?
- Health Insurance Card → Bring it when you visit hospitals and clinics. You’ll only need to pay 30% of medical costs.
- Pension → Keep payment slips safe, or confirm auto-withdrawal setup.
- Leaving Japan? → Apply for Lump-Sum Withdrawal Payment to reclaim some of your pension contributions.
👉 Related: Lump-Sum Withdrawal Payment
FAQ
Q: Do I need to enroll if I only stay one year?
A: Yes. Enrollment is mandatory. However, you may apply for a Lump-Sum Withdrawal Payment when leaving Japan.
Q: Can I skip the pension if I’m a student with no income?
A: No, but you can apply for an exemption or reduction (免除/減免). Ask the pension officer at the city office.
Q: I already have insurance from my employer. Do I still need National Health Insurance?
A: No. If your employer covers you under Employer’s Social Insurance, you should not enroll in National Health Insurance.
Q: How soon will I get my Health Insurance Card?
A: Either on the same day or within 1–2 weeks by mail, depending on your city/ward office.
Conclusion
Joining Japan’s health insurance and pension system is not optional—it’s the foundation for safe and legal living. Do it right after your Resident Registration, and you’ll avoid stress later.
👉 Related: Living and Working in Japan: First Steps
