Health insurance while in Japan on a working holiday visa

Is it necessary to take out health insurance for just a year’s stay in Japan?

While in other countries it is generally up to the individual to decide whether to take out medical insurance, in Japan all citizens (regardless of nationality) are required to take out some form of medical insurance. In other words, foreigners who stay in Japan for a long period of time including working holiday visa, other than for short-term stays such as tourism, must have medical insurance.

What kind of health insurance is available in Japan?

There are generally two types of medical insurance in Japan. These are the basic health insurance (Shakai Hoken) for company employees working in Japan and the National Health Insurance (Kokumin Kenko Hoken) for foreign students and foreigners coming to Japan on a working holiday.

Social insurance schemes in Japan, including health insurance

Social insurance consists of five components: health insurance, employees’ pension insurance, long-term care insurance, workers’ accident compensation insurance and employment insurance.

In Japan, any employee who meets certain conditions (e.g. 20 hours of work per week) is obliged to join the social insurance system.

How much are the social insurance costs?

The amount of social insurance premiums depends on the area where the member lives, his/her income and which health association he/she belongs to. Therefore, the premiums paid by those working in Tokyo will differ from those working in Osaka.

And the payment of social insurance premiums is not a payment procedure on the part of the employee, as the company usually deducts the monthly social insurance premiums and pays the salary to the employee.

In the case of the Kyokai Kenpo, which employees and family members working for small and medium-sized enterprises are enrolled in, the monthly health insurance premium rate in Tokyo from April 2020 will be 9.87% of the monthly salary as a monthly health insurance premium.

However, instead of the full amount being paid by the individual, the company and the individual will pay half each. Therefore, half of the 9.87% on the monthly salary will be deducted from the salary as health insurance premiums.

In addition to these health insurance premiums, social insurance also includes employee pension insurance premiums, which are generally deducted from the monthly salary.

What is national health insurance (Kokumin Kenko Hoken)?

It is a health insurance policy operated by the local government and is a medical insurance policy for people who are listed in the Basic Resident Registers and who are not covered by company health insurance. You are obliged to join if your stay in Japan is for more than three months, except for tourism purposes. For example, foreign students studying in Japan for academic purposes and foreigners coming to Japan on a working holiday must join the National Health Insurance.
There are links to explanations about National Health Insurance in English, Spanish, Chinese and other multilingual languages, so if you want to know more about National Health Insurance, check the information on health insurance on the website of the local (municipal) authorities in your area. This is the website of the City of Osaka.
https://www.city.osaka.lg.jp/contents/wdu020/fukushi/english/kokuho/index.html

How much are the premiums for national health insurance?

Insurance premiums vary greatly depending on the municipality you live in, your income and other factors. The following website provides a simulation of the approximate National Health Insurance premiums. (However, insurance premiums vary from municipality to municipality, so please use this as a guide only.
https://www.mmea.biz/simulation/kokuho_calculation/

Procedures for joining the National Health Insurance scheme

When joining National Health Insurance, you must complete the procedures within 14 days from the date of entry into Japan, the date you move house, or the date you lose your entitlement to be a member of Social Insurance health insurance (e.g. the date you resign from your job).

Note that in Japan it is compulsory to join health insurance, so if there is a delay in the procedure, you will be charged for the delay at a later date. In the unlikely event that you go to a hospital or other healthcare facility during a period when you do not have insurance, you will be responsible for 100% of the consultation fees.

For working holiday visas, a residence card and passport are required during the application process.
Procedures vary from municipality to municipality, so please refer to the website of each municipality for details.
This is the case of Osaka City.

https://www.city.osaka.lg.jp/contents/wdu020/fukushi/english/kokuho/35_kokuminkenkohoken_todokede.html

In large cities such as Osaka and Tokyo, each ward has its own local municipality. You should apply for health insurance at the municipality (city, ward, town or village) where you live.

市 (SHI) : City
区 (KU) : Ward
町 (CHO) : Town
村 (MURA) : Village