If you live in Japan but don’t work for a company that provides social insurance, you may need to join Kokumin Kenkō Hoken — the National Health Insurance system. This public insurance helps residents pay for medical treatment and is an important part of living legally and safely in Japan.

What Is Kokumin Kenkō Hoken?

Kokumin Kenkō Hoken is Japan’s National Health Insurance for people who are self-employed, freelancers, students, part-time workers, or retired. It’s managed by your local city or ward office and provides basic health coverage across the country.

If you are not enrolled in Shakai Hoken (social insurance for company employees), you are usually required to register for Kokumin Kenkō Hoken.

Who Needs to Join?

You must join Kokumin Kenkō Hoken if:

1. You are a resident of Japan with a mid- to long-term visa
2. You are not covered by Shakai Hoken
3. You are not a tourist, diplomat, or public welfare recipient
4. You are under 75 years old

Even if you are unemployed or just arrived in Japan, registration is required. Not joining may result in penalties or back payments.

How to Enroll

You can register at the Health Insurance and Pension Division of your local city or ward office. Bring your:

1. Residence card
2. Passport
3. My Number card (if you have one)
4. Proof of moving-in (if just arrived)

After registration, you’ll receive a health insurance card, which you’ll need to show at hospitals or clinics.

How Much Does It Cost?

The premium depends on your household income, assets, and number of dependents. Each city calculates it differently, so your exact amount may vary.

If you’re unemployed or have a low income, you can apply for discounts or reductions. Be sure to ask about this at the time of registration.

What’s Covered?

With Kokumin Kenkō Hoken, you only pay 30% of medical costs for approved treatments. The insurance covers:

1. Doctor visits and hospital care
2. Prescriptions
3. Dental treatment
4. Childbirth-related costs (in some cases)
5. Funeral allowances (in certain cases)

Private treatments or cosmetic procedures are not covered.

Why It Matters

Kokumin Kenkō Hoken protects you from paying full medical costs out of pocket. Medical bills in Japan can be expensive without insurance, so having this coverage gives peace of mind.

Whether you plan to stay short-term or long-term, joining the national insurance is part of living responsibly in Japan.