How to Pay National Health Insurance in Japan
If you are living in Japan and enrolled in National Health Insurance (NHI), it is your responsibility to pay monthly premiums to maintain your insurance.
This article will teach you how to pay national health insurance premiums and provide some points to keep in mind when paying.
Understanding Japan’s health insurance system
National Health Insurance is a public medical insurance system that covers part of the medical treatment expenses for members when they become ill or are injured by accident and need to receive medical treatment.
Related article: 8 Top English-Speaking Hospitals in Tokyo
Employee health insurance (Shakai Hoken) vs. National health insurance (Kokumin Kenkou Hoken)
In Japan, the public health insurance system consists of the following:
Employee health insurance (Shakai Hoken): For full-time employees provided by a company
National health insurance (Kokumin Kenkou Hoken): For self-employed persons, part-time workers, students, and the unemployed
If you do not work full-time, therefore are not covered by the employer, you must enroll in National Health Insurance through your local city office.
Foreigners who are staying in Japan for more than 3 months and holding a residence card (zairyu card) are legally required to enroll in the national health insurance, under Japan’s Health Insurance Act and National Health Insurance Act.
When enrolling at your local city office, you will need your residence card (zairyu card) and address registration. Once you are registered, you will receive a health insurance certificate (NHI card), which you must show when visiting a medical institution.
How National Health Insurance premiums are calculated
National Health Insurance premiums are calculated based on the insured person's income tax return from the previous year, household size, local tax rates in your city or ward, and other factors.
If you are a new resident or student with no income, you might be eligible for a reduction or exemption.
When and how often do you need to pay
Insurance premiums are usually divided into monthly payments in Japan.
The city office sends payment slips with the amount and the due date of the insurance premiums.
What will happen if you fail to pay?
If you fail to pay by the deadline, you will receive a reminder notice letter urging you to pay by the specified date.
If you continue to be late, you will be reminded by phone or in writing to pay your premiums. In some cases, you may even be visited by the local city officer. Additionally, a late fee will be added.
If you are behind on your payments for less than a year and there are no special circumstances, your card will be changed to a "short-term insurance card" with a validity period of six months or so.
If you are behind on your payments for more than a year, your insurance card (NHI card) will be changed to an "eligibility certificate." In this case, after paying 100% of the medical expenses at the medical facility, you can apply to have the amount you are responsible for deducted.
Suppose you are late for more than one year and six months. In that case, your special medical care expenses and high-cost medical care expenses will be suspended in whole or in part, so you will have to pay the full amount of medical fees yourself. You will no longer be able to receive health insurance benefits.
If you continue not to pay, your assets will eventually be seized.
Furthermore, from the age of 40, you will also be required to pay nursing care insurance premiums. There will also be penalties depending on the period of non-payment.
If you are unable to pay your national health insurance premiums or nursing care insurance premiums for unavoidable reasons, you may be able to receive reductions or exemptions, so be sure to consult with your local government office as soon as possible.
How to pay National Health Insurance premiums
There are many ways to pay National Health Insurance premiums.
Bank transfer (automatic payment)
Payment slips
Cashless payments
Credit card
Deduction from pension (special method)
Bank transfer (automatic payment)
If you apply for a bank transfer payment method, the payment amount will be automatically withdrawn from your bank account.
You can apply at your local city office by submitting the bank transfer request form.
When applying, you will need to bring:
Bank book and cash card
Seal used for your bank account
Insurance card (If you don't have one, an eligibility certificate, payment notice, or payment slip)
Depending on the city you live in, you may be able to apply on the website.
Read also: Top English-Friendly Japanese Banks for Foreigners
Payment slips
You can bring the payment slip to the bank, financial institutions, post office, local city office counter, and convenience stores to complete the payment.
Many people think that paying at the convenience store is the easiest way.
How to pay for health insurance at a convenience store
You can pay your national health insurance premiums at convenience stores nationwide.
Simply, take the payment slip with the convenience store barcode printed on it to the convenience store cash register and pay.
When you make a payment, a receipt will be issued along with the invoice, so be sure to receive and keep it.
Note: You cannot pay at a convenience store after the payment deadline has passed. Also, if the payment slip doesn't have the convenience store barcode or the total amount exceeds ¥300,000, then you cannot pay at the convenience store.
Cashless payments
Starting from February 20th, 2023, cashless payments using a smartphone application became possible.
You can pay on the spot by installing a payment app such as dPay, PayPay, or auPay on your smartphone.
Use the application to scan the barcode on the payment slip to complete the payment.
Credit card
It is also possible to pay for the insurance premium using your credit card.
You can use the barcode reading payment service called "Mobile Register."
There is no need to download a dedicated app or register initially. You just need to access the Mobile Register payment website and use your smartphone camera to read the QR code on the payment slip. After that, select payment by credit card and proceed with the payment process to complete the payment.
Deduction from pension (special method)
For some households with members aged 65 to 74, national health insurance premiums will be paid by special collection (deduction from pensions).
You may be able to change to direct debit by application, but you cannot change to payment by payment slip or cashless payment.
Payment when you temporarily leave Japan
If you temporarily leave Japan but maintain your residence status, you are generally still responsible for paying your National Health Insurance (NHI) premiums.
If you remain enrolled in National Healthcare Insurance, you can continue paying from abroad by:
Asking a friend or family member in Japan to pay using your payment slips
Setting up an automatic bank transfer before departure
Contacting your city office to explore online or overseas payment options (not all municipalities offer this)
If you are leaving Japan permanently (such as ending your residence and visa), visit your city office before departure to submit a withdrawal notice and cancel your enrollment. This will stop further premium charges.
What to do if you lose your payment slips
If you lose your payment slip, contact or visit your city office, and they can reissue the slips for the unpaid months.
Remember to bring an identification document such as your residence card or NHI card when making the request.
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FAQ (Frequently Asked Questions)
Here are some frequently asked questions about health insurance payment in Japan.
Q: How can I pay for Japanese national health insurance at a convenience store?
Simply take the payment slip to the convenience store cash register and pay in cash. You can pay your national health insurance premiums at convenience stores nationwide, even on holidays and at night. However, you cannot pay at a convenience store after the payment deadline. Also, if the payment slip doesn't have the convenience store barcode or the payment amount exceeds ¥300,000, then you cannot pay at the convenience store.
Q: How can I pay for Japanese national health insurance?
There are many ways to pay National Health Insurance premiums.
Bank transfer (automatic payment)
Payment slips
Cashless payments
Credit card
Deduction from pension (special method)
Q: What will happen if I don't pay the Japanese national health insurance on time?
You'll receive reminder notices, and late fees will be added. If you're behind for less than one year, your card becomes a "short-term insurance card." After more than one year, you'll receive an "eligibility certificate" and must pay 100% of medical costs upfront. After 1.5 years, you lose special medical benefits entirely.
Q: I lost my Japanese national health insurance payment slip. What should I do?
Contact or visit your city office. They can reissue payment slips for unpaid months. Bring identification such as your residence card or NHI card when making your request.
Q: Can I get a reduction or exemption if I'm having financial difficulties?
You may be able to qualify for reductions or exemptions due to job loss, business closure, illness, natural disasters, or other financial hardships. Apply at your local city office with documentation proving your circumstances.
Q: Do I need to pay for national health insurance if I temporarily leave Japan?
If you maintain your residence status, you're generally still responsible for paying premiums. You can have someone in Japan pay using your slips, set up automatic bank transfers, or contact your city office about online payment options.
In closing
Paying your National Health Insurance premiums on time is not only a legal obligation but also essential for maintaining access to Japan’s healthcare system.
You can choose to pay through convenience stores, bank transfer, credit card, or a smartphone app.
If you're facing financial difficulties or leaving Japan, contact your local city office for guidance. They can help you explore exemptions, reductions, or proper withdrawal procedures.
Also, consider using MailMate for digital mail management and bill payments, so you never miss important notifications or deadlines.
Read also: English-Friendly Insurance for Emergencies in Japan
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