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National Health Insurance Isn't Optional — It's a Duty

In Japan, if you have no other health insurance, you're automatically subject to National Health Insurance — even if you never signed up.

National Health Insurance Isn't Optional — It's a Duty
  • Anyone with an address in Japan who isn't covered by other insurance is subject to this scheme.
  • Register at the National Health Insurance counter of your local city hall within 14 days.
  • Short-term residents are one of the groups excluded from this requirement.

Who must join

"National Health Insurance is something you join only if you want to" — many people believe this, but it's wrong.

The rule works in reverse: anyone with an address in Japan, unless excluded, is already an insured member of this system. Going to city hall is only to complete the paperwork.

Four groups are excluded: people already covered by company health insurance (and their dependents), people receiving livelihood assistance, people under the late-stage elderly healthcare system, and short-term residents.

You complete the procedure at the National Health Insurance counter of your local city hall, within 14 days of becoming eligible — for example, the day you moved in, or the day you left your job and dropped out of company insurance.

Register — and don't delay

I'd like to join National Health Insurance.

There's a real reason not to delay: premiums are calculated retroactively from the date you became eligible — not from the date you show up to register.

A six-month delay means one day you'll suddenly receive a bill covering all six months at once — and during those same six months, any hospital visit would have cost you the full amount out of pocket.

Words in this article

国民健康保険こくみんけんこうほけん
National Health Insurance
被保険者ひほけんしゃ
insured person
加入かにゅう
enrollment, joining
脱退だったい
withdrawal
保険料ほけんりょう
insurance premium
窓口まどぐち
service counter
扶養ふよう
dependency, dependent

How much you'll pay

The premium is based on income and varies by municipality, so there's no single nationwide figure.

Ask directly at your local counter.

This article was checked on September 20, 2026.

Source: 厚生労働省 (20 Sept 2026)