Health Insurance and Pension in Japan for Foreign Residents (2026)

1

Current coverage

Ask which health insurance and pension apply.

2

A change

Check the dates when employment changes.

3

Your records

Keep enrollment and payment evidence.

A visual summary of this guide. Read the relevant sections below for conditions and exceptions.

Short answer: Public health insurance and pension coverage depend on age, residence and employment. National Pension participation generally covers residents aged 20 through 59; children are not required to pay adult Nat

Short answer: Public health insurance and pension coverage depend on age, residence and employment. National Pension participation generally covers residents aged 20 through 59; children are not required to pay adult National Pension contributions. If you work for an employer that enrolls you, you are in employee insurance (健康保険 and 厚生年金) and the employer handles it. If you are not covered as an employee or eligible dependent and meet the respective rules, you join National Health Insurance (国民健康保険, 国保) and the National Pension (国民年金) at your city or ward office. The National Pension premium in FY2026 (April 2026 to March 2027) is 17,920 yen per month.

General information, not legal or tax advice. Rules and eligibility depend on your residence status and your employer.

Employee insurance rates. The Employees' Pension total rate is 18.3% of pay (fixed since September 2017), shared equally with your employer, so your share is about 9.15%. The health insurance rate depends on your insurer

Employee insurance rates. The Employees' Pension total rate is 18.3% of pay (fixed since September 2017), shared equally with your employer, so your share is about 9.15%. The health insurance rate depends on your insurer and prefecture, and your employer pays half (Kyokai Kenpo, Tokyo, FY2026: 9.85% in total). Since April 2026 a child-rearing support contribution (0.23% in total, half paid by you) is added to health insurance premiums. (See our pay slip guide.)

Your insurance card. Paper and plastic health insurance cards are no longer issued, and old cards could be used only until 1 December 2025. Now you show your My Number card (set up as a health insurance card) at the hospital, or a qualification confirmation certificate (資格確認書) issued by your insurer. Ask your employer or ward office which one you will get.

Rules below are from a Tokyo ward office's guidance for foreign residents.

Rules below are from a Tokyo ward office's guidance for foreign residents.

Who must join

• Foreign residents recorded as residents, generally with a stay exceeding three months, must join if not covered by another qualifying system. Some designated-activities categories are excluded; some shorter permitted stays can qualify with evidence of an expected longer stay.

Who cannot join

• Stay of 3 months or less; expired residence status; status "Diplomat" or "Temporary Visitor".

• People covered by employee health insurance, including eligible dependents. If your employer should enroll you but has not, consult the employer and insurer rather than assuming National Health Insurance resolves the omission.

• People on public assistance; people aged 75 or over (they join a separate system).

Deadline

• Apply within 14 days after moving in or after losing employee health insurance (normally the day after leaving).

• If you miss the deadline, you may have to pay the premiums back to the start date ("遡って").

How much? Premiums are set by each municipality, so there is no single national amount. Ask your ward or city office for a calculation based on your income.

• FY2026 premium: 17,920 yen per month, set each fiscal year by the Japan Pension Service.

• FY2026 premium: 17,920 yen per month, set each fiscal year by the Japan Pension Service.

• If you cannot afford the premium, ask the Japan Pension Service or your municipal office about exemption and deferral programs. These require an application and an income assessment. Students use the student payment special system rather than ordinary non-student deferral. An approved student deferral counts toward eligibility but does not increase the old-age pension amount unless later paid.

• If you leave Japan after paying into the pension, you may be able to claim a lump-sum withdrawal payment. See our guide on the pension lump-sum withdrawal.

1. Employee insurance qualification generally ends the day after you leave.

1. Employee insurance qualification generally ends the day after you leave.

2. If your next job starts right away and the employer enrolls you, you are covered again through the employer.

3. If there is a gap, compare National Health Insurance, eligible dependent coverage and voluntary continuation of previous health insurance. Voluntary continuation generally requires two months of prior coverage and application within 20 days of losing eligibility. For National Pension, people aged 20–59 must also check whether they become Category I or qualify as a dependent spouse (Category III).

4. Residents with certain statuses must also notify Immigration of a job change within 14 days (see our guide on changing jobs).

Whether a part-time worker is enrolled in employee insurance depends on working hours, employer size and student status. According to the Ministry of Health, Labour and Welfare (MHLW):

Whether a part-time worker is enrolled in employee insurance depends on working hours, employer size and student status. According to the Ministry of Health, Labour and Welfare (MHLW):

The usual employee-insurance route also covers people meeting the three-quarter working-hours and working-days test, regardless of the 51-person short-hours threshold. Employment duration and applicable workplace conditions also matter.

Employment insurance has its own condition (20 hours a week and a job expected to last 31 days or more). A future expansion to 10 hours is outside this enrollment checklist; use the current rule for today’s application. Ask your employer, and if you are not enrolled, consider 国保 and 国民年金 yourself.

Keep notices, receipts and exemption decisions. If a bill looks wrong, ask the insurer before its due date; do not ignore it. This article does not determine permanent-residence eligibility.

Keep notices, receipts and exemption decisions. If a bill looks wrong, ask the insurer before its due date; do not ignore it. This article does not determine permanent-residence eligibility.

Do I need to pay if I'm a student? Health coverage is required if you meet its conditions. National Pension normally applies from age 20 to 59. Eligible students can apply for the student payment special system; it is no

Do I need to pay if I'm a student? Health coverage is required if you meet its conditions. National Pension normally applies from age 20 to 59. Eligible students can apply for the student payment special system; it is not automatic.

Can I choose not to join? Not if you meet the conditions above. The relevant age, residence, dependent and employee-coverage conditions determine which system applies.

Where do I apply? The insurance and pension counter at your city or ward office. Ask in advance which documents to bring ; normally identity/residence documents and proof of loss of previous coverage are useful, but the exact list is municipal.

• Japan Pension Service, FY2026 National Pension premium (17,920 yen/month): Source: www.nenkin.go.jp

• Japan Pension Service, FY2026 National Pension premium (17,920 yen/month): Source: www.nenkin.go.jp

• Meguro City, National Health Insurance for foreign residents (Japanese): Source: www.city.meguro.tokyo.jp

• Kyokai Kenpo, FY2026 premium rates (Tokyo 9.85%; child-rearing support 0.23%): Source: www.kyoukaikenpo.or.jp

• MHLW, expansion of social insurance coverage for part-time workers (PDF): Source: www.mhlw.go.jp

• Setagaya City, end of paper health insurance cards, My Number insurance card and qualification confirmation certificate (Japanese): Source: www.city.setagaya.lg.jp

• Japan Pension Service pension calculation: Source: www.nenkin.go.jp

• Japan Pension Service October 2026 change: Source: www.nenkin.go.jp

• Japan Pension Service student system: Source: www.nenkin.go.jp

• Kyokai Kenpo voluntary continuation: Source: www.kyoukaikenpo.or.jp

• Official reference: Source: www.nenkin.go.jp

• Official reference: Source: www.nenkin.go.jp