For employees
Kousei Nenkin (Employees' Pension)
18.3% of salary
You: halfEmployer: half
Employees' Pension. Includes Kokumin Nenkin automatically.
住Chapter 03 · Get set up
Insurance & Pension
Health insurance and pension are mandatory for all residents in Japan
Mandatory for all residents staying 3+ months. Non-enrollment can result in back-payments and visa complications.
Your health insurance card is now your My Number Card (Myna Hokensho)
Japan stopped issuing the old health insurance card in December 2024, and the last ones expired by December 2025. Register your My Number Card as your insurance card and show it at the clinic. No card yet? Your insurer automatically sends a Certificate of Eligibility (shikaku kakuninsho) so you can still be treated. Read the full My Number Card guide →
Start here · up to 4 questions
Shakai Hoken or NHI — which one am I on?
Pinned by your employment shape — answer up to 4 questions.
How do you make a living in Japan?
Which System Applies to You?
社保Shakai Hoken (Employees' Insurance)Employee Health Insurance + Pension
vs
国保Kokumin Kenko Hoken (National Health Insurance)National Health Insurance
Company employees (full-time or part-time 20h+/week)
Who
Self-employed, freelancers, students, unemployed, WHM
~10%of salary, split 50/50 with your employer
Cost
¥20,000 – ¥80,000per month, based on last year's income (often low in year 1)
Your employer handles everything
How to join
City Hall within 14 days of residence registration
Health insurance + pension (Kousei Nenkin) bundled together
Pension
Health insurance only — pension (Kokumin Nenkin) enrolled separately
Health Insurance Card from employer
Card
NHI Card from City Hall
What Does Insurance Cover?
Who pays a medical bill
70%30%
Covered by insuranceYou pay
Monthly cap on what you pay
¥36,900 – ¥270,300depending on income, raised on August 1, 2026Covered
Doctor visitsHospitalSurgeryPrescriptionsBasic dentalMental healthMaternity · ¥500,000 birth lump sum
Not covered
Cosmetic proceduresOrthodonticsPrivate hospital roomsUnapproved treatments
High-Cost Medical Expense Benefit (高額療養費)
New ceilings in force since 1 August 2026
Whatever your treatment costs, what you actually pay in a month is capped. Your insurer refunds anything above the ceiling — and since 1 August 2026 the monthly ceilings are higher and there is also a yearly ceiling. Figures below are for people under 70.
Annual income
You pay at most, per month
¥85,800Until July 2026¥80,100+¥5,700 since August 1, 2026
+ 1% of the cost above ¥286,000
Yearly ceiling¥530,000New: anything above it is refunded
From the 4th month¥44,400多数回該当: 4th high-cost month within 12 months
The yearly ceiling is new. Your monthly out-of-pocket amounts add up over the year; once the total reaches the yearly ceiling for your bracket, your insurer refunds everything above it.
A second step lands on 1 August 2027: the income brackets are split much more finely, and households under about ¥2M get a 25% cut on the repeat-month ceiling.
Money for families with children
What your child brings in, age by age. Apply at your city office once your residence is registered.
Childbirth lump sum出産育児一時金 · per baby
~¥500,000at birth
Child Allowance児童手当 · no income limit · paid 6×/year
¥15,000/moAge 0–2
¥10,000/moAge 3 – end of high school
Free preschool幼保無償化 · nationwide
Free
Child Medical Subsidy子ども医療費助成 · Tokyo 23 wards
Outpatient + inpatient, to age 18Often little or nothing to pay
Tokyo 018 Support018サポート · Tokyo residents
¥5,000/moPer child living in Tokyo
High-school tuition就学支援金
Tuition support
3rd child onward¥30,000/moSingle-parent allowance · Means-testedup to ¥48,050/moMedical subsidy varies by city: confirm locally
Pension (Nenkin)
MandatoryPension enrollment is mandatory for all residents aged 20–59, separate from health insurance.
For everyone else
Kokumin Nenkin (National Pension)
¥17,920/month
Fixed amount, whatever your income
National Pension. Students can apply for an exemption.
Leaving Japan for good
Lump-Sum Withdrawal (Dattai Ichijikin)
5 yrsof contributions refunded, at most
2 yrsto apply after you leave
Dattai Ichijikin: a partial refund of your pension contributions when you leave Japan permanently.
If You Need Medical Care
Bring your Health Insurance Card (or My Number Card) to any clinic or hospital
You pay 30% at the counter — insurance covers the rest
For emergencies, call 119 (ambulance is free)
If monthly costs exceed the cap, apply for High-Cost Medical Expense refund at your insurer
The Vault · ¥1,480/mo
Store your insurance cards and find them in seconds.
The Vault reads, files and protects your documents — and helps with the next form.
Discover the Vault