If you plan to attend a language school or higher education institution in Japan on a stay of three months or more, enrolling in National Health Insurance (NHI) is mandatory. You must complete this registration at your local municipal office right after registering your living address in Japan. Joining NHI reduces your out-of-pocket medical bill to 30% for covered services, protecting your budget while you study in 2026.
Who is required to join Japan's National Health Insurance in 2026?
Foreign nationals residing in Japan with an intended stay duration of three months or more must enroll in the National Health Insurance program, locally known as *Kokuho*. This statutory requirement applies to language school students, university students, exchange participants, and other medium-to-long-term residents. Official information on healthcare regulations can be found at Study in Japan (JASSO). Because individual visa and immigration conditions vary, students should confirm their specific status requirements directly with official administrative sources.
How do international students register for NHI at municipal offices?
To register for health coverage, you must visit the city hall or ward office of the municipality where you reside. The application for health insurance is handled right after completing your resident registration at the same municipal office. Once your registration is processed, you will be issued a health insurance card that you must bring and show at medical counters whenever you seek treatment for an illness or injury.
How are NHI premiums calculated and reduced for students?
Insurance premiums under the NHI program are calculated based on your reported income from the previous calendar year, which includes earnings from part-time jobs in Japan. To ensure that your monthly premium is calculated accurately, you are required to submit an income declaration at your local municipal office.
Students whose prior-year earnings fall below a specific income threshold are eligible for a reduction in their insurance premiums. However, this discount is not awarded automatically; declaring your income is necessary to qualify. Even if you had zero income or earned a very small amount during the preceding year, you must still file an official income declaration to receive the reduced rate.
What medical expenses does National Health Insurance cover?
When you present your valid health insurance card at a medical facility, NHI pays 70% of the covered total medical bill, meaning you pay only 30% out of pocket. Any medical care, procedures, or treatments that fall outside the scope of official national insurance coverage must be paid in full by the patient.
How can students handle high-cost monthly medical bills?
For unexpected health situations that result in unusually high medical costs during a single calendar month, the health insurance system provides additional financial protections:
- Medical Expense Refunds: If your total out-of-pocket expenses exceed your designated individual limit in a single month, you can apply to receive a refund for the excess cost.
- Eligibility Certificates for Hospitalization: If you know in advance that you need to be hospitalized or receive extensive treatment, you can apply for an eligibility certificate (limit certificate). Presenting this document at the hospital allows you to pay only up to your personal ceiling amount upfront.
What additional insurance plans protect international students?
Because NHI is focused solely on medical treatment costs, it does not cover personal liabilities or property damage. To bridge these gaps, educational institutions suggest additional casualty and liability insurance coverage:
- Casualty and Personal Liability Coverage: These plans help pay for damages caused by unexpected accidents not covered by NHI. Examples include accidentally causing a kitchen fire while deep-frying food that requires wall repairs, injuring another person in a bicycle collision and having to pay their medical expenses, or having items such as a laptop computer or camera stolen during a room burglary.
- Gakkensai (Personal Accident Insurance for Students Pursuing Education and Research): Offered through Japan Educational Exchanges and Services, this plan is adopted by most Japanese universities, graduate schools, junior colleges, and technology colleges to cover injuries sustained during lectures, research, or daily commutes. An optional plan named "Inbound Futai-Gakuso" can be added to supplement coverage for international students. Since Gakkensai is not offered at every single institution, students should check directly with their school.
- University CO-OP Kyosai: A university co-op mutual aid insurance system available to students enrolled at participating universities.
Finding a place to stay
Arranging accommodation is a key setup task when preparing to study in Japan. It is best to finalize your housing after your Certificate of Eligibility or visa is issued, but prior to your arrival in Tokyo. Having your address confirmed early ensures you can complete resident registration and health insurance enrollment smoothly right after moving in. Look for housing with flexible lease terms and convenient transit routes to your school. Many newcomers stay in a furnished monthly apartment first while getting settled in Japan. OHAYO Stay offers furnished monthly apartments and rooms in Tokyo, where most homes have a minimum stay of 30 nights (shown on each listing). Booking is completed online with a passport or ID and a credit card, requiring no guarantor, no key money and no agency fee.
FAQ
Is National Health Insurance mandatory for language school students in Japan?
Yes, foreign residents staying in Japan for three months or longer are required to subscribe to National Health Insurance.
What percentage of medical expenses is covered by National Health Insurance?
National Health Insurance covers 70% of eligible medical bills, meaning you pay 30% out of pocket at the counter.
Do students with no income still need to declare their income at the city hall?
Yes, you must declare your income at your municipal office even if you had zero or minimal income to qualify for premium reductions.
Sources
- Study in Japan(JASSO)「Insurance｜Study in Japan Official Website」(checked 2026-10-17)
This article was created by OHAYO Stay based on the sources above (edited, reorganized and translated). It is not an official publication.
Rules and dates can change. Always confirm with the official source before you apply.