If you are moving to Japan in 2026 as an international graduate student holding a Residence Card, enrolling in the National Health Insurance and National Pension programs is compulsory by law. After finishing resident registration at your local city government office, you can register for health insurance—which reduces out-of-pocket medical costs to 30%—and apply for pension payment deferral through the Special Payment System for Students (*Gakusei Nōfu Tokurei Seido*). Because individual circumstances vary, you should always confirm your specific procedures directly with your local municipal office or university desk.
Who must enroll in Japan's National Health Insurance and National Pension in 2026?
Under Japanese rules, any individual who holds a Residence Card is required to enroll in the National Health Insurance program. In addition, Residence Card holders who are between 20 and 59 years of age are required to enroll in the National Pension System.
Both administrative processes start at your local city government office. Once you complete your resident registration upon arriving in Japan, you must proceed to the respective counters at the city office to handle your insurance enrollment and pension application. Further official details are provided on the Hamamatsu University School of Medicine Healthcare and Insurance guide.
How does National Health Insurance work for international students in Japan?
Enrolling in National Health Insurance requires paying monthly insurance premiums. However, once you are enrolled, you are generally responsible for paying only 30% of your total medical expenses. This 30% out-of-pocket coverage applies to general medical treatments as well as hospitalization or necessary care resulting from severe illness or injury, significantly lowering your personal financial risk.
Insurance premium amounts are calculated based on the municipality where you reside and factors such as your previous income. For individuals with low income, premium reduction programs are available to further lower monthly costs. You can complete your enrollment at the National Health Insurance counter at your city government office right after finishing your resident registration.
In addition to local medical facilities, universities often provide basic healthcare resources. For example, students can visit their campus Health Administration Center, where doctors and public health nurses are available for medical consultations on weekdays from 9:00 AM to 5:00 PM. Untreated symptoms like persistent headaches, insomnia, or loss of appetite can turn into serious conditions, so seeking prompt advice is encouraged.
How can international graduate students defer National Pension payments?
By enrolling in the National Pension System as required for those aged 20 to 59, you gain qualification to receive a Disability Basic Pension if you become disabled due to an illness or injury. Although pension enrollment is obligatory, full monthly contribution payments may place a strain on student budgets.
To address this, Japan offers the Special Payment System for Students (*Gakusei Nōfu Tokurei Seido*). If your income falls below a designated threshold, an approved application under this system allows your National Pension premium payments to be deferred throughout your period of study. To set up this deferral, visit the National Pension counter at your local city government office after finishing resident registration and complete the application paperwork.
Why are annual spring campus health checkups required for graduate students?
Universities in Japan hold a student health checkup every spring, and undergoing this examination every year is mandatory. Maintaining an updated annual health record is essential for monitoring your physical well-being while managing demanding academic schedules.
Beyond basic health monitoring, your participation in the annual spring checkup directly affects your academic and financial support opportunities. Official health certificates required when submitting scholarship applications or applying for on-campus Teaching Assistant (TA) and Research Assistant (RA) positions are issued based on the results of this annual checkup. Missing the yearly screening can prevent you from securing required certificates for these opportunities.
Finding a place to stay
Arranging your initial housing should take place after your Certificate of Eligibility (COE) or student visa is issued, but well before your departure for Japan. Having a confirmed temporary home ready allows you to focus immediately on completing resident registration, National Health Insurance enrollment, and pension deferral procedures at the municipal office upon arrival. Many newcomers stay in a furnished monthly apartment first. OHAYO Stay offers furnished monthly apartments and rooms in Tokyo. No guarantor, no key money and no agency fee; booking is online with a passport or ID and a credit card. Most homes have a minimum stay of 30 nights (shown on each listing).