If you plan to stay in Japan for three months or more as an international student, you are required to enroll in the National Health Insurance (NHI) program, also known as Kokuho. Once registered, the system covers 70% of eligible medical bills, leaving you to pay only 30% out of pocket whenever you present your insurance card at a clinic or hospital. You can complete your insurance signup at your local municipal office right after finishing your resident registration.
Who must join National Health Insurance in Japan?
According to official guidelines from Study in Japan, any foreign resident residing in Japan for three months or longer must subscribe to the National Health Insurance system. This legal requirement applies to international students attending Japanese universities, graduate schools, junior colleges, or colleges of technology. Joining Kokuho provides access to Japan's national healthcare network and prevents individuals from bearing full medical costs during unexpected illnesses or injuries while studying abroad. For individual visa eligibility or status questions, readers should confirm details directly with official government sources.
How do you register for health insurance at the local city hall?
To enroll in National Health Insurance, you must visit the local municipal office or city hall that governs your area of residence in Japan. The registration procedure requires you to complete your resident registration first. Once your resident registration is finalized at the city office, you can complete your application for the National Health Insurance program at the designated counter. Completing this step promptly ensures that your health coverage takes effect smoothly and that your official insurance card can be processed without delay.
How are health insurance premiums calculated and reduced?
Your National Health Insurance premium is calculated based on your total income from the previous year, which includes earnings from any part-time employment in Japan. Because local authorities determine your annual payments using your financial background, it is essential to formally declare your income at your municipal office every year.
Even if you had little or no income during the preceding year, you are still required to submit an income declaration. Declaring your income allows the city office to evaluate whether you meet the specific income threshold for a premium reduction. If your reported income falls below this established threshold, your health insurance premium can be reduced accordingly. However, if you fail to declare your financial status, municipal staff cannot perform the correct calculations, and you will not qualify for the discount.
What medical costs does National Health Insurance cover?
When receiving medical care for an injury or illness at a clinic or hospital, you must present your physical National Health Insurance card at the reception counter. Under this coverage, 70% of the total medical cost is paid by the National Health Insurance program, meaning you only need to pay the remaining 30% of the medical bill out of pocket.
It is important to remember that medical treatments, procedures, or services that fall outside the standard scope of National Health Insurance coverage are not discounted. For any medical expense not covered by the national insurance framework, patients must pay the full 100% amount out of pocket.
What happens if you face high medical bills or hospitalization?
To protect residents from excessive financial burdens due to severe illness or major treatment, the National Health Insurance program includes a high-cost medical expense system. If your combined medical payments within a single calendar month exceed your personal maximum limit, the program provides a refund for the excess amount.
Additionally, if you are scheduled for hospitalization or anticipate major medical care, you can apply for an eligibility certificate in advance through your municipal office. Presenting this eligibility certificate at the hospital enables you to pay only up to your personal ceiling amount at the time of billing, preventing you from having to pay huge upfront sums before receiving a reimbursement later.
What private and student insurance options supplement National Health Insurance?
While National Health Insurance covers standard medical treatment, it does not cover accidental damages, property loss, or personal liability expenses. International students can enroll in supplemental casualty and personal liability insurance plans to cover unexpected accidents that fall outside Kokuho.
For example, additional insurance plans cover scenarios such as:
- Accidental kitchen fires, such as deep-frying oil catching fire and burning wall surfaces that require renovation.
- Bicycle accidents where you collide with and injure a pedestrian, making you liable for their medical bills.
- Room burglaries while you are away, resulting in stolen items such as personal computers or digital cameras.
Your school will normally provide details regarding suitable supplemental coverage options.
What is Gakkensai and Inbound Futai-Gakuso?
The majority of Japanese educational institutions—including universities, graduate schools, junior colleges, and technical colleges—adopt the Personal Accident Insurance for Students Pursuing Education and Research, commonly known as Gakkensai. Offered by the Japan Educational Exchanges and Services (JEES) public interest foundation, Gakkensai covers injuries occurring during lectures, laboratory work, official school events, and daily commutes between home and campus.
To complement Gakkensai, international students can also enroll in Inbound Futai-Gakuso, another plan provided by JEES that offers expanded coverage tailored for foreign students. Because availability varies, students should confirm with their specific institution whether these insurance programs are offered.
How does University CO-OP Kyosai protect students?
Another widespread option is University CO-OP's Kyosai, a mutual aid insurance system available to students while enrolled at a university in Japan. Joining this co-op system provides extra support against daily risks and financial difficulties throughout your academic journey.
Finding a place to stay
When preparing to study in Japan, organizing your housing is an important step that usually takes place after your Certificate of Eligibility or student visa is issued and before your arrival in the country. Securing an initial residence early allows you to complete your municipal address registration and National Health Insurance sign-up smoothly during your first days. Many newcomers stay in a furnished monthly apartment first to settle into their new surroundings without stress. OHAYO Stay offers furnished monthly apartments and rooms in Tokyo, giving arriving students a comfortable home base. Most homes have a minimum stay of 30 nights (shown on each listing). The monthly price includes electricity, gas, water and Wi-Fi, which simplifies budgeting. You can browse online and prepare your housing arrangements well before landing in Tokyo.
FAQ
Who is required to register for National Health Insurance in Japan?
Foreign residents staying in Japan for three months or longer must subscribe to the National Health Insurance program at their municipal office after completing resident registration.
How much of my medical expenses will National Health Insurance cover?
The program covers 70% of eligible medical costs, leaving you responsible for paying the remaining 30% of the bill when you present your insurance card.
What should I do if I need to be hospitalized in Japan?
You can apply for an eligibility certificate in advance from your local municipal office to cap your upfront hospital payments at your individual monthly limit.
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.