Japan’s social insurance system is comprehensive and applies to foreign residents. Understanding how it works — what you’re paying, what you get in return, and what your options are — is essential for managing your finances and protecting your wellbeing in Japan.

The Two Systems: Shakai Hoken vs. Kokumin Hoken

There are two main social insurance tracks in Japan:

1. Employees’ Social Insurance (Shakai Hoken)

If you work full-time for a company, you are automatically enrolled in the employees’ social insurance system, which includes:

  • Kenko Hoken (employees’ health insurance)
  • Kosei Nenkin (employees’ pension)
  • Koyo Hoken (employment insurance / unemployment)

Premiums are split roughly 50/50 between you and your employer. This is generally more financially favorable than the self-employed equivalent.

2. National Insurance (Kokumin Hoken / Kokumin Nenkin)

If you are self-employed, unemployed, or work part-time below the enrollment threshold, you must enroll in:

  • Kokumin Kenko Hoken (national health insurance)
  • Kokumin Nenkin (national pension)

These are administered by your local municipal government (ward office). Premiums for kokumin kenko hoken are based on your previous year’s income, so they can be higher than the employees’ equivalent in some cases.

Health Insurance in Japan

All foreign residents in Japan for more than 3 months must enroll in one of the above health insurance systems.

What health insurance covers:

  • Doctor visits (you pay 30% of costs; insurance covers 70%)
  • Hospital stays and surgery
  • Prescription medications
  • Childbirth (maternity benefits under shakai hoken)
  • Emergency care

High-Cost Medical Care System (Kōgaku Ryōyō Hiyo) If your monthly medical costs exceed a certain threshold (based on income), you can apply for reimbursement. This effectively caps your out-of-pocket medical expenses — an important protection for serious illness or surgery.

Private Insurance as a Supplement

Japan’s public health insurance is robust, but there are gaps — particularly for serious illness requiring long hospital stays, dental care, vision correction, and mental health services. Many foreigners in Japan choose to add private supplemental insurance.

For straightforward guidance on what supplemental insurance actually makes sense for your situation in Japan, みんなの生命保険アドバイザーは全国相談無料！ offers free nationwide consultations with independent advisors who can explain options in plain language. Similarly, 顧客満足度95％の保険相談なら保険マンモス connects residents with advisors specializing in coverage for people living in Japan.

Pension (Nenkin)

Employees’ Pension (Kosei Nenkin)

Deducted from your salary automatically. Both you and your employer contribute approximately 9.15% each of your monthly salary.

National Pension (Kokumin Nenkin)

For those not enrolled in shakai hoken, the flat monthly premium is ¥16,980 (2025 figure). Payment is required for all residents aged 20–59.

The Lump-Sum Withdrawal for Foreigners

If you leave Japan without qualifying for a pension (typically you need at least 10 years of total contributions to receive payouts), you can claim a lump-sum withdrawal payment (dattai ichijikin). You can claim this up to 2 years after leaving Japan for contributions up to 60 months (5 years). This is money that was deducted from your salary — claim it when you go.

Note: Once you claim the withdrawal, those contribution months are erased from your record. If you plan to return to Japan long-term, consult a pension specialist before claiming.

Employment Insurance (Koyo Hoken)

Employment insurance (unemployment insurance) is available to full-time and certain part-time employees. If you lose your job (through no fault of your own — i.e., layoff or company closure), you can receive Kihon Teate (basic unemployment allowance):

  • Approximately 50–80% of your previous daily wage
  • Duration: 90–150 days (longer with more employment history)

To claim, you must:

  1. Register as job-seeking at Hello Work (public employment office)
  2. Wait a 7-day waiting period (and potentially a further 2–3 month penalty period if you resigned voluntarily)
  3. Actively search for work and report your job-seeking activities

Foreigners are fully entitled to these benefits as long as they were enrolled and contributed.

Nursing Care Insurance (Kaigo Hoken)

Foreign residents aged 40 and above automatically contribute to nursing care insurance (kaigo hoken). This provides access to public long-term care services if needed.

Premium Reduction and Exemption

If your income is low, you can apply for:

  • Kokumin Nenkin exemption (full, 3/4, half, or 1/4 exemption based on income)
  • Kokumin Kenko Hoken premium reduction (applied automatically in some municipalities)

Apply at the ward office. Exemption periods still count as contribution periods for some pension calculations.