How much is National Health Insurance in Japan?
Last checked: 2026-11-06
There is no single national price, because each municipality sets its own National Health Insurance premiums, based on your previous year's income and your household. As one example, Kashiwa City in Chiba charged a flat 60,744 yen a year for one adult under 40 with no income in fiscal 2026, before any reductions, plus percentages of income on top.
Who has to join
The Ministry of Health, Labour and Welfare (MHLW) says anyone who lives in Japan, regardless of nationality, must join a public health insurance system. National Health Insurance is mainly for people who are not covered by employees' health insurance or the system for people aged 75 and over. That includes self-employed people, students, unemployed people and foreign residents staying more than three months.
If you came from a country with a social security agreement with Japan, you may not need to join. Ask the National Health Insurance office at your municipality. People who leave employees' health insurance should complete the procedure within 14 days.
How premiums work
MHLW says premiums are based on your previous year's income and household circumstances, and that the amount and the calculation method vary from one municipality to another. So a figure from one city does not apply in another.
With insurance, you usually pay 30% of medical costs at the hospital or clinic, up to a monthly limit. Joining is one step in our moving to Japan checklist. Resident tax also looks back at last year's income.
One real example: Kashiwa City, fiscal 2026
These are Kashiwa's published rates, from a page updated on April 9, 2026. Other municipalities use other rates, and some use a different structure.
| Portion | Income rate | Per person | Per household | Yearly cap |
|---|---|---|---|---|
| Medical | 7.20% | 30,000 yen | 14,340 yen | 670,000 yen |
| Late-elderly support | 2.68% | 14,520 yen | None | 260,000 yen |
| Long-term care (ages 40 to 64) | 2.17% | 16,260 yen | None | 170,000 yen |
| Child support | 0.27% | 1,800 yen, plus 84 yen per member aged 18 or over | None | 30,000 yen |
The income rate applies to your total income for calendar 2025 minus a basic deduction, which is 430,000 yen for most people. Total income is not the same as gross salary. The household head pays for all members. Members under 18 do not pay the child per-person charge.
Two worked examples for Kashiwa
This is our own arithmetic for one adult under 40 living alone, using the table above. Low-income reductions are not included, and the city's rounding may differ. Your bill from the city is the real figure.
| Total income in 2025 | Income-based part | Flat part | Yearly total |
|---|---|---|---|
| 0 yen | 0 yen | 60,744 yen | 60,744 yen |
| 3,000,000 yen | 260,855 yen | 60,744 yen | About 322,000 yen |
If you cannot pay
MHLW says you may be able to get a reduction or pay in installments, so talk to your municipal office as soon as you can. If you do not pay for a long time, your property may be seized and your benefits may be limited. Your payment status is also considered when you renew your period of stay or change your status of residence. The pension has its own system, explained in our National Pension exemption guide.
What we could not confirm
- Your first year in Japan. We did not find an official page that says how income earned abroad is treated. Non-official sites make claims about this, so we leave them out. Ask your municipal office.
- The enrollment deadline for new arrivals. The MHLW leaflet gives 14 days for people leaving employees' insurance. It does not state a deadline for people who have just arrived.
- Reduction amounts. Kashiwa has a separate page for reductions, which we did not check.
- Tokyo wards. We did not verify any ward's fiscal 2026 rates.
This page is general information, not advice. Your municipal National Health Insurance office can calculate your own premium.