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Health insurance and pension in Japan, explained simply
Which health insurance and pension you join in Japan, what paying 30% means, and the lump-sum withdrawal payment when you leave Japan.
Updated: 2026-11-09
Quick answer
- Everyone living in Japan must join public health insurance.
- Residents aged 20 to 59 join the pension system.
- Your type depends on whether your employer enrols you.
Health insurance
| Your situation | What you join | How |
|---|---|---|
| Employer enrols you | 社会保険 / 健康保険 (employee insurance) | Through work |
| Not enrolled at work | 国民健康保険 (National Health Insurance) | At the city office |
What “30%” means
With insurance, you usually pay 30% of medical costs at the hospital. Insurance pays the rest. Example: if the cost is 1,000 yen, you pay 300 yen. (This is only an example of the percentage.)
Bring to the hospital
- Your insurance card or papers
Pension
| Your situation | What you join |
|---|---|
| Employee | Employee pension (厚生年金), through work |
| Others, aged 20 to 59 | National Pension (国民年金), at the city office |
Leaving Japan: lump-sum withdrawal (脱退一時金)
- Foreign residents who leave Japan may be able to claim a lump-sum withdrawal payment (脱退一時金, dattai ichijikin).
- You must make the claim within 2 years after leaving Japan.
Watch out
- Do not forget this deadline. Set a reminder before you leave.
- Report moving out (転出届) at the city office before you leave.
- Who can claim and how much:
Resident tax (住民税)
Your city charges resident tax based on your previous year’s income. That is why it can start in your second year.
Help
Ask your employer’s office, your city office, or a multilingual consultation desk.
This guide is general information. Rules can change and your city may differ; check with your city or ward office and the Immigration Services Agency of Japan.