← Back to home

中文 English 日本語

National Health Insurance, Pension & Lump-Sum Withdrawal in Japan

Living in Japan long-term without employer-provided health and pension insurance? You must enrol in two systems yourself: National Health Insurance (Kokumin Kenko Hoken) for medical coverage, and National Pension (Kokumin Nenkin) for retirement. When you leave Japan permanently, you can claim part of what you paid in — the Lump-sum Withdrawal Payment (Dattai Ichijikin). This guide covers all three.

📅 Page verified: September 2026

📋 At a glance

System	Who	Covers	If you skip it
National Health Insurance (NHI)	Residents not on employer insurance	Medical costs	Full price at the clinic, plus a fine
National Pension	Residents aged 20–59	Basic retirement pension	No pension later, plus back-collected premiums
Lump-sum Withdrawal	Foreigners leaving Japan	Refund of National Pension paid	Auto-forfeit if you don't claim

* All three are tied to residence status + jūminhyō (resident registration), not nationality. As a mid/long-term resident, you are generally required to enrol.

🏥 National Health Insurance (Kokumin Kenko Hoken): 70% covered

Who must enrol?

• Anyone with a jūminhyō (residence registration) excluding short-stay visas
• Not on employer health insurance — e.g. between jobs, self-employed, students whose part-time work doesn't qualify for shakai hoken, retirees
• Under 75 years old (75+ goes to the separate Late-Stage Elderly system)

International students with a 資格外活動 (part-time work) permit but no employer insurance are usually required to enrol. Follow your school's guidance.

Where and what to bring?

• Counter: National Health Insurance desk (国民健康保険課) at your local city/ward office (区役所/市役所)
• Documents (typical):
  • Residence Card (在留カード)
  • Passport
  • Hanko / personal seal (often useful, not always required)
  • Resignation letter (退职证明) if you recently left a job
  • My Number card or notification card (optional but speeds things up)
• What you get: a paper 保険証 (insurance card) — bring this to every clinic visit

How the premium is calculated

Premiums are set by each municipality — no national standard. The formula is roughly:

• Income-based (所得割) — on last year's income (often ¥0 for students)
• Per-head (均等割) — a flat amount per insured person
• Per-household (平等割) — in some cities

Rough numbers for students: income ¥0–1.5M, annual premium about ¥15,000–¥40,000 (~¥1,000–¥3,500/month). Always check your municipal notice for the exact amount.

How it works at the clinic

• Show your 保険証 at any "insurance-covered" clinic/hospital (almost all are). You pay only 30% of the bill (different rates apply under 6 and 70–74).
• High-cost medical care benefit (高額療養費): if a month's bill exceeds a ceiling (varies by income), the excess is refunded after you pay. Don't skip treatment thinking it's too expensive.
• Birth allowance: ~¥500,000 one-off for childbirth (figure changes — verify current policy)
• Funeral benefit (葬祭費): paid to the family of a deceased insured person

📑 National Pension (Kokumin Nenkin): monthly premiums, monthly pension later

Who must enrol?

• Residents aged 20–59 with a jūminhyō
• Not already covered by Kōsei Nenkin (employee pension) at work — full-time employees are auto-enrolled

Three insured categories

Category	Who	How you pay
Category 1	Self-employed, students, job-seekers	Pay directly to the city/ward office
Category 2	Employees covered by Kōsei Nenkin	Auto-deducted from salary
Category 3	Spouse of a Category 2 (income ≤ ~¥1.3M)	Paid by the spouse's Kōsei Nenkin

How much is the premium?

National Pension is a flat rate, the same nationwide. It is revised each April — check the latest announcement. Recent levels:

• FY 2024: ¥16,980 / month
• FY 2025: ¥17,510 / month
• FY 2026: TBA (typically +¥500 each year)

Student special payment (学生納付特例): students with low income can apply to skip premium payments while still keeping pension credits. Must reapply every year — no retroactive fix if you forget.

Premium exemption (保険料免除): anyone with low income can apply for full or partial exemption (4 tiers: full / 3/4 / half / 1/4). Exempted periods still count toward your pension record.

What if you don't pay?

• Forced collection: Japan Pension Service sends reminders, then after ~2 years hands it to compulsory collection. Can affect visa renewal and lead to asset seizure.
• Lower or no pension later: unpaid months don't count toward your record.
• 10-year retroactive payment window: you can pay up to 10 years back, with caps and interest.

✈️ Lump-sum Withdrawal Payment (Dattai Ichijikin): get part of it back when you leave

Eligibility (all conditions)

1. Enrolled in National Pension (or Kōsei Nenkin) as a foreign national (not Japanese)
2. Paid ≥ 6 months of premiums (less = not eligible)
3. No longer have Japanese residence (you've left the country)
4. Never received Japanese old-age or disability pension
5. Apply within 2 years of losing residence

How much do you get?

It's a flat amount per paid month, not a return of actual premiums. The "lump-sum withdrawal rate" is published each year and varies by the number of months paid. Rough numbers:

• 6–11 months paid: about ¥30,000–¥60,000
• 5 years (max 60 months): about ¥500,000 maximum (subject to annual revisions)

* Exact amounts are revised annually. Always check the current year's official figures.

How to apply

1. Download the form: from the Japan Pension Service website — 「脱退一時金 請求書」
2. Fill in and attach:
   • Passport copy (photo page + entry/exit stamp pages)
   • jūminhyō removal certificate or proof of departure
   • Your basic pension number notification or payment slips
   • Bank account info (overseas accounts are fine in most countries)
3. Mail to Japan: send to the Pension Service processing centre (address on the form)
4. Wait: about 2–6 months after approval

📋 Sequence across a typical stay

1. Arrive + register: file 転入届 at the ward office → get your jūminhyō
2. Same trip: enrol in NHI (within 14 days)
3. Same trip: enrol in National Pension (if you're not Category 2/3)
4. Start a job: employer handles Kōsei Nenkin + health insurance → you switch to Category 2
5. Quit / lose eligibility: within 5 days, switch back to NHI + National Pension (Cat. 1)
6. Leave Japan: file 転出届 + claim the lump-sum withdrawal (within 2 years)

❓ FAQ

Official references: Japan Pension Service ↗ ｜MHLW — Medical Insurance ↗