Health Insurance for International Students in Japan

If you're studying in Japan on a residence status valid for more than 3 months, health insurance for international students in Japan is mandatory. Almost all students enroll themselves in National Health Insurance (NHI, kokumin kenko hoken 国民健康保険), since NHI covers anyone not enrolled through a Japanese employer's shakai hoken. Enroll at your ward office within 14 days of registering your address, the move-in notification (転入届). Because NHI premiums are calculated from your previous year's Japan income - usually zero for someone who just arrived - student NHI premiums typically come out modest. Once enrolled, NHI pays 70 percent of your bill at the pharmacy counter, same as any other insured resident. Bringing your existing medication in legally is a separate process, covered further down.

Student health insurance in Tokyo runs through the same two systems as anywhere else in Japan: shakai hoken (社会保険), which a Japanese employer enrolls you in automatically, and NHI (国民健康保険, kokumin kenko hoken), which you enroll in yourself. Full-time students without a Japanese employer fall into the second group by default. Part-time work that enrolls you in shakai hoken supersedes NHI; the two aren't stacked. For the fuller comparison, see shakai hoken vs. NHI at the pharmacy.

Enroll within 14 days of your move-in registration - the ward office needs your resident record on file first. Premiums are set from your previous year's Japan income, typically zero for a student who just moved from abroad, which keeps first-year premiums low. The calculation looks one year backward, so a student who picks up part-time work may see the premium rise the year after.

Student NHI behaves exactly like shakai hoken at the pharmacy counter: show your insurance credential when a prescription is filled, and you pay a 30 percent co-pay for the standard ages-6-to-69 bracket while NHI covers the rest, applied automatically. What it doesn't cover: anything bought over the counter without a prescription. For the full mechanics, see does Japanese health insurance cover prescriptions; for what a co-pay totals, see how much prescriptions cost in Japan.

NHI enrollment has nothing to do with whether you can legally bring your current medication - that's a separate track, governed by MHLW's import rules. Without a certificate, you can bring up to a 1-month supply of prescription drugs and a 2-month supply of OTC drugs, quasi-drugs, and vitamins - carry a copy of your prescription and a doctor's letter even within those limits. Exceed them, or bring certain narcotics or psychotropics above threshold, and you need an import certificate, Yunyu Kakunin-sho (輸入確認書, still commonly called Yakkan Shoumei), applied for at least 14 days ahead via the online portal.

For ward registration ahead of insurance, see the moving to Japan guide; for the fuller system, see the health guide.