Health Insurance in Japan: After You Leave Your Job

The two kinds of public health insurance

• Employee health insurance (kenkō hoken): if you work for a company, you are enrolled through your employer (Kyokai Kenpo or a company health insurance society). The premium is a percentage of your pay, split 50/50 with your employer, and your dependent family is covered at no extra cost.
• National Health Insurance (kokumin kenkō hoken): everyone else with an address in Japan, including freelancers, students and people between jobs, joins through their city office. This includes foreign residents staying more than three months. The premium is based on the previous year's income and the number of people in the household.

Either way, you pay 30% of medical costs at the clinic (under age 70), and a monthly cap applies to large bills.

Your options after you quit

1. National Health Insurance: register at your city office within 14 days of losing your employer's insurance. If you lost your job through dismissal or bankruptcy, the premium is reduced.
2. Voluntary continuation (nin'i keizoku): keep your employer's insurance for up to two years, if you were enrolled for at least two months. Apply within 20 days of leaving. You now pay the full premium (both halves), but the salary it is based on is capped, and your dependents stay covered for free.
3. Join a family member's insurance: if your spouse or parent has employee health insurance and your expected income is low enough, you can be added as their dependent without paying a premium.
4. A new job: if you start a new job soon, your new employer enrolls you. You still need coverage for any gap between jobs.

Example: ¥300,000 a month and ¥3.6 million last year, single, under 40, Tokyo. National Health Insurance would be about ¥279,731 a year, voluntary continuation about ¥362,880.

If you are leaving Japan

When you file your moving-out notification at the city office, National Health Insurance ends. If you are on voluntary continuation, contact the insurer to end it. See the Leaving Japan money checklist for the other steps.

Assumptions

• National Health Insurance uses the FY2026 standard rates of Tokyo's 23 wards. Other cities set their own rates, so treat the result as a guide and check with your city office.
• Household income is your salary only. Reductions for low-income households are not included.
• Voluntary continuation uses your prefecture's Kyokai Kenpo rate and the FY2026 cap on standard monthly remuneration (¥320,000).