Health Insurance in Japan + How Dogpay Helps

What Is Health Insurance in Japan All residents in Japan with long-term visas (over 3 months), including expatriates, are legally required to enroll in one of the public health insurance schemes: Empl...

What Is Health Insurance in Japan

  • All residents in Japan with long-term visas (over 3 months), including expatriates, are legally required to enroll in one of the public health insurance schemes: Employee Health Insurance (Kenko Hoken / SHI) if employed, or National Health Insurance (Kokumin Kenko Hoken / NHI) if self-employed, unemployed, students, or people whose employer does not provide SHI.  

  • The public insurance covers about 70% of medical costs; the patient generally pays the remaining 30% as a co-payment. For people over a certain age (elderly), or in special cases, co-payment rates may be reduced.  

Types of Public Insurance & Cost Differences

Insurance TypeWho It CoversHow Premiums / Contributions WorkEmployee Health Insurance (SHI / Kenko Hoken)People working for companies/employers who provide SHI; includes dependents.  Premium is shared: about half paid by employer, half by employee; based on income.  National Health Insurance (NHI / Kokumin Kenko Hoken)Those not covered by SHI (students, self-employed, retirees, etc.) and foreign residents with long-term visa.  Premium depends on income, household size, local municipal rates. Not employer-subsidized.  

What’s Not Covered & Supplemental Options

  • Certain medical services are not fully covered by public insurance: dental work beyond basic care, elective procedures, many cosmetic treatments, some mental health services, etc.  

  • Many expats opt for private or international health insurance as a supplement—for ensuring continuity while waiting for public insurance, for treatments public insurance doesn’t cover, or for broader network / English support.  

Practical Cost & Payment Details

  • Public insurance co-payment: usually 30% of medical cost; for elderly (age 75+), or certain low-income groups, it could be 10-20%.  

  • Premiums or contributions: For SHI, based on salary; for NHI, based on income + local government rules + household size.  

  • Medical expenses must often be paid upfront or at time of service, with reimbursement or co-payment deducted later; patients need to present a health insurance card.  

How Dogpay Helps with Health Insurance & Medical Payment Management

ScenarioCommon Financial / Payment Pain PointDogpay’s AdvantagePremium payments for public or private insurancePaying insurance premiums from abroad or with foreign bank accounts can involve currency conversion fees, delays, unclear ratesDogpay supports multi-currency transfers, shows exchange rates/fees upfront, helps schedule or batch payments, reduces surprisesCo-payments & Out-of-Pocket medical expensesThe 30% portion + any uncovered services can add up; paying at clinic or hospital sometimes demands full payment before insurance reimbursement; foreign cards may incur extra feesDogpay lets you track these payments cleanly, maybe pay in local currency, keep receipts and logs for insurance or tax useSupplemental / private insurance & services not coveredFinding insurance that fills gaps, paying additional policy premiums, possibly remote or foreign providers with payment difficultiesDogpay can manage cross-border insurance payments, ensure smoother receipt of policies, help keep financial proof if needed for claimsMedical emergencies or high-cost situationsUnexpected hospitalizations or specialist treatments can produce large bills; delays due to payment or insurance eligibility issues are stressfulDogpay’s faster cross-border capabilities and transparent costs help you handle large payments more reliably; helps ensure you have proof of payment/documentation needed for reimbursement or claim

Health Insurance in Japan + How Dogpay Helps