Japan has one of the most accessible health systems in the world, and as a working holidaymaker you are expected to be part of it. If you stay more than three months you are required to enrol in National Health Insurance (kokumin kenko hoken), the public scheme run by your city or ward. Once you are in, the system pays most of your medical bills and you pay a fixed share at the counter. This guide explains how it works, how to enrol, what you actually pay, and why you should keep private cover for the gap before your enrolment is active.
If you live in Japan for more than three months you must enrol in National Health Insurance, and you do it at the municipal (city or ward) office at the same time as you register your address. Once enrolled, you show your insurance card at any clinic or hospital and pay a fixed share of the bill, normally 30% for working-age adults, with the public scheme covering the rest. Premiums are based on your income and set by each municipality, so newcomers with no prior-year Japan income usually start low. The working holiday visa has no reciprocal public-health agreement, so keep private travel or medical insurance until your National Health Insurance is active.
National Health Insurance is the public scheme for everyone in Japan who is not covered by an employer's health insurance or the system for people aged 75 and over. That includes the self-employed, students, part-timers and, in practice, most working holidaymakers. It is run by your local municipality, not by a single national body, but the rules and the patient share are set nationally and are the same wherever you live (City of Yokohama).
Once you are enrolled you receive an insurance card (or, increasingly, a My Number card registered for health-insurance use). You show it at any participating clinic, hospital or dentist, and you only pay your share of the cost at the counter. The scheme settles the rest directly with the medical institution, so there is no claim form to fill in for ordinary care.
You enrol at the municipal (city or ward) office for the area you live in, at the same visit where you register your address. You should do this within 14 days of becoming eligible, for example within 14 days of moving into your address (City of Yokohama).
Bring a form of personal identification such as your residence card and passport. The counter staff process your enrolment and issue your card or eligibility notice. Because enrolment is tied to your resident registration, it slots neatly into the same first-weeks sequence as your address registration and My Number; see the getting started guide for the full order.
The scheme does not pay everything. At the point of care you pay a set share of the treatment cost, and National Health Insurance covers the rest. For working-age adults (from the start of compulsory education to age 69) the patient share is 30%, so the scheme covers 70% (MHLW: Overview of Medical Service Regime in Japan).
| Treatment cost | National Health Insurance covers | You pay at the counter |
|---|---|---|
| Working-age adult (school age to 69) | 70% | 30% |
| Source | [MHLW](https://www.mhlw.go.jp/bunya/iryouhoken/iryouhoken01/dl/01_eng.pdf) | [MHLW](https://www.mhlw.go.jp/bunya/iryouhoken/iryouhoken01/dl/01_eng.pdf) |
A few points worth knowing:
You pay a premium to be in the scheme. Premiums are calculated from your income and are set by each municipality, so there is no single national figure and the amount varies from city to city (City of Yokohama: National Health Insurance premiums).
Because the calculation is based largely on your previous year's income in Japan, a newcomer who has only just arrived and has no prior-year Japan income typically starts on a low premium, with the amount rising in later years once you have a full year of earnings on record. Treat this as a general pattern rather than a fixed number: the only reliable figure is the one your own municipal office quotes you, so ask them, or check your city's premiums page, for your actual amount.
For everyday illness you go to a local clinic; for anything more serious you go to a hospital. There is no need to register with a single family doctor first, and you can generally choose where you go (JNTO emergency guide). Take your insurance card with you; with it, you pay only your share at reception. Clinics often take cash only, while larger hospitals are more likely to accept cards, so carry some cash for a first visit (JNTO emergency guide).
If you need help finding an English-speaking or foreigner-friendly facility, JNTO runs an official medical-institution search and a 24-hour multilingual visitor hotline (JNTO emergency guide).
After a consultation you are usually given a prescription to take to a pharmacy, where you pay separately for any medicine, again at your insurance share. For minor complaints you can buy over-the-counter medicines at a pharmacy or drugstore without seeing a doctor; an official English-language search exists for finding the right product (JNTO emergency guide). Some medicines can only be sold when a pharmacist is present, so opening hours matter.
In an emergency, the numbers are nationwide and free to call:
Both are confirmed on the official JNTO emergency guide (JNTO). If you cannot speak Japanese and need an ambulance, the guide suggests showing the Japanese phrase for "please call an ambulance" to someone nearby. You cannot choose which hospital an ambulance takes you to, and you may be treated before any paperwork, so emergency care is never delayed over payment (JNTO).
There is a window between landing and having active National Health Insurance: you need to find your address, register it, and enrol before your card is in hand. During that gap you are not yet covered by the public scheme, and the working holiday visa carries no reciprocal public-health agreement to fall back on. Keep private travel or medical insurance running until your National Health Insurance is active.
Whether private cover is merely recommended or actually a documented condition of your visa depends on your nationality. For Irish applicants insurance is a mandatory visa requirement, and Canadian applicants need a doctor's note; these corridor-specific rules live in your visa snapshot, so check the rule that applies to you there rather than relying on a general statement here.
Insurers offering policies built around long stays and working holidays include SafetyWing and Cover-More. Check that any policy you buy covers medical care and hospitalisation, and that it runs from your departure date until your National Health Insurance is active. There is also private medical insurance you can buy online after you arrive in Japan; JNTO links to one such option on its official emergency guide (JNTO).
Yes, if you stay more than three months. Non-Japanese residents staying longer than three months are required to enrol at the municipality where they live, at the same time as registering their address (City of Yokohama).
For working-age adults the patient share is 30% of the treatment cost, with National Health Insurance covering the other 70% (MHLW). You pay that share at the counter and there is usually no claim form for ordinary care.
Premiums are income-based and set by each municipality, so there is no single figure (City of Yokohama). Newcomers with no prior-year Japan income generally start low, but the only reliable number is the one your own city or ward office quotes you. Ask them or check your city's premiums page.
119 for fire and ambulance, and 110 for police. Both work anywhere in Japan and are free (JNTO).
Yes, for the gap. Your public cover only starts once you enrol after arriving and registering your address, so hold private travel or medical insurance until then. The working holiday visa has no reciprocal public-health agreement to bridge that window.
At the municipal (city or ward) office for the area you live in, within 14 days, at the same visit as your address registration. Bring your residence card and passport (City of Yokohama).
Verified on 23 June 2026 by the WHE research team. Sources: city.yokohama.lg.jp · mhlw.go.jp · jnto.go.jp. How we verify →