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 Type | Who It Covers | How Premiums / Contributions Work |
|---|---|---|
| Employee 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
| Scenario | Common Financial / Payment Pain Point | Dogpay’s Advantage |
|---|---|---|
| Premium payments for public or private insurance | Paying insurance premiums from abroad or with foreign bank accounts can involve currency conversion fees, delays, unclear rates | Dogpay supports multi-currency transfers, shows exchange rates/fees upfront, helps schedule or batch payments, reduces surprises |
| Co-payments & Out-of-Pocket medical expenses | The 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 fees | Dogpay lets you track these payments cleanly, maybe pay in local currency, keep receipts and logs for insurance or tax use |
| Supplemental / private insurance & services not covered | Finding insurance that fills gaps, paying additional policy premiums, possibly remote or foreign providers with payment difficulties | Dogpay can manage cross-border insurance payments, ensure smoother receipt of policies, help keep financial proof if needed for claims |
| Medical emergencies or high-cost situations | Unexpected hospitalizations or specialist treatments can produce large bills; delays due to payment or insurance eligibility issues are stressful | Dogpay’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 |
