How does private medical insurance in Japan work for foreign residents?

Moving to Japan doesn’t just mean learning a new language—it also means learning a new healthcare system, likely starting from scratch without the local connections and easy communication you had back home. Japan might have a great public healthcare system, but that doesn’t mean you’ll never worry about what happens if you fall seriously ill, or need treatment for something you don’t fully understand. As a team of foreign residents ourselves, here at Japankuru, we know firsthand that there are significant obstacles when using Japan’s public health insurance system: language barriers, structural differences in the medical system, cultural confusion, changes in medication… the list goes on!

(Have you ever tried to explain your newfound allergies to a doctor in Japan when you can’t speak Japanese? We can’t recommend the experience.)

Japan’s National Health Insurance system is respectable by global standards, but we’ve seen many foreign residents seek extra support when it comes to dealing with the complications of moving to a new country with a different language and culture. That’s why private medical insurance is increasingly popular among foreign residents as a supplement to public health insurance, especially for those planning to stay long-term. Thanks to the services provided specifically for foreigners in Japan, the major insurance company Nanairo Life is a strong choice for many.

Here at Japankuru, our team members have been in Japan anywhere from 2 to 20 years, which means we’ve each had our own unique healthcare journeys. We’ve put together a short list of some of the major questions we each had when looking into medical insurance, and how Nanairo Life‘s foreigner-centric services work. We hope it helps you on your own journey in Japan!

The Basic Facts: All About Japanese Medical Insurance

・Do I need private medical insurance on top of Japan’s public health insurance? Do I still need public health insurance if I buy private medical insurance?

We’re starting with an important two-in-one question, so we’ll sum up the answer as clearly as possible. If you’re in Japan for more than three months, then you must enroll in public health insurance (national health insurance or an equivalent service provided by an employer). But national health insurance doesn’t cover 100% of your medical expenses—so private medical insurance like Nanairo is designed to supplement public insurance, not replace it. Private insurance is often purchased to fill in the gaps, helping to cover out-of-pocket expensive or remaining medical bills with lump sums, and providing additional cash benefits during hospitalization or illness. Private medical insurance isn’t mandatory, but if you’re a contract English instructor, private tutor, or work any number of other jobs that could be disrupted by a medical emergency, then it’s a nice safety net.

・What exactly does private health insurance in Japan cover?

Japan’s private medical insurance, like the plans offered by Nanairo Life, focuses primarily on direct financial support. Coverage varies, but common options include a daily stipend for hospital stays (hospitalization benefits/入院給付金), as well as larger lump-sum payments* paid out when diagnosed with a major disease or illness. Public health insurance covers a large portion of your medical fees, but the cash infusions you can get from private insurance are flexible, and you get to decide how it’s used. Many people spend the money on hospitalization payments to cover private hospital rooms, or even uncovered treatments, but you’re free to use it on rent and all your other bills.

Some jobs in Japan offer great benefits, including impressive sick leave, but we know the truth is that a large portion of foreign workers in Japan aren’t so lucky. Whether it’s a part-time job at a nearby family restaurant, or a full-time gig at an English school, you’re probably not getting paid if you spend a whole week in the hospital—unless you have private medical insurance providing financial support instead.

^{*For policyholders who add the Cancer Diagnosis Lump-Sum Payment Rider (2024).}

・Is private medical insurance expensive in Japan?

Compared to many countries, private medical insurance in Japan is often relatively affordable! Premiums vary based on age and other factors, but Nanairo offers plans that start from around 1,000 yen a month.

・I feel fine, do I really need to sign up for private medical insurance right now?

Whatever your age, or your health records, if you’re even considering adding private medical insurance, now is the time to sign up. Prices only go up as you age, but Nanairo Life actually offers fixed premiums, ensuring fees never go up. Lock in a reasonable rate while you’re still young, and you’ll have the same coverage for the same fees, for as long as you want.

Sure, if you’re reading this article right now, you might only be planning to stay a year in Japan as an ALT or explore the country on a working holiday. But that’s what half our English-teacher friends said 10 years ago, before they fell in love with Japan and decided to stay here long term. We say start your insurance policy early, and go for the lower premium while you still can!

Choosing Insurance: Private Medical Insurance Options for Foreigners

・Why do foreign residents in Japan choose medical insurance from Nanairo Life?

Nanairo Life is one of Japan’s top medical insurance providers, known for offering an array of different options, but foreign residents are free to sign up for insurance from whichever company they choose. The real reason why many foreigners choose Nanairo Life is that the company has chosen to cater to foreigners specifically. When you apply for any insurance in Japan, you won’t be required to show that you’re a Japanese citizen, but you will need to fully understand the details of your application before signing any contracts—and at most Japanese insurance companies, that includes a whole mess of frustrating phone calls and documents in Japanese.

Nanairo Life, on the other hand, offers multilingual support to help guide foreigners through the process, from the coverage calculator on their English homepage to English-language phone support. It’s best to know exactly what you’re signing up for when you enter an insurance contract, and in Japan, Nanairo Life offers some very helpful options.

On top of all that, Nanairo Life policyholders can also take advantage of a general medical helpline in English. When you’re approaching your second spring in Japan, and Japan’s famous cedar trees release so much pollen that your allergies have you suffering like you caught the flu, it’s reassuring to have someone to reach out to, and ask what to do next.

For Foreigners: What Foreign Residents Need to Know About Insurance in Japan

・Why should I need medical insurance as a foreigner, when my Japanese friends don’t bother?

This is a question one member of the Japankuru team asked when first learning about private medical insurance, but really, it was a holdover from an insurance system in another part of the world. You might be surprised to learn (we certainly were) that supplemental insurance is actually pretty common among Japanese citizens, too. For all the reasons mentioned above, adding private medical insurance alongside public health insurance is basically a given.

Foreign residents face different challenges when interfacing with Japan’s medical system and public health insurance, and having a specific insurance plan designed to support foreigners can really come in handy. Nanairo Life’s English homepage includes links to a helpful list of medical facilities that offer some amount of English support, but Japan’s healthcare system and public health insurance still mainly operate in Japanese, from forms and prescriptions to all the details of the billing process. English-speaking staff at Nanairo can help you figure out some of the process, and a dedicated multilingual hotline can help you find answers to a broader range of medical questions.

Many Japanese locals have an established local support network of family and friends within their community, ready to help each other with transportation, meals, childcare, or even finances, if illness strikes. For us foreigners living in Japan, we’re often far from our own hometowns and communities, separated from that kind of reliable support, so it’s good to have an alternative safety net for emergencies.

・What happens to my insurance if I change jobs in Japan?

If you’re depending on an employment visa to stay in Japan, then you know that finding a new employer is complicated, and getting through all the accompanying paperwork is a harrowing process. When you leave your old job in Japan, your employer-sponsored insurance usually ends as well, and you’re expected to enroll in National Health Insurance within 14 days of that. Good thing private medical insurance is separate from your employer! As long as you’re not leaving Japan, your policy will go on as normal, even if you change jobs, or go freelance. If you’re working contract jobs, or end up changing companies frequently, this is one thing you don’t have to worry about.

・What happens when it’s time to update my visa? What about if I need to change it completely?

Unless you’re sitting pretty with PR, updating your visa is a fact of life for foreigners living long-term in Japan, as inconvenient as the process may be. Sometimes things get extra complicated when you even need to change the visa type—maybe you got married, or maybe you went from teaching English as an ALT to teaching English at a cram school. (Fun fact! Did you know these are different visas? One of our editors found out the hard way, a few years back.)

Like changing jobs, updating or changing your visa can be a bit of a headache in Japan, as you go around updating all the places that have your residency card registered. It shouldn’t affect your private medical insurance policy, but you do need to update your provider. Nanairo Life, at least, makes it as easy as possible. Just call on the phone and have the English-language support staff do it for you.

Should foreigners in Japan sign up for private medical insurance?

For some foreign residents, Japan’s National Health Insurance feels like enough coverage for their everyday medical needs. But if you’re planning to settle down in Japan long-term, or simply worried about the kind of medical emergency that could happen any time, adding private medical insurance alongside public health insurance starts to make sense.

Unless you’re arriving in Japan with fluent Japanese and a strong social support network, Nanairo Life’s foreign-language support and medical hotline can be a real help. Plus, their hospitalization benefits and lump-sum payments can remove a little of the financial anxiety that comes from missing work due to illness or injury. It’s a little peace of mind, even if you have to take a break from leading walking tours after breaking a leg, or you come down with the flu so bad you end up in the hospital instead of at the office.

In our experience, and for many foreigners living in Japan, the real benefit of private medical insurance like the kind offered by Nanairo Life isn’t just that it can add coverage to public health insurance, but that it can take away some of the worrisome what-ifs of living abroad. When you’re navigating illness and an unfamiliar system far from home, the peace of mind that comes from knowing you’re protected matters just as much as the coverage itself.

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