In certain regions of Japan, non-residents could potentially face the requirement to pay a substantial amount for health insurance coverage.

In certain regions of Japan, non-residents could potentially face the requirement to pay a substantial amount for health insurance coverage.

Starting in 2025, foreign residents in Japan may be required to pay their national health insurance (NHI) premiums as a lump sum upfront in some municipalities. This policy change is proposed by the Ministry of Health, Labour, and Welfare to improve payment compliance and ensure foreign residents contribute their fair share to the healthcare system.

Under the NHI system, all residents—including foreign nationals living in Japan for more than three months who are not covered by employer-based insurance—must enroll and pay premiums. Currently, foreign residents only pay their premiums 63% of the time, compared to 93% for all residents including Japanese nationals.

The lump-sum payment approach aims to reduce premium evasion and incentivize timely premium payment. Each local government will decide whether to require lump sum payments for national health insurance, and the Japanese Health, Labour, and Welfare Ministry will notify municipalities this fiscal year of what ordinances they need to amend to require advance payment of premiums, starting as early as April 2023.

Failure to pay premiums or medical bills may lead to denial of visa renewals or other immigration consequences by 2027. The government intends to implement rigorous screening measures that will deny visa renewals to mid- and long-term foreign residents who have unpaid medical or social insurance debts. This is part of broader reforms aimed at establishing an orderly society by preventing so-called "free riders" who do not fulfill their financial obligations.

The Immigration Services Agency will use records of premium payments to screen residents as early as June 2027. The government aims to make improvements in understanding foreign residents' payment history and screening processes by this date. In the future, the government hopes to make it possible to share information about whether foreigners are paying their pension premiums and medical fees.

Many foreigners fail to make national health insurance premium payments due to a lack of understanding about the system. To address this, the health ministry will begin improving its understanding of foreign residents' payment history, with improvements to be made in fiscal 2026. The national health insurance program sends payment slips by mail for premium payments, but many foreigners fail to use them.

It's important to note that foreigners who live in Japan for more than three months and are not covered by other insurance are required to enroll in national health insurance. As of the end of 2024, foreigners were only paying their insurance premiums 63% of the time, compared to 93% for all residents of Japan. Currently, most local governments do not know whether foreign residents are paying their insurance premiums due to a lack of knowledge about the nationality or residence status of those enrolled in insurance.

This policy change will likely affect foreign residents by increasing their immediate financial burden due to lump-sum payments and incentivizing timely premium payment to avoid immigration problems. It underscores the importance for foreign residents to understand and comply with Japan’s health insurance and immigration regulations.

1. The government's proposal in 2025 targets foreign residents in Japan, requiring them to pay their National Health Insurance (NHI) premiums as a lump sum upfront in some municipalities.
2. This policy change aims to enhance payment compliance and ensure foreign residents contribute fairly to the healthcare system.
3. Under the NHI system, all residents, including foreign nationals, must enroll and pay premiums, with 63% of foreign residents currently complying.
4. In contrast, 93% of all residents, including Japanese nationals, pay their premiums.
5. The lump-sum payment approach is designed to reduce premium evasion and promote timely premium payments.
6. Each local government will decide whether to require lump sum payments for NHI, with notification from the Japanese Health, Labour, and Welfare Ministry to be issued this fiscal year.
7. Implementation could begin as early as April 2023.
8. Failure to pay premiums or medical bills may lead to visa renewal denials or other immigration consequences by 2027.
9. The government intends to enforce rigorous screening measures to deny visa renewals to mid- and long-term foreign residents with unpaid medical or social insurance debts.
10. These measures are part of broader reforms aimed at establishing an orderly society and preventing "free riders" who do not meet their financial obligations.
11. The Immigration Services Agency will begin screening residents as early as June 2027.
12. The government aims to improve its understanding of foreign residents' payment history and screening processes by 2027.
13. Many foreigners struggle to understand the NHI system, causing them to miss payments.
14. To address this, the health ministry plans to improve its understanding of foreign residents' payment history, with improvements expected in fiscal 2026.
15. The national health insurance program sends payment slips by mail for premium payments, but many foreigners fail to use them.
16. All foreigners living in Japan for more than three months and not covered by other insurance are required to enroll in national health insurance.
17. As of the end of 2024, foreigners were only paying their insurance premiums 63% of the time.
18. Most local governments lack knowledge about the nationality or residence status of those enrolled in insurance, making it difficult to monitor compliance.
19. The policy change will likely increase the immediate financial burden for foreign residents due to lump-sum payments.
20. It will also incentivize timely premium payments to avoid immigration problems.
21. Foreign residents are encouraged to understand and comply with Japan’s health insurance and immigration regulations.
22. Understanding these regulations can help foreign residents avoid potential financial and immigration complications.
23. In addition to health insurance, foreign residents should also be aware of their housing responsibilities in Japan.
24. Embracing emerging technologies such as Artificial Intelligence (AI) can facilitate the management of housing and other aspects of life in Japan.
25. The government is also focusing on addressing issues related to chronic diseases, cancer, respiratory conditions, digestive health, eye health, hearing, and mental health.
26. Workplace-wellness initiatives are being promoted to address these issues, making the workplace a safer environment for employees.
27. The government is also actively involved in the field of science, particularly in areas like climate change, renewable energy, and environmental science.
28. The manufacturing sector in Japan is adapting to these changes, focusing on sustainable practices and technologies.
29. With the aging population and increasing health concerns, the demand for therapies and treatments, nutritional advice, fitness and exercise programs, and skin care products is on the rise.
30. The government is working to address the unique health needs of women, men, and various autoimmune disorders, ensuring that healthcare services are inclusive and comprehensive.

Read also: