Understanding health insurance and the social security system is crucial for international university students considering long-term work in Japan. Japan's social security system offers high-quality medical care and comprehensive support, ensuring a secure working environment for foreign workers. However, without a proper understanding of these systems, you might miss out on essential medical services or means to alleviate financial burdens in times of need. This article provides a detailed explanation of how Japan's social security system works and how it applies to foreign workers.
Overview of Japan's Social Security System and its Applications to Foreign Workers
Basic Structure of the Social Security System
Japan's social security system aims to provide all citizens with a certain level of livelihood security and medical services. It consists of the following main programs:
Public Pension
Japan's public pension system offers coverage for old age, disability, and survivors.
Insured individuals pay monthly premiums and can receive pension benefits upon reaching a certain age.
Health Insurance
Health insurance is designed to cover a portion of medical expenses, making it easier for citizens to access necessary medical services.
There are two types of health insurance: the National Health Insurance and Employees' Health Insurance provided by companies.
Nursing Care Insurance
This system provides care services for the elderly and those requiring assistance.
Through nursing care insurance, individuals can receive care services either at home or in facilities.
Employment Insurance
Employment insurance offers benefits to support individuals during periods of unemployment. The benefits of employment insurance in Japan includes various services such as unemployment benefits and reemployment support.
Workers' Accident Compensation Insurance
This insurance provides medical expenses and compensation for leave if a worker is injured or falls ill due to work-related causes. All workers are covered under this system.
Application to Foreign Workers
Japan's social security system also applies to foreign workers.
Foreign workers in Japan are generally required to enroll in the social security system just like Japanese citizens. This requirement applies to most work visa holders, excluding short-term residents and specific visa categories.
Social security premiums are shared by both the employee and the employer, and they are typically deducted directly from the employee's salary. The enrollment process is usually handled by the employer.
Japan's Public Pension System
Overview of the Public Pension System
Japan's public pension system provides benefits for old age, disability, and survivors. All workers in Japan are required to join this system.
National Pension (Basic Pension)
The National Pension is mandatory for everyone living in Japan aged 20 to 59. It provides basic benefits, including old-age pension, disability pension, and survivor's pension.
Employees' Pension Insurance
Employees' Pension Insurance covers salaried workers, such as company employees and civil servants. It supplements the National Pension. Premiums are shared between the employee and the employer and are deducted from the employee's salary.
Enrollment Procedures for Foreign Workers
The following are the specific procedures for enrolling foreign workers in the public pension system*1:
Necessity of Joining the Public Pension
Foreign workers with a work visa in Japan are required to join the public pension system.
If employed by a company in Japan, you will join the Employees' Pension Insurance provided by your employer.
If self-employed or freelancing, you will join the National Pension.
Joining the Employees' Pension Insurance
Submit Necessary Documents: Upon employment, submit the required documents to your employer.
Employer Handles Enrollment: The employer will handle the Employees' Pension Insurance application process.
Premium Deductions: Premiums are deducted from your monthly salary.
Joining the National Pension
For self-employed or freelance workers:
Visit Municipal Office: Go to the municipal office in your area of residence.
Bring Required Documents: Take your passport, residence card, My Number, and any other necessary documents.
Complete Application: Fill out the application form with the required information.
Receive Pension Handbook: Your pension handbook will be issued once the process is completed.
Types of Pension Benefits
Old-Age Pension
The old-age pension is paid when you reach a certain age and have fulfilled the required contribution period. Typically, payments begin at age 65.
Disability Pension
The disability pension is provided if you become disabled due to illness or injury. The amount varies depending on the degree of disability.
Survivor's Pension
The survivor's pension is paid to the family of a deceased insured person. This includes the spouse and children.
Pension Refund and Lump-Sum Withdrawal Payments
Foreign workers who return to Japan after working in Japan are entitled to receive a refund of part of their pension premiums as a lump-sum withdrawal payment if certain conditions are met*2. Procedures for how to claim pension refund from Japan and receive the lump-sum withdrawal payment are as follows:
Application for Lump-Sum Withdrawal Payment
After returning to your home country, submit the prescribed application form to the pension office.
Required Documents: ・A copy of your passport ・Documents confirming you no longer reside in Japan ・Bank details including the name, branch, and address of the bank, account number, and account holder's name ・Notification of basic pension number or documents proving your basic pension number such as a pension handbook ・If a representative is handling the process, a letter of attorney is required
Calculation of Refund Amount
The lump-sum withdrawal payment is calculated based on the premiums you have paid, with a certain upper limit. Applications must be submitted within two years of leaving Japan.
Japan's Health Insurance System
Types of Health Insurance
Japan's health insurance system is a vital part of ensuring medical services for all residents.
National Health Insurance (NHI)
National Health Insurance is for self-employed individuals, unemployed people, retirees, students, and others not covered by employer-provided insurance. It is managed by local municipalities, and individuals apply at their municipal office.
Premiums are calculated based on the previous year's income.
Employees' Health Insurance
Employees' Health Insurance is for company employees and civil servants. It is managed by the employer’s health insurance association or the government-operated Japan Health Insurance Association (Kyokai Kenpo).
Premiums are jointly paid by the worker and the employer and are deducted from the salary.
Enrollment Procedures for Foreign Workers
Foreign workers in Japan must join the health insurance system, either through their employer's health insurance or, if applicable, through the National Health Insurance. Here's the key information of securing healthcare as a foreign worker in Japan, with a focus on health insurance enrollment:
Joining Employees' Health Insurance
The employer will handle the health insurance application process.
Upon starting your job, submit the required documents to your employer.
he health insurance card will be distributed to you through your company.
Joining National Health Insurance
If you are not eligible for Employees' Health Insurance, you will need to join the National Health Insurance.
Go to the municipal office in your area of residence. ・Take your passport, residence card, My Number, and any other necessary documents.
Complete Application ・Fill out the application form with the required information.
Receive Health Insurance Card ・Your health insurance card will be issued on the spot.
Calculation and Payment of Premiums
Employees' Health Insurance
Premiums are automatically deducted from your monthly salary and are shared between you and your employer.
National Health Insurance
Premiums are calculated based on the previous year's income and are notified by the municipality. Payments are typically made monthly or annually.
By joining the health insurance system, a portion of your medical expenses will be covered, reducing the financial burden when accessing medical services.
Using Medical Services in Japan
Choosing Medical Facilities
When using medical services in Japan, selecting the appropriate medical facility is essential.
Differences Between Clinics and Hospitals
Clinics (診療所): These are smaller medical facilities that provide general consultations and treatment for minor health issues. For everyday health problems or minor illnesses, it is common to visit a clinic first.
Hospitals: Larger medical institutions that offer specialized treatments and surgeries. Hospitals are generally used for serious illnesses or emergencies.
Referral System to Specialists
In Japan, if specialized treatment is needed, a referral from a primary care doctor to a specialist is often required. Initially, you visit a clinic or general practice, and if necessary, you receive a referral letter to see a specialist. This referral system ensures you receive appropriate medical care.
Medical Facilities with Foreign Language Support
Japan has many medical facilities that cater to foreign languages. These facilities have doctors and staff who can communicate in languages such as English, Chinese, and Korean, making it easier for non-Japanese speakers to receive medical care.
List of Medical Institutions Accepting Foreign Patients: Compiled by the Ministry of Health, Labour and Welfare
Insurance Coverage and Out-of-Pocket Expenses
Japan's health insurance system covers many medical costs, but not everything is free. In this section, we will explore the cost of social security in Japan for foreign workers and the coverage it offers.
Insurance Coverage
Health insurance covers a wide range of medical expenses, including consultation fees, medication costs, surgery fees, and hospitalization costs.
Certain treatments, such as cosmetic surgery, some preventive vaccinations, and specific advanced medical treatments, are not covered by insurance. These costs must be fully borne by the patient.
Calculation of Out-of-Pocket Expenses
For insured medical expenses, there is a set out-of-pocket amount.
Typically, the out-of-pocket cost is 30% of the medical expenses. The rate may vary based on age and income. For example, people aged 75 and older or those with low income may have reduced out-of-pocket expenses.
Under the High-Cost Medical Expense Benefit System, you can receive a refund for medical expenses that exceed a certain amount.
Employment Insurance and Workers' Accident Compensation Insurance
Overview of Employment Insurance
Employment insurance is a system that provides benefits to workers in the event of unemployment, supporting their financial stability. Foreign workers in Japan are also covered by employment insurance.
Premium Contributions
Premiums are jointly paid by the employee and the employer.
The contributions are automatically deducted from the employee's salary and paid by the employer.
Types of Benefits
Unemployment Benefits
Provides financial support during periods of unemployment.
The duration and amount of benefits depend on the length of employment and the reason for leaving the job.
Childcare Leave Benefits
Paid to workers who take childcare leave.
Partially compensates for the income lost during the leave.
Care Leave Benefits
Paid to workers who take leave to care for family members.
Partially compensates for the income lost during the leave.
Enrollment Procedures for Foreign Workers
Joining Employment Insurance
The procedure is carried out when you join the company.
Submit necessary documents (residence card, My Number, etc.), and the employer will handle the process.
Procedures When Unemployed
Visit the Hello Work office (Public Employment Security Office) to apply for unemployment benefits.
Bring required documents (certificate of separation, residence card, My Number, etc.) and complete the prescribed procedures.
Overview of Workers' Accident Compensation Insurance
Workers' accident compensation insurance provides coverage for medical expenses and compensation for lost wages if a worker is injured or falls ill due to work-related causes. All workers, including foreign workers, are covered.
Premium Contributions
The entire premium is paid by the employer.
Workers do not bear any part of the premium.
Procedures for Foreign Workers
When an Accident Occurs
Report the accident or illness to your employer immediately and complete the necessary procedures.
Receive treatment at a designated medical facility and submit the required documents (accident report, medical certificate, etc.).
Applying for Benefits
To receive benefits, submit the prescribed application form to the Labor Standards Inspection Office.
The employer will assist with the procedure.
Conclusion
For international university students considering long-term work in Japan, understanding the health insurance and social security system is essential. Japan offers high-quality medical care and comprehensive support, providing a secure environment for foreign workers.
Japan's health insurance system is renowned for its top-tier medical services, and the extensive network of hospitals and clinics makes access to healthcare convenient. Additionally, the social security system includes various benefits such as pensions, unemployment insurance, and workers' compensation, which can significantly enhance your stability and security while living in Japan.
By effectively utilizing these systems, you can ensure a more stable and secure life in Japan. If you have any questions or concerns about living in Japan, feel free to ask on Feed of the Jelper Club platform.
At Jelper Club, we're here to support you every step of the way for your career development in Japan. Our platform connects ambitious students from top universities worldwide with exclusive internship and full-time job opportunities in Japan with a variety of Japanese proficiency requirements. We also provide access to practical information, member-only events, and a professional community of like-minded individuals.
If you're ready to embark on your own Japanese adventure, visit Jelper Club today and discover how we can help you unlock your potential in Japan.
Sources and Notes
１.「 外国人のみなさまへ 国民年金（こくみんねんきん）のご案内（ごあんない）」（日本年金機構）：
２.「 脱退一時金を請求する方の手続き」（日本年金機構）：
(Editor: Jelper Club Editorial Team)
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