How Health Insurance Works in Japan (2025 Guide for Foreign Residents) Japan’s healthcare system is widely respected for its accessibility and quality — and participation is mandatory for everyone who resides in the country. Whether you’re employed, self-employed, or studying, you must be enrolled in either Employee Health Insurance (Shakai Hoken) or National Health Insurance (Kokumin Kenko Hoken) . This guide explains how Japan’s health insurance works, how to register, and what to expect in terms of costs and coverage. 1) Types of Health Insurance in Japan Japan operates a universal health insurance system, meaning all residents must join one of the following: Employee Health Insurance (社会保険 / Shakai Hoken): For full-time employees. Enrollment is handled by your employer, and premiums are automatically deducted from your monthly salary. Employers cover roughly half of the total contribution. National Health Insurance (国民健康保険 / Kokumin Kenko Hoken...