Japan Plans Advanced Health Insurance Payments for Foreign Residents

Tokyo (ANN) — Japan’s Health, Labour and Welfare Ministry is planning to allow local governments to collect national health insurance premiums in advance from foreign residents in certain areas, in a bid to curb non-payment issues.

Foreigners living in Japan for over three months without employer-provided insurance are required to join the national health insurance scheme. However, a 2024 survey of 150 municipalities showed that foreigners were only paying their premiums 63% of the time, compared to 93% for the general population.

To address this gap, the ministry intends to notify municipalities within this fiscal year on how to amend local ordinances, allowing for upfront premium collection, potentially starting April 2026. The plan may require foreigners to pay a lump sum equivalent to a year’s coverage upon registering with a local government.

As health insurance premiums vary by municipality, each local authority will decide whether to adopt the lump sum model. The ministry will also improve monitoring systems to track foreign residents’ payment history. From 2027, the Immigration Services Agency may use these records during visa renewal screenings.