National Health Insurance bill

Last checked: 6 October 2026

This is your bill for National Health Insurance (kokuho). If you live in Japan for more than 3 months and are not in your company’s health insurance, you join kokuho through your city and pay this premium in monthly parts.

What to do now

Check the amount for each month. Set up direct debit (口座振替) if you can, or pay each slip by its date.

What it is: The yearly premium for National Health Insurance, split into parts. It is based on your household’s income last year.
Who sends it: Your city or ward office (the 国民健康保険 section).
When it arrives: June or July each year, for example mid-June in Yokohama and mid-July in Setagaya. Also when you first join.
Deadline: Usually the end of each month, from June or July until March. The dates are printed on your letter.

How to read it

Tap a number to see what it means. Yellow marks the amount and the deadline.

Simplified drawing. The exact layout differs by city.

Step by step

Check who in your household is covered and the total for the year.
Write down every deadline, or apply for direct debit so you do not miss one.
Pay by direct debit, at a convenience store or bank, with Pay-easy, or with a payment app. Methods differ by city.
If your income was low, make sure everyone in your household has declared their income. The 70%, 50% and 20% discounts on the flat per-person and per-household parts are applied automatically only when income is declared.
If you join your company’s health insurance, tell your city office so that your kokuho ends and the bills stop.

Ways to pay

Direct debit (口座振替)Some cities, such as Yokohama, make this the standard way.
Convenience storeUse the barcode on the slip.
Bank or post office
Pay-easy (ペイジー)
Smartphone payment appsWhich apps work depends on your city.

Payment methods differ by city. Your letter lists the ones you can use.

If you do not pay

You receive a formal reminder (督促状), then a notice warning that property may be seized (催告書・差押事前通知書). Late fees are added at your city’s rate.
If you do not pay for a long time, you may have to pay the full cost at the hospital first and claim part of it back later (特別療養費).
Unpaid premiums can stop a visa renewal. From June 2027, cities will share the last 5 years of your kokuho payments with Immigration. Without proof of payment, or of an agreed payment plan (分納誓約書 and similar), renewal or change of status will in principle not be allowed.

If you cannot pay

If money is tight or your situation has changed, ask your office first.

For low-income households, the flat per-person and per-household parts of the premium are cut by 70%, 50% or 20%. This is automatic if everyone in the household has declared their income.
If you lost your job because you were laid off or for a similar reason, your salary can be counted at 30% when the premium is calculated. Apply at your city office.
If your income suddenly dropped, or after a disaster, ask about a reduction (減免) or more time to pay (徴収猶予) before the deadline.
For children who have not started school, the per-person part of the premium is halved.

Common questions

Do I still use a health insurance card?

The old health insurance cards stopped being valid on 1 December 2025. Use your My Number card as your health insurance card. If you have not registered your My Number card as a health insurance card, your city sends you an eligibility certificate (資格確認書) without an application.

I joined my company’s insurance. Do I still pay kokuho?

No. You cannot be in both. Tell your city office that you joined your company’s insurance so that kokuho ends.

I just arrived in Japan. Do I need to pay in advance?

From fiscal 2026, cities may choose to ask newly arrived residents to pay the first year in advance. This is not nationwide, so check with your city office.

Show this at the counter

Show this to the staff if you go to the office in person.

国民健康保険料の通知について相談したいです。日本語があまり分かりません。払い方と期限を教えてください。分割や減額ができるかも相談したいです。

In EnglishI would like to ask about my National Health Insurance bill. I do not understand much Japanese. Please tell me how to pay and the deadlines. I would also like to ask if I can pay in parts or get a reduction.

Official sources