Health insurance and pension in Japan: what foreign residents need to know (2026)

In Japan, the old health insurance card is gone: the My Number card now takes its place. And from June 2027, your contributions should count when you renew your visa. Here is how health insurance and pension work for foreign residents, from arrival to departure.

On arrival: it all starts at city hall

You must register your address at city hall within 14 days of choosing it. This registration gives you access to national health insurance, and the My Number you then receive is used for tax and insurance formalities (Toshima City).

All the arrival steps are in our guide to moving to Tokyo.

The My Number card replaces the insurance card

Since 1 December 2025, the old health insurance cards are no longer valid, with a grace period until the end of March 2026 (Insurance Business).

• Your My Number card, linked to your insurance, serves as your health insurance card.
• Without a My Number card, a certificate of eligibility lets you get treatment at the insured rate.
• Since 14 June 2026, a single optional card can combine your residence card and your My Number card: see our guide to Japan visa renewal fees.

Your contributions will soon be checked at renewal

From June 2027, payment of national health insurance and national pension contributions should be taken into account when you renew or change your status of residence, according to government plans. Not all the details have been set yet (Insurance Business, citing NHK; Solution Supporter).

Paying taxes, pension and health insurance correctly also counts for permanent residency: see our guide to Japan permanent residency.

Employees seconded by a French company

The France-Japan social security agreement, signed on 25 February 2005, allows a seconded employee to stay in the French system for an assignment of up to 5 years. The employer applies online for the SE 217-06 certificate from its Urssaf account (Cleiss).

Beyond 5 years, or if the conditions for secondment are not met, an exceptional exemption can be requested. Check your situation with your employer before you leave.

When you leave Japan: getting part of your contributions back

Foreigners who leave Japan can apply for the lump-sum withdrawal payment (dattai ichijikin). The main conditions are (Japan Pension Service, updated 1 April 2026):

• not having Japanese nationality and no longer being covered by the Japanese pension system;
• having contributed for at least 6 months;
• not meeting the conditions for an old-age pension (a 10-year eligibility period);
• never having been entitled to a disability pension;
• no longer having an address in Japan.

You must apply within 2 years of giving up your address in Japan. The calculation takes up to 60 months of contributions into account for periods after March 2021 (36 months before that).

Getting support

Kizuna Relo supports you with your settling-in formalities, from city hall to your My Number card and health insurance enrolment. If you are moving with your family, also read our guide to living in Tokyo with a family. Tell us about your project.