I am a student. How much do I pay?

Students join National Health Insurance and normally pay 30% of covered medical costs.

I was hurt at work. Should I use my health insurance card?

No. Work injuries use 労災保険. If you used your health insurance by mistake, tell the hospital and your employer quickly so it can be switched to 労災.

Is 高額療養費 calculated per year or per month?

Per calendar month, from the 1st to the last day. Over the whole year, medical costs may also reduce your income tax through 医療費控除.

Japanese health insurance: the 30% co-pay, 高額療養費 and 労災

Updated: October 2026

With public health insurance you normally pay only part of your medical costs in Japan. This guide explains the types of insurance, your share, the monthly cost cap and what happens if you are hurt at work.

The two main types

Employee health insurance (健康保険, often called 社会保険): for full-time employees; the employer pays half the premium. You join through your company.
National Health Insurance (国民健康保険): for students, the self-employed and others not covered at work. Join at your city or ward office.
Foreign residents with a residence card staying more than 3 months are generally required to join one of them.

Your share (自己負担) by age

Example: if the total bill is ¥5,000, someone paying 30% pays ¥1,500 at the counter; insurance covers the rest.

Not covered: general health check-ups, most voluntary vaccinations, cosmetic treatment and optional extras such as a private room.

Age	You pay	Notes
Before elementary school	20%	Many municipalities add subsidies; some make children's care free.
From elementary school to 69	30%	The usual rate for workers and students.
70–74	20%	30% for those with working-level income.
75 and over	10%	20% or 30% depending on income.

The monthly cap: 高額療養費

If what you pay in one calendar month (the 1st to the last day) exceeds a ceiling, insurance refunds the excess. The ceiling depends on age and income.

With a マイナ保険証 or a ceiling certificate (限度額適用認定証), you only pay up to the ceiling at the counter. If you paid more, claim the refund from your insurer (your company's health insurance society or the city office).

Going into hospital or having surgery? Ask about 高額療養費 beforehand so you do not have to pay a large sum up front.

Hurt at work: 労災

Injury or illness caused by work, or an accident on the way to or from work, is covered by workers' accident insurance (労災保険), not ordinary health insurance. Part-time and foreign workers are covered too.

Tell your employer at once and tell the hospital it is 労災. At hospitals designated for 労災, workers usually pay nothing.

Off work through illness: 傷病手当金

Members of employee health insurance (健康保険) who cannot work because of illness or injury outside work may receive sick pay: from the 4th day off (after 3 consecutive days), about two-thirds of the standard daily wage, for up to 1 year and 6 months in total. National Health Insurance generally has no such benefit.

How ViCare helps

ViCare's Insurance & procedures section has more than 40 articles on insurance, costs and refunds, family, work and emergencies, each with steps, what to bring and official sources. The visit diary records your costs by month and year.

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Quick answers

I am a student. How much do I pay?: Students join National Health Insurance and normally pay 30% of covered medical costs.
I was hurt at work. Should I use my health insurance card?: No. Work injuries use 労災保険. If you used your health insurance by mistake, tell the hospital and your employer quickly so it can be switched to 労災.
Is 高額療養費 calculated per year or per month?: Per calendar month, from the 1st to the last day. Over the whole year, medical costs may also reduce your income tax through 医療費控除.

This article is general reference information and does not replace advice from a doctor, pharmacist or public office. Rules can differ by municipality and change over time; check with your clinic or city office.