Leaving Japan: Cancel National Health Insurance & Shakai Hoken

Japanese public health insurance has two exits when you move abroad for a year or more. National Health Insurance (Kokumin Kenko Hoken 国民健康保険, NHI) ends from the day after your Japanese address ends, while employee health insurance (Shakai Hoken 社会保険, often called Kenpo) ends from the day after your last day of employment.¹² Both dates are fixed by statute, neither waits for your flight to land, and in October 2026 there is no plastic card to “hand in”: you deal with a My Number card or a Certificate of Eligibility instead (as of October 2026).³⁴

The Principle of Universal Healthcare Deregistration Upon Departure

Japan’s system is universal for people who live in Japan, not for Japanese citizens wherever they are. Understanding which legal trigger ends your coverage tells you which counter to visit, which date to plan around and which premium month is the last one.

Why Japanese Health Insurance Ends When Your Japanese Address Ends

Article 5 of the National Health Insurance Act makes every person with an address in a prefecture an NHI member, unless an exclusion in Article 6 applies (employee insurance members and their dependents are the main exclusions).¹ Article 8 then says eligibility is lost “from the day after the day the person ceases to have an address in the prefecture”.¹ The same-day exception in Article 8 applies only when a new address in another prefecture begins that day, which cannot happen on a move abroad.¹

In practice NHI ends on the day after your move-out date, as Ota City and Otsu City (which uses the planned departure date) both confirm.⁵⁶ The date on your moving-out notification (Kaigai Tenshutsu-todoke 海外転出届) therefore drives your coverage; the separate guide to the moving-out notification covers how that form is filed.

Employee health insurance follows employment, not residence. Under Article 36 of the Health Insurance Act (Kenko Hoken Ho 健康保険法), an insured employee loses eligibility from the day after they stop being employed by the workplace.² Japan Pension Service gives the example of resigning on 31 March and losing eligibility on 1 April.⁷

Which System Are You In? NHI, Shakai Hoken, Dependent, or Late-Stage Elderly

Identify the system for each family member first, because one household can straddle two systems.

Your status	System	Where the exit happens	Who files
Self-employed, freelancer, unemployed, most students, retirees under 75	National Health Insurance (Kokumin Kenko Hoken)	City or ward office NHI counter (Kokuho counter)	You or a household member / proxy⁸
Salaried employee	Kyokai Kenpo (協会けんぽ) or a company health insurance society (Kenko Hoken Kumiai 健康保険組合)	Through your employer	Employer files the loss notification⁷
Spouse or child supported by an employee (Hi-fuyosha 被扶養者)	Same scheme as the employee	Through the employee’s employer	Employer, on the employee’s notice¹⁷
Aged 75 or over	Late-Stage Elderly Medical Care (Koki Koreisha Iryo 後期高齢者医療)	City or ward office	You or a proxy¹⁶

People aged 75 and over are outside NHI but close their Late-Stage Elderly Medical Care membership at the same city hall desk; Otsu City handles both together on departure and asks for the Certificate of Eligibility to be returned.¹⁶ Healthcare planning for retirees abroad is covered in the guide to senior healthcare and medical insurance abroad.

The 1-Year Threshold and Why “Keep Paying From Abroad” Is Usually Not an Option

Municipalities apply the moving-out notification to stays abroad of 1 year or more. Okayama City says that working, being posted, travelling on business or studying abroad for 1 year or more (or moving your base of life abroad) requires the notification, and that filing it takes you out of NHI.⁹ Once that happens there is nothing left to pay into.

NHI has no voluntary overseas enrollment. National Pension lets Japanese nationals aged 20 to under 65 living abroad join voluntarily (with a narrow exception for certain German nationals under the Japan-Germany agreement),¹⁰¹¹ but the NHI Act ties membership to an address in Japan (Art. 5 and Art. 8) and contains no comparable route.¹ Some commercial checklists present “keep paying NHI from abroad” as an option; in law, the only way to stay in NHI is not to deregister at all.

Staying registered is only appropriate for a genuine temporary absence. Okayama City treats someone who lived with family and will be abroad for under 1 year as still having an address at the family home, so no overseas move-out is needed and NHI continues.⁹ This includes students on a short study-abroad stay in that municipality, but other municipalities may apply the test differently, so confirm with yours; whether you are a temporary or long-term absentee for tax and legal purposes is covered in the guide to long-term relocation versus temporary stay.

Exiting National Health Insurance (Kokumin Kenko Hoken) at City Hall

For NHI members, the exit happens at city hall, normally on the same visit as the moving-out notification. The details below vary by municipality, so check your own city or ward page before you go.

When and Where to File the NHI Withdrawal

Whether you need a separate NHI step depends on your municipality (as of October 2026). Ota City says the moving-out notification itself ends NHI and no separate NHI procedure is needed.⁵ Meguro City ends NHI automatically for domestic moves but requires a counter visit at its NHI section when you move abroad.⁸

Otsu City in Shiga routes departing residents to its insurance and pension division, with separate desks for eligibility and levies, Late-Stage Elderly Medical Care, and premium collection (as of October 2026).⁶ The safest plan is to go to the NHI counter right after the resident registration counter, usually within the municipality’s advance window for the moving-out notification.

Municipality	Separate NHI step for an overseas move?	Source note (as of October 2026)
Ota City (Tokyo)	No; the moving-out notification ends NHI	Page updated 1 September 2026⁵
Meguro City (Tokyo)	Yes; visit the NHI counter in person	Page updated 1 April 2026⁸
Otsu City (Shiga)	Handled at the insurance and pension division with the departure checklist	Checklist dated 7 January 2026⁶

What to Bring and What to Hand Back in 2026

The old plastic health insurance card no longer exists in practice. All conventional health insurance cards expired on 1 December 2025, and the provisional measure that let clinics accept expired cards ended on 31 July 2026 (as of October 2026).³⁴ New card issuance stopped on 2 December 2024, according to Ota City and the enforcement date of the amending ministerial ordinance.⁵¹⁴

Today you prove coverage in one of two ways (as of October 2026). Most people use a My Number card registered for health insurance use (Maina Hokensho マイナ保険証); people without that registration receive a free Certificate of Eligibility (Shikaku Kakuninsho 資格確認書) from their insurer without applying.⁴ Maina Hokensho holders also receive a Notice of Eligibility Information (Shikaku Joho no Oshirase 資格情報のお知らせ), which cannot be used on its own at a clinic.⁴

Item	Return it on leaving NHI?	Notes (as of October 2026)
Certificate of Eligibility (Shikaku Kakuninsho)	Yes, to city hall	Ota and Otsu ask for it back; Meguro lets holders shred an expired certificate themselves⁵⁶⁸
Notice of Eligibility Information (Shikaku Joho no Oshirase)	No	Meguro states it does not need to be returned⁸
My Number card (health insurance registration)	Nothing to return for insurance purposes	The registration persists; the insurer updates eligibility data in the system¹⁵
Old conventional card	No use at clinics	Expired 1 December 2025³

Bring photo ID, your My Number card and any Certificate of Eligibility to the counter. If someone else files for you, Meguro requires a letter of authorization (Ininjo 委任状) when the agent is not in your resident-record household.⁸ Some municipalities may also ask to see proof of your departure date, so carry your itinerary.

The My Number card itself is a separate question. MHLW says the health insurance registration does not need to be redone after a job change, resignation or move, because the insurer updates the eligibility record.¹⁵ Whether a Japanese citizen can keep using the card abroad, and what happens to a foreign resident’s card, is covered in the guide to My Number card overseas use and departure procedures.

Household Billing: When Only Some Family Members Leave

NHI premiums are billed to the head of household (Setai-nushi 世帯主), not to each member, under Article 76 of the NHI Act.¹ Some municipalities levy the same charge as National Health Insurance tax (Kokuho-zei 国保税) instead of a premium (Kokuho-ryo 国保料), which matters for who can receive notices on your behalf.¹

When one member leaves and others stay, the remaining household’s premium is recalculated and the municipality sends a revised notice. Otsu City says premium changes take effect from the planned departure date and asks departing residents to agree a mailing address for the change notice and a settlement method.⁶ If the person leaving is the household head, ask the NHI counter who will become the billing head.

Members aged 40 to 64 also pay a long-term care portion (Kaigo Hoken 介護保険) inside their NHI levy, and it ends with NHI.¹ Since April 2026 the levy also funds the child and child-rearing support contribution (Kodomo Kosodate Shien Nofukin 子ども・子育て支援納付金) (as of October 2026).¹

Adjacent Counters: National Pension and Child Allowances (Pointer Only)

The National Pension counter is usually next to the NHI counter, and Category 1 National Pension coverage also ends on the day after the move-out date.¹⁶ Voluntary enrollment, lump-sum withdrawal and child allowance stops are covered in their own guides.

Exiting Employee Health Insurance (Shakai Hoken) via Your Employer

Employees do not visit city hall to end Shakai Hoken. Your employer reports the loss of eligibility, and your job is to return documents, time your last day and close any gap before departure.

Loss of Eligibility the Day After Your Last Working Day

Coverage ends from the day after your employment ends, and the employer must submit the loss-of-eligibility notification (Hihokensha Shikaku Soshitsu Todoke 被保険者資格喪失届) within 5 days of the event.²⁷ Article 48 of the Health Insurance Act is the employer’s legal duty to report it.²

Return your Certificate of Eligibility to HR straight after you leave (as of October 2026). Kyokai Kenpo’s Saitama branch says the in-work certificate can be used only up to the resignation date and asks members to return it, including dependents’ certificates, to the employer immediately.¹⁷ For Kyokai Kenpo members the employer attaches these certificates (plus any elderly recipient or limit certificates) to the notification, or files a non-recovery form if they cannot be collected.⁷

Some items are not returned (as of October 2026). Kyokai Kenpo says the Notice of Eligibility Information does not need to be returned, and the old light-blue cards no longer need to be collected from 2 December 2025.¹⁸¹⁷ Members of a company health insurance society should follow the society’s own instructions, since JPS lists no attachments for them.⁷

Ask HR for written proof of your coverage end date if an overseas insurer, school or visa office may want evidence of prior coverage. This is practical advice rather than a legal requirement; the document is often called a Certificate of Loss of Eligibility (Shikaku Soshitsu Shomeisho 資格喪失証明書).

Resigning Then Staying in Japan for a While: The Gap Before the Flight

If you resign weeks before your flight, you are uninsured from the day after your last working day unless you act. You have two statutory options: join NHI at city hall (notify within 14 days) or elect voluntary continuation of your employee insurance (apply within 20 days of losing eligibility).¹⁴²

flowchart TD
    A["Last working day"] --> B["Shakai Hoken lost from next day"]
    B --> C{"Departure soon after?"}
    C -->|"Yes, overseas cover starts now"| D["Rely on overseas policy"]
    C -->|"No, still living in Japan"| E{"Choose interim cover"}
    E -->|"Join NHI within 14 days"| F["NHI at city hall"]
    E -->|"Apply within 20 days"| G["Voluntary continuation (Nin'i Keizoku)"]
    F --> H["Withdraw from NHI with moving-out notification"]
    G --> I["Confirm with insurer whether membership continues abroad"]

The two options are priced on different bases (as of October 2026). Kyokai Kenpo calculates voluntary continuation premiums from your standard monthly remuneration at retirement times your prefecture’s rate, with the remuneration capped at 320,000 yen; because there is no employer share, the premium is roughly double what you paid while employed.¹⁹ NHI premiums are set by your municipality, so compare both before you choose.

Voluntary Continuation (Nin’i Keizoku): Conditions and Whether It Survives a Move Abroad

Voluntary continuation (Nin’i Keizoku 任意継続) requires at least 2 months of continuous coverage up to the day before you lost eligibility, and an application within 20 days of the loss date.¹³² Membership lasts up to 2 years, and missing the first premium deadline means you are treated as never having joined.²¹⁹

Article 38 of the Health Insurance Act lists seven ways membership ends: 2 years elapse, death, late premium payment, becoming an employee member again, joining seamen’s insurance, joining Late-Stage Elderly Medical Care, or a request to leave.² Members can now leave by application, with membership ending at the end of the month in which the request is accepted.²

Moving abroad is not on that list, but insurer practice varies. The Act does not end voluntary continuation when you leave Japan, and at least one health insurance society accepts members who become non-residents abroad, provided they keep a Japanese contact and pay into its domestic account (as of October 2026).²²⁰ Kyokai Kenpo publishes no position on overseas residence, so confirm with your insurer before you rely on it.¹⁹²¹

Even where membership continues, treatment abroad is not billed directly. Overseas claims would go through the overseas medical expense reimbursement (Kaigai Ryoyohi 海外療養費) process, covered in the guide to senior healthcare and medical insurance abroad. Dependents under voluntary continuation must meet the same domestic-residence rules as other employee-insurance dependents.²¹

Corporate Assignees (Chuzai): Why Your Shakai Hoken Usually Continues

If your Japanese employment contract continues during a posting abroad and the Japanese employer still pays at least part of your salary, the Japan Pension Service says your Shakai Hoken in principle continues; Article 36 ends coverage only when you are no longer employed by the Japanese workplace.²²² This usually describes a secondment that keeps your Japanese contract (Zaiseki Shukko 在籍出向); a full transfer to the overseas entity (Tenseki 転籍) ends that employment and so ends coverage.

Family members who accompany an assignee remain eligible dependents under a specific exception to the domestic-residence rule.²³ Whether a Social Security Agreement can spare you from paying into the host country’s health system depends on the agreement; only some of Japan’s agreements cover public medical insurance (as of October 2026).²⁴ See the guide to bilateral Social Security Agreements for the country detail.

Premium Settlement: Proration, Overpayment Refunds, and Final Invoices

Your final health insurance bill depends on which side of a month-end your loss date falls. A one-day shift in your move-out date or last working day can add or remove a whole month’s premium.

The Month-End Rule for NHI Premiums

NHI premiums for a mid-year withdrawal are charged monthly up to the month before the month of withdrawal. Funabashi City and Kawasaki City both state this rule; Kawasaki’s example of a withdrawal on 15 September gives April to August, or 5 months.²⁵²⁶ Combined with the day-after rule in Article 8, a month is billed if you are still insured on its last day.¹

Move-out date on the notification	NHI lost from	Last month billed
29 June	30 June	May (June not billed)
30 June	1 July	June

Premiums are calculated per fiscal year on the assumption that you stay until 31 March, so the bill you are paying when you withdraw does not change on the spot.²⁵ Funabashi recalculates the following month, refunds any overpayment and bills any shortfall in a final settlement (Seisan 精算).²⁵

Shakai Hoken Premiums in the Final Month

No employee premium is charged for the month in which you lose eligibility, if you were insured in the previous month.² Because loss happens the day after your last day, the same 29 June versus 30 June boundary applies to your last working day.

Last working day	Shakai Hoken lost from	June premium?
29 June	30 June	No
30 June	1 July	Yes

Leaving on the last day of a month can mean two premiums in one payslip. Japan Pension Service notes that when an employee resigns at month end, the employer may deduct both the previous month’s and the final month’s premiums from the final month’s salary.²⁷ This is a timing point to discuss with HR, not a reason on its own to change your leaving date.

Refunds of Overpaid Premiums and Paying Final Invoices From Abroad

Overpaid NHI premiums are refunded and shortfalls are billed after recalculation, which often happens after you have left.²⁵ Meguro City warns that if the withdrawal is filed very late, overpaid premiums may not be refundable (as of October 2026).⁸

Agree the settlement method before you leave. Otsu City asks departing residents to discuss where the change notice will be sent and how the balance will be settled (as of October 2026).⁶ Refunds are normally paid into a Japanese account, so confirm how yours will be paid.

Ask whether your municipality levies NHI as a premium or as a tax, and how a representative can receive notices for you. Appointing a representative and keeping a Japanese bank account open are covered in the guides to appointing a tax agent (Nohzei Kanrinin 納税管理人) and to retaining Japanese bank accounts abroad.

The Departure Day Coverage Cliff: Mitigating Interim Medical Gaps

The most expensive mistake in this process is a single uninsured day. The two Japanese loss dates rarely line up neatly with your flight, so plot them before you buy any overseas policy.

Exactly When Coverage Ends: NHI Loss Date vs Shakai Hoken Loss Date

NHI ends from the day after your move-out date; Shakai Hoken ends from the day after your last day of employment.¹² Otsu City ties the NHI loss date to the planned departure date, which normally matches your flight.⁶ For an employee who resigns early, the Shakai Hoken loss date can come weeks before departure.

flowchart LR
    A["Last working day"] --> B["Shakai Hoken lost: next day"]
    B --> C["Interim period in Japan"]
    C --> D["Moving-out notification filed"]
    D --> E["Departure date (move-out date)"]
    E --> F["NHI lost: next day"]
    B -.-> G["Overseas policy starts here unless interim cover is taken"]
    class C gap
    classDef gap fill:#f8d7da,stroke:#c0392b

Read the diagram as a warning: the shaded interim period is uninsured unless you joined NHI or elected voluntary continuation. If you were on NHI throughout, the cliff is the day after departure, so your overseas policy must be active on arrival.

Using Your My Number Card or Certificate After Eligibility Ends

Treatment received on a lapsed membership must be repaid (as of October 2026). Meguro City says that if you use the Maina Hokensho or a Certificate of Eligibility at a clinic after NHI ends, you will have to repay the medical costs NHI covered.⁸ Kyokai Kenpo says a mistakenly used certificate means repaying the insurer’s share, which is 7 to 9 tenths of the total cost, even if you have since joined NHI.¹⁷

Insurer records can take time to update after a resignation, so the online eligibility check may not reflect the change immediately (as of October 2026).¹⁸ That does not extend your coverage. If your departure date changes, tell the city hall counter, because the planned departure date drives both the loss date and the premium.⁶

Dependents Who Stay Behind or Study Abroad

Family members who stay in Japan need their own insurance once the employee’s coverage ends. NHI applies to them from the day the employee-insurance exclusion ends, so they should enroll at city hall.¹

Since 1 April 2020, employee-insurance dependents must have an address in Japan, judged by the resident record, under Article 3(7) of the Health Insurance Act.¹³²⁸ The Enforcement Regulations (Art. 37-2) allow five exceptions.²³

A student studying abroad.
A person accompanying an insured employee posted abroad.
A person temporarily abroad for tourism, recreation, volunteering or another non-work purpose.
A person whose family relationship with the insured began during the posting and who is equivalent to an accompanying family member.
Any other person whose base of life is recognized as being in Japan, considering the purpose of travel and other circumstances.

Each exception needs evidence, such as a visa, student ID or enrollment certificate for students, or an assignment order for accompanying family.²⁸ The employer must be notified when a dependent goes abroad or returns, and a dependent abroad who starts working or settles permanently stops being a dependent.²⁸ This exception belongs to employee health insurance; NHI has no equivalent.¹¹³

Bridging the Gap: International Private Medical Insurance (IPMI)

This section only maps the categories of cover. Product features and comparisons are covered in the guide to long-term travel and digital nomad health insurance, and retiree underwriting in the guide to senior healthcare and medical insurance abroad.

Travel Insurance vs Expat Health Insurance vs Destination Public Systems

Three kinds of cover can follow Japanese insurance, and they suit different departures. The table describes typical features at principle level; individual policy terms always prevail.

Type	When to buy	Typical term	Pre-existing conditions	Who it suits
Japanese overseas travel insurance (Kaigai Ryoko Hoken 海外旅行保険)	Before leaving Japan; many policies must be bought in Japan	Fixed trip length	Often excluded or limited	Short stays, students, the first months after arrival; not available if you have no plan to return to Japan²⁹
International private medical insurance (IPMI)	Before departure, often with medical underwriting	Annual, renewable	Underwritten case by case	Long-term movers without access to a public system
Destination public system or visa-mandated insurance	After arrival, per destination rules	Ongoing while resident	Depends on the system	Residents eligible for local public cover, possibly after a waiting period

Sequencing the Start Date So There Is No Uninsured Day

Set your overseas cover to start no later than the day your last Japanese coverage ends.¹² For an employee with no interim cover, that is the day after the last working day; for anyone on NHI until departure, it is the day after the move-out date.

Check whether a policy starts on purchase or only when you leave Japan, and keep the written proof of your Japanese coverage end date. If your destination’s public system has a waiting period, a private policy may need to cover that window too. If the insurer has no branch in Japan, check Insurance Business Act Article 186 before contracting while you still have an address or residence in Japan.³⁰

Step-by-Step Administrative Procedure & Timeline

Health insurance exit work starts about 3 months out, because the key decisions are your resignation date and your overseas policy. Use the checklist below alongside your wider departure plan.

Step	Timing	Applies to	Where / who
1. Confirm which system you and each dependent are in	T-3 months	Both	Insurer documents, HR
2. Choose your last working day with the month-end rule in mind	T-3 months	Shakai Hoken	HR
3. Check dependents abroad against the five exceptions	T-3 months	Shakai Hoken	HR / Japan Pension Service rules²⁸
4. Get quotes for overseas cover and check destination visa insurance rules	T-2 months	Both	Insurers, destination authority
5. Buy overseas cover with the correct start date	T-1 month	Both	Insurer
6. Tell HR your departure plan and ask for written proof of the coverage end date	T-1 month	Shakai Hoken	HR
7. Return Certificates of Eligibility (yours and dependents’)	Last working day	Shakai Hoken	HR¹⁷
8. Join NHI (within 14 days) or apply for voluntary continuation (within 20 days) if staying on in Japan	After resignation	Shakai Hoken	City hall or insurer¹⁴²
9. Withdraw from NHI and return the Certificate of Eligibility	With the moving-out notification	NHI	City hall NHI counter⁸⁵
10. Agree the settlement method and mailing address for final notices	Same visit	NHI	City hall NHI counter⁶
11. Stop using the My Number card or certificate at clinics after the loss date	From the loss date	Both	Clinics⁸¹⁷
12. Receive the final premium notice or refund	After departure	NHI	Domestic account or representative²⁵

Japanese Citizens vs. Foreign Residents: Critical Distinctions

The exit rules are the same for both groups; the consequences differ. Registered foreign residents are covered by NHI on the same address basis as citizens, with only non-registered and certain short-stay foreign nationals excluded.¹¹⁴

Topic	Japanese citizens	Foreign residents (PR, long-term, work and student visas)
Keep NHI from abroad after deregistering	Not possible¹	Not possible¹
Short absence without deregistering	NHI and premiums continue where the municipality treats you as still resident⁹	Same; if you leave on a Special Re-entry Permit (Minashi Sainyukoku みなし再入国) and your municipality still treats you as resident without a moving-out notification, premiums keep running⁹³¹
My Number card after departure	May stay valid abroad but no longer proves Japanese insurance; see the My Number card guide	Card handling on departure differs; see the My Number card guide
Unpaid premium consequences	Arrears and collection by the municipality or insurer	Also weighed in Permanent Residence applications and, from 1 April 2027, a possible revocation ground if wilful³²³³
Re-enrolling on return	NHI applies once a new address in Japan is registered¹	Same, once registered as a resident¹

Foreign residents should treat unpaid premiums as an immigration issue, not just a debt. The ISA Permanent Residence guideline counts public medical insurance and pension as non-tax public charges and assesses improper payment negatively (as of October 2026).³² A 2024 amendment, scheduled to take effect on 1 April 2027, allows Permanent Resident status to be revoked (in most cases converted to Long-Term Resident) for wilful non-payment of taxes and social insurance premiums, including NHI and employee health insurance premiums (as of October 2026).³⁴³³

“Wilful” has a specific meaning in the ISA revocation guideline: knowingly choosing not to pay despite knowing the obligation, not mere arrears or non-payment for unavoidable reasons.³³ The rule is not in force as of October 2026, but once it applies, wilful non-payment after PR was granted and before 1 April 2027 can count, though not on a single pre-enforcement point alone.³³ Settling your final NHI bill before you leave, or arranging payment from abroad, avoids the issue.

Pension choices are a separate decision. Voluntary National Pension enrollment and the lump-sum withdrawal payment (Dattai Ichijikin 脱退一時金) are covered in the guides on Japanese citizens versus foreign residents and on pensions.

Common Pitfalls & Regulatory Compliance Risks

Most problems come from assumptions, not paperwork. Check your plan against this list.

Assuming you can keep paying NHI from abroad. Once you deregister, NHI ends; there is no voluntary overseas membership.¹⁹
Skipping the NHI counter where it is required. Meguro requires an in-person visit for overseas moves even though domestic moves end NHI automatically.⁸
Resigning mid-month and assuming you are covered until the flight. Shakai Hoken ends the day after your last day; the NHI 14-day and voluntary continuation 20-day windows are short.¹⁴²
Resigning on the last day of a month without expecting that month’s premium. It is owed and may be deducted together with the previous month’s premium.²²⁷
Using the My Number card or a certificate at a clinic after the loss date. You will repay the insurer’s share of the cost, 7 to 9 tenths.⁸¹⁷
Filing the NHI withdrawal late. Overpaid premiums may become non-refundable.⁸
Assuming a dependent abroad stays covered. A dependent who starts working or settles permanently abroad stops being a dependent.²⁸
Calling Maru-gaku an overseas student rule. It applies only to study within Japan.¹¹²
Relying on voluntary continuation abroad without asking the insurer. Practice varies, and Kyokai Kenpo publishes no position.¹⁹²⁰
Closing your Japanese bank account before the final premium settlement. Refunds and shortfall bills often arrive after departure.²⁵
A Chuzai assignee assuming coverage continues after a full transfer. Coverage follows the Japanese employment relationship.²
Foreign residents leaving unpaid premiums behind. They can weigh against Permanent Residence applications now, and wilful non-payment becomes a revocation ground from 1 April 2027 (as of October 2026).³²³³

References & Official Sources

e-Gov (Digital Agency / MHLW), 国民健康保険法 (National Health Insurance Act, Act No. 192 of 1958), Arts. 5, 6, 7, 8, 76, 116, consolidated revision enforced 1 October 2026, fetched via e-Gov API October 2026, https://laws.e-gov.go.jp/law/333AC0000000192 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵
e-Gov, 健康保険法 (Health Insurance Act), Arts. 36, 37, 38, 48, 156, consolidated revision enforced 1 October 2026, fetched via e-Gov API October 2026, https://laws.e-gov.go.jp/law/211AC0000000070 ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸
Ministry of Health, Labour and Welfare, “資格確認方法について”, 2026, fetched October 2026, https://www.mhlw.go.jp/stf/newpage_50657.html ↩ ↩² ↩³
Ministry of Health, Labour and Welfare, web magazine “医療機関・薬局では、マイナ保険証か資格確認書をご提示ください”, 2026 (date not shown on page), fetched October 2026, https://www.mhlw.go.jp/stf/web_magazine/closeup/50.html ↩ ↩² ↩³ ↩⁴
Ota City, “国民健康保険の加入・喪失・再交付の手続き”, updated 1 September 2026, fetched October 2026, https://www.city.ota.tokyo.jp/seikatsu/kokunen/kokuho/kanyuu.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶
Otsu City (Shiga), departure procedures checklist “syukkoku.pdf” (国民健康保険・後期高齢者医療制度 row), PDF dated 7 January 2026, fetched October 2026, https://www.city.otsu.lg.jp/material/files/group/228/syukkoku.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹
Japan Pension Service, “従業員が退職・死亡したとき（健康保険・厚生年金保険の資格喪失）の手続き”, updated 1 October 2026, fetched October 2026, https://www.nenkin.go.jp/service/kounen/tekiyo/hihokensha1/20150407-02.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶
Meguro City, “国民健康保険の脱退の届出”, updated 1 April 2026, fetched October 2026, https://www.city.meguro.tokyo.jp/kokuho/kurashi/kokuho/dattai_todoke.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³
Okayama City, FAQ “海外に引っ越しするとき、国民健康保険はどうしたらいいですか？”, posted 6 March 2023, fetched October 2026, https://www.city.okayama.jp/faq/faq_detail.php?frmId=843 ↩ ↩² ↩³ ↩⁴ ↩⁵
e-Gov, 国民年金法 (National Pension Act, Act No. 141 of 1959), Supplementary Provisions Art. 5(1)(iii), current revision enforced 1 October 2026, fetched October 2026, https://laws.e-gov.go.jp/law/334AC0000000141 ↩
e-Gov, 社会保障協定の実施に伴う厚生年金保険法等の特例等に関する法律 (Act on Special Provisions for the Implementation of Social Security Agreements, Act No. 104 of 2007), Art. 8, revision enforced 1 October 2026, fetched October 2026, https://laws.e-gov.go.jp/law/419AC0000000104 ↩
Meguro City, “修学や施設入所のために区外へ転出するときの届出”, updated 1 October 2025, fetched October 2026, https://www.city.meguro.tokyo.jp/kokuho/kurashi/kokuho/marugaku.html ↩ ↩²
e-Gov, 健康保険法 (Health Insurance Act, Act No. 70 of 1922), Art. 3(4) and 3(7), consolidated revision enforced 1 October 2026, fetched via e-Gov API October 2026, https://laws.e-gov.go.jp/law/211AC0000000070 ↩ ↩² ↩³ ↩⁴
e-Gov, 国民健康保険法施行規則 (NHI Act Enforcement Regulations), Arts. 1 and 3 and supplementary provisions (ordinance effective 令和六年十二月二日), consolidated revision enforced 1 October 2026, fetched via e-Gov API October 2026, https://laws.e-gov.go.jp/law/333M50000100053 ↩ ↩² ↩³ ↩⁴ ↩⁵
Ministry of Health, Labour and Welfare, “マイナンバーカードの健康保険証利用についてよくある質問” (Q8, Q9, Q40), fetched October 2026, https://www.mhlw.go.jp/stf/newpage_40406.html ↩ ↩²
Koto City, National Pension page on overseas moves (第1号被保険者 loss “転出日の翌日付”), updated 15 May 2026, fetched October 2026, https://www.city.koto.lg.jp/060306/kurashi/nenkin/kokumin/todokede/5212.html ↩
Japan Health Insurance Association (Kyokai Kenpo) Saitama Branch, “《退職》退職後の資格確認書の取り扱いについて”, fetched October 2026, https://www.kyoukaikenpo.or.jp/shibu/saitama/public_relations/018/index.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶
Japan Health Insurance Association (Kyokai Kenpo) Tokushima and Miyagi Branches, “退職等による保険証の返却・回収について” and “《就職、退職》マイナ保険証や資格確認書の使用について”, search-verified October 2026, https://www.kyoukaikenpo.or.jp/shibu/tokushima/public_relations/003/008/index.html and https://www.kyoukaikenpo.or.jp/shibu/miyagi/public_relations/019/index.html ↩ ↩²
Japan Health Insurance Association (Kyokai Kenpo), “任意継続”, fetched October 2026, https://www.kyoukaikenpo.or.jp/g3/sb3270/ ↩ ↩² ↩³ ↩⁴
Microsoft Health Insurance Society (マイクロソフト健康保険組合), “退職した後は”, fetched October 2026, https://www.microsoftkenpo.or.jp/member/benefit/retire_a.html ↩ ↩²
Japan Health Insurance Association (Kyokai Kenpo), Nin’i Keizoku FAQ and “任意継続被保険者被扶養者（異動）届”, search-verified October 2026, https://www.kyoukaikenpo.or.jp/faq/voluntary_continuation/010/index.html and https://www.kyoukaikenpo.or.jp/application_form/voluntary_continuation/002/index.html ↩ ↩²
Japan Pension Service, leaflet 「日本国内の厚生年金保険適用事業所での雇用関係が継続したまま海外で勤務する場合…」 (pay and remuneration of overseas workers), c. 2014, accessed October 2026, https://www.nenkin.go.jp/oshirase/taisetu/2014.files/0000020022FUlxbluFis.pdf ↩
e-Gov, 健康保険法施行規則 (Health Insurance Act Enforcement Regulations), Art. 37-2, consolidated revision enforced 1 October 2026, fetched via e-Gov API October 2026, https://laws.e-gov.go.jp/law/215M10000008036 ↩ ↩²
Japan Pension Service, “協定を結んでいる国との協定発効時期および対象となる社会保障制度”, updated 27 October 2025, fetched October 2026, https://www.nenkin.go.jp/service/shaho-kyotei/kunibetsu/kyoteitimesystem.html ↩
Funabashi City, FAQ “年度途中で国民健康保険に加入または脱退した場合の保険料はどうなりますか。”, updated 22 March 2022, fetched October 2026, https://www.city.funabashi.lg.jp/faq/kenkou/kokuho/002/p020437.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶
Kawasaki City, FAQ on NHI premiums when withdrawing mid-year, updated 1 January 2025, fetched October 2026, https://www.city.kawasaki.jp/templates/faq/350/0000115890.html ↩
Japan Pension Service, “退職した従業員の保険料の徴収”, updated 30 March 2012, fetched October 2026, https://www.nenkin.go.jp/service/kounen/hokenryo/nofu/20120330-01.html ↩ ↩²
Japan Pension Service, “従業員の家族が海外居住の場合の手続き”, updated 6 October 2026, fetched October 2026, https://www.nenkin.go.jp/service/kounen/tekiyo/hihokensha1/kyojuyoken.html ↩ ↩² ↩³ ↩⁴ ↩⁵
General Insurance Association of Japan, 損害保険Q&A 問77 「海外旅行保険は、どのような保険ですか。」, fetched October 2026, https://soudanguide.sonpo.or.jp/body/q077.html ↩
e-Gov, 保険業法 (Insurance Business Act, Act No. 105 of 1995), Art. 186, revision enforced 12 August 2026, fetched October 2026, https://laws.e-gov.go.jp/law/407AC0000000105 ↩
Kobe City, foreign-resident living guide (Japanese edition), search-verified October 2026, https://www.city.kobe.lg.jp/documents/48/nihon.pdf ↩
Immigration Services Agency of Japan, “永住許可に関するガイドライン（令和８年１０月１日改定）”, fetched October 2026, https://www.moj.go.jp/isa/10_00279.html ↩ ↩² ↩³
Immigration Services Agency of Japan, “永住者の在留資格の取消しに関するガイドライン” (令和８年１０月１日策定), fetched October 2026, https://www.moj.go.jp/isa/content/001416944.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵
Immigration Services Agency of Japan, “令和６年入管法等改正について”, fetched October 2026, https://www.moj.go.jp/isa/05_00045.html ↩