Health insurance and pension after leaving a job
Options, premiums, exemption, and high medical costs
When you leave a job in Japan, your employer's health insurance and Employees' Pension end on the day after your last day. This page explains your options and costs, based on official information from the Japan Pension Service, Kyokai Kenpo, and the Ministry of Health, Labour and Welfare.
Checked against official pages in October 2026.
Key points
- Health insurance: join National Health Insurance within 14 days, or continue your employer's insurance within 20 days, or become a dependent of a family member
- National Pension: ¥17,920 a month (FY2026). People who lost their job can apply for an exemption regardless of their own previous income
- Monthly medical costs have a cap: about ¥92,940 for ¥1,000,000 of medical costs in income bracket C (from August 2026)
This site is mainly in Japanese. English pages: Leaving a job in Japan (checklist) ・ Unemployment benefits calculator ・ How to quit a job ・ Immigration notification ・ Resident tax ・ Health insurance and pension ・ Lump-sum withdrawal calculator
Health insurance: three options
| Option | Deadline | Premium |
|---|---|---|
| National Health Insurance (国民健康保険) | Within 14 days, at your city or ward office | Based on your previous year's income; differs by city |
| Voluntary continuation of your employer's insurance (任意継続, up to 2 years) | Within 20 days from the day after you leave | Your standard monthly remuneration at leaving (capped at ¥320,000 for Kyokai Kenpo) × the rate for your prefecture |
| Dependent of a family member | Ask the family member's employer | None, if your income is low enough |
Japanese calculators: 健康保険の比較 (compare the options) and 国民健康保険料が高い市・安い市 (premiums by city).
High medical costs: the monthly cap
If your medical costs in a month are high, the amount you pay is capped and the rest is refunded as the high-cost medical expense benefit (高額療養費). The caps were raised for care from August 2026 (people under 70).
| Income bracket | Monthly cap | From the 4th time in 12 months |
|---|---|---|
| A | ¥270,300 + (total cost − ¥901,000) × 1% | ¥140,100 |
| B | ¥179,100 + (total cost − ¥597,000) × 1% | ¥93,000 |
| C | ¥85,800 + (total cost − ¥286,000) × 1% | ¥44,400 |
| D | ¥61,500 | ¥44,400 |
| E (resident-tax exempt) | ¥36,900 | ¥24,600 |
- The bracket is based on your standard monthly remuneration (employer's insurance and voluntary continuation) or your household's previous-year income (National Health Insurance). Bracket C is a standard monthly remuneration of ¥280,000 to ¥500,000
- If you switch from your employer's insurance to National Health Insurance, the count for the lower cap from the 4th time starts again
- With a My Number health insurance card, you pay only up to the cap at the hospital. Meals during a hospital stay and private-room charges are not included
Japanese calculator: 高額療養費の計算. Source: Kyokai Kenpo (in Japanese)
National Pension and the premium exemption
People aged 20 to 59 who live in Japan and are not covered by an employer join National Pension within 14 days (Japan Pension Service). The premium is ¥17,920 a month in FY2026. If you lost your job, you can apply for an exemption regardless of your own previous income, but the income of your spouse and the head of your household is still checked.
| Level | Monthly premium you pay | Reduction in your future pension (per year exempt) |
|---|---|---|
| Full exemption | ¥0 | about ¥10,591 |
| 3/4 exemption | ¥4,480 | about ¥7,943 |
| 1/2 exemption | ¥8,960 | about ¥5,296 |
| 1/4 exemption | ¥13,440 | about ¥2,648 |
| Payment postponement (under 50) | ¥0 | about ¥21,183 |
You can pay exempted premiums later, within 10 years, so that your pension is not reduced. If you do not pay the reduced premium under a partial exemption, the months are treated as unpaid. Japanese calculator: 国民年金の免除. Japan Pension Service leaflet (English, PDF)
FAQ
Which is cheaper, National Health Insurance or voluntary continuation?
It depends on your previous year's income, your city, and your family. Voluntary continuation is often cheaper in the first year after leaving a well-paid job. The Japanese calculator 健康保険の比較 compares them.
Does a pension exemption reduce my future pension?
Yes, partly. A full exemption for 1 year reduces your old-age basic pension by about ¥10,591 a year. You can pay the exempted premiums later (within 10 years) to avoid the reduction.
I will leave Japan soon. Should I still join National Pension?
Yes, while you live in Japan you must join. When you leave, you may be able to claim the lump-sum withdrawal payment for the months you paid.
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