Japan is preparing to introduce new regulations that would tie foreign residents’ ability to renew or change their residency status to their record of public health insurance and pension payments.
According to government sources, the Ministry of Health, Labor and Welfare – in collaboration with the Immigration Services Agency – plans to incorporate insurance and pension payment histories into the screening process for residency applications. This policy shift is scheduled for implementation in June 2027, according to NHK World Japan’s report.
Currently, all foreign nationals who reside in Japan for three months or longer are required to enrol in the country’s national pension and health insurance systems. However, recent data indicate that compliance remains an ongoing challenge.
The Ministry of Health, Labor and Welfare reported that, for the fiscal year ending March 2025, foreign residents contributed less than half (49.7%) of the pension amounts owed.
Additionally, a survey of 150 municipal governments found that foreign residents had paid an average of 63% of their health insurance premiums by the end of the previous year.
Instances have also been reported where foreign nationals have departed Japan with unpaid health insurance premiums, despite having utilised public healthcare services.
In a parallel development, the ruling Liberal Democratic Party (LDP) has recommended that foreign residents be required to pay national health insurance (NHI) premiums in advance at the time of enrolment. Under the current system, enrolees receive a bill by mail after registering. The proposed change would require local governments to collect premiums for a set period during the initial registration process.
A recent government review found that only 63% of foreign residents pay their NHI premiums, compared to a 93% payment rate among all enrolees, including Japanese citizens. According to the LDP committee, one factor contributing to lower payment rates is a lack of familiarity among foreign residents with Japan’s insurance and tax systems.
To address this, the committee has suggested that information about insurance obligations be provided before individuals arrive in Japan. The committee also proposed additional measures to improve compliance and transparency. These include sharing data on unpaid premiums for use in immigration-related decisions and regularly publishing statistics on premium collection and disbursement.
These policy discussions coincide with a broader review by the Ministry of Health, Labor and Welfare into how foreign residents participate in the public health insurance system. The ministry began examining the balance between contributions and benefits for non-citizen enrolees in April 2025.
As of the fiscal year ending March 2024, approximately 970,000 foreign nationals were enrolled in the NHI, accounting for about 4% of all participants. During this period, the system paid out ¥980.3 billion in reimbursements, with ¥11.8 billion (1.2%) going to foreign enrolees.
Ministry officials noted that this proportion aligns with the group’s share of total membership.
