Procedures › Health insurance and pension
My wardsNational Health Insurance premium bill
Overview
How the National Health Insurance premium bill works in the ward. Each fiscal year's bill is sent to the household head in July, and the premium is based on the household's income from January to December of the previous year. For a full year of enrolment, the premium is paid in nine instalments from July to March. A month counts in full if you are enrolled on its last day. If income was declared late, the bill may not reflect it. Until a new bill arrives after a change, pay the amount you were told. Questions go to the National Health Insurance and Pension Section, Eligibility and Premium.
Why you receive a bill
The bill is sent to the household head on the resident register, because the household head is liable for the premium under the National Health Insurance Act. This applies even if the head is not enrolled. A separate bill is issued for each insurance number, so one year can have several bills. Each bill gives the reason it was sent.
| Reason shown on the bill | What it means |
|---|---|
| Initial decision | The premium for the year was set for the first time |
| Initial decision (reduction applies) | The premium was set for the first time, and a reduction of the equal part applies |
| Joining or leaving | A member joined or left the ward's National Health Insurance, including moves from another city |
| Change of household head | The household head on the resident register changed |
| Change in eligibility | A reduction for people who lost their job involuntarily applied, or members were added or removed through a merger or a move |
| Care level 2 | The care part was added from the month of the 40th birthday (or the month before, for a birthday on the 1st) |
| Tax income information found or changed | Tax income information of the household head or members was found or changed |
| Special collection stopped | Collection from pension was stopped because of a change in eligibility |
Months of payment
The ward sets the premium for the new fiscal year in July, after the resident tax is set in May and June, so payments start in July. For a person enrolled from April, the premium for 12 months is paid in nine instalments from July to March. A month counts as a full month if you are enrolled on its last day. There is no daily pro-rating.
Moving from another city
When you move in from another city, the ward asks your previous city for the income data used to calculate the premium. If the bill shows an empty income column, the premium is calculated on the equal part only, and it is recalculated when the data arrives. Keep paying the current amount until then. If the recalculation does not change the premium, no notice is sent.
- Each city sets its own calculation method, so the same income can give a different premium.
- The number of instalments differs, and the premium for 12 months is usually paid in nine instalments from July to March in the ward.
Reductions and declarations
The premium is based on income from the previous year, so a low income can lead to a reduction. Student status is not a condition. If you had Japanese salary income last year and your employer sent a report to the ward's resident tax section, you generally do not need to file a declaration. If you lived abroad from January to December of the previous year with no income in Japan, a simplified declaration form may reduce the premium.
| Registered address on 1 January | Form to file | Where to send it |
|---|---|---|
| Abroad | Simplified declaration form for National Health Insurance premiums | National Health Insurance and Pension Section, 03-5432-2331 |
| In the ward | Resident tax return | Taxation Section |
| Elsewhere in Japan | Resident tax return | The city where you lived on 1 January |
Why the premium may rise
- The maximum amount was raised compared with the previous year.
- Medical costs per person have risen, because of population ageing and more advanced medicine.
- The child and childcare support levy was added from fiscal year 2026.
- The household's income rose, a member was added, a member turned 40, or a member's income was not declared.
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- Check the reason for the bill and the months of enrolment shown on it.
- Pay each instalment by its due date.
- Report any change of enrolment or household, so that a new bill can be issued.
Contact
National Health Insurance and Pension Section, Eligibility and Premium, 03-5432-2331, fax 03-5432-3038
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