Japan health ministry plans upfront premiums for foreigners

The measure targets low payment compliance amongst foreign residents.

Japan’s Health Ministry plans to allow municipalities to require foreign residents to pay national health insurance premiums upfront, starting as early as April 2026, according to Japanese news agency ANN.

The measure targets low payment compliance amongst foreign residents, who paid premiums only 63% of the time in 2024, compared to 93% for all residents.

The proposed system would collect lump-sum payments—potentially covering up to one year—when foreign residents register with local governments. 

Municipalities will decide whether to adopt the system, as refunding payments after residents relocate could add administrative burdens.

The ministry will also improve tracking of payment records by fiscal 2026. From June 2027, the Immigration Services Agency may use premium payment data to assess residence status renewals. Failure to pay could lead to visa non-renewal.