NHI Enrollment at the Ward Office

NHI enrollment at the ward office is the 14-day filing that puts a new arrival or job leaver onto public coverage.¹² The counter takes your residence and My Number details, opens the qualification from the eligibility date, and mails the proof you show at clinics.³⁴

Confirm current details with official sources

Procedures, fees, and requirements can change. Confirm current details at the ward or city office covering your registered address. This article is general information, not medical advice; for decisions about your own care, consult a licensed healthcare provider.

Overview

Japan requires every resident to hold some form of public health insurance, and the 国民健康保険 (kokumin kenkō hoken, "National Health Insurance, NHI") is the municipality-run scheme for residents outside employer coverage.⁵² Members pool premiums, and the insurer pays the scheduled share behind the clinic counter.⁵

This article covers the ward-office enrollment procedure only. It walks through the 14-day triggers, the bring-list by case, the counter sequence, the proof you leave with, household handling, and first-year premium coordination.³⁴ Ward offices vary in counter names and delivery speed, so confirm with the office covering your registered address.³⁴

When enrollment is due

The 世帯主 (setai nushi, "head of household") must file the enrollment notification within 14 days of the qualifying event.⁵³¹ Any same-household member may file in practice, while a proxy outside the household needs a power of attorney plus identification.⁴⁶

Eligibility runs from the day you should have enrolled, not from the filing date.¹ Late filing does not save money. Premiums run back to the eligibility month, and interim medical costs are generally full self-pay unless the delay was unavoidable.³²

New arrival, job leaver, and returnee triggers

A move into the municipality starts the clock from the move-in date, whether the move is from abroad or from another Japanese city.¹⁴² Return from abroad follows the same move-in path at the new address counter.³⁴

Leaving an employer plan starts the clock from the loss-of-coverage date, normally the day after retirement.³⁴ End of public assistance and birth of a child carry the same 14-day duty.¹⁴

Required documents

Since January 2016, filers write the マイナンバー (mai nanbā, "My Number") of the household head and each enrolling member on the form, then present My Number confirmation plus identity confirmation documents.³⁴ Bring originals, not copies, for the counter check.

The table below separates the two cases in scope. Confirm the exact row with your ward office before going, since counters phrase the same requirement in slightly different words.³⁴

New arrival document set

New foreign-resident filers bring the residence card or special permanent resident certificate plus the passport.⁵³² The 在留カード (zairyū kādo, "residence card") proves stay status and address, while the passport backs identity and nationality.⁵

Bring the My Number Card if held, otherwise a My Number confirmation document such as the notification card or a My Number-bearing residence record.³⁴²⁶ Designated Activities holders add the passport with the DESIGNATION slip attached for purpose check.⁵³

Item	What to bring	Notes
Residence status	Residence card or special permanent resident certificate	Physical card5
Identity backup	Passport	Asked in most wards56
My Number link	My Number Card if held, otherwise notification or record	Written onto the form3
Purpose check	DESIGNATION slip, Designated Activities only	Attached inside passport3

Where the granted stay is three months or less, add proof of a longer planned stay in the ward, such as an agency contract or school enrollment certificate.⁵³⁶

Transitioner document set

Leavers of an employer plan bring proof of the loss date, normally the 健康保険資格喪失証明書 (kenkō hoken shikaku sōshitsu shōmeisho, "Certificate of Loss of Eligibility").⁵³⁴ The former employer or insurer certifies the date, and blank forms sit at the ward office too.⁶

Where no dependents are involved, a retirement certificate or separation slip may substitute.³⁴ Dependent removals need the insurer-issued loss certificate; the retirement paper alone does not cover a removed dependent.³

Item	What to bring	Notes
Loss-date proof	Certificate of Loss of Eligibility	Names the end date5
Substitute, no dependents	Retirement certificate or separation slip	Ward confirms scope3
Delay fallback	Printed MynaPortal health-insurance screen per ward instruction	Shibuya path when the certificate stalls3

Ask the former employer for the loss certificate on the last day

The ward cannot open NHI without the loss date on paper. Requesting the certificate before leaving the job removes the most common second-trip cause.³

At the counter: the enrollment sequence

Complete the residence-record move first at the resident-registry counter, then file NHI enrollment at the 国民健康保険課 (kokumin kenkō hoken ka, "NHI counter or division") in the same building.³ The sequence below shows the one-visit order.

Shibuya handles foreign-resident enrollment at the 3rd-floor NHI Division, with branch offices covering most cases except overseas move-ins routed to the resident-registry section.³ Shinjuku accepts enrollment at the main-building Medical Insurance and Pension Division plus any special branch office regardless of jurisdiction.⁴ Osaka routes the same filing to the ward-office health-insurance and pension section within 14 days of eligibility.⁶⁷

Electronic and mail filing exist for loss-of-coverage and assistance-ending cases, with scope varying by ward.³⁴ A same-household member may file; an outside proxy adds the proxy letter.⁴⁶

Address registration first, NHI counter second

Address registration and NHI enrollment fit in one building visit in dependency order.³ The NHI desk reads the freshly registered address, so reversing the order forces a wait.

Keep the moving-out certificate where an inter-municipal move requires it. The 転出証明書 (tenshutsu shōmeisho, "moving-out certificate") is the paper the prior office issued, and the new office may ask for it where held.³⁴

Payment setup and what arrives by mail

New members choose bank auto-debit with a cash card or mailed transfer form, or pay by mailed slip at banks, post offices, convenience stores, or ward counters (as of 2025-11-19; confirm current payment points with your ward office).² Shibuya sends NHI invoices in June for the year, and Toshima sends slips yearly in June absent mid-year changes (as of 2026-04-01).⁵²

Auto-debit lands on the last day of each month, or the next business day on bank holidays, with funds in place by the prior day (as of 2025-11-19).² Shinjuku mails the Confirmation Form or information notice home in principle, with counter handover only on a government photo ID and mail delivery for proxy filings.⁴

Step	Timing	Notes
Filing deadline	Within 14 days of trigger	Statutory1
Premium start	Eligibility month, not filing month	Retroactive3
Osaka issuance notice	Mailed 2 to 3 days after application, then collected at counter	Ward-specific7
Proof delivery	Mailed to household head in Tokyo wards	Counter handover is the exception4

Proof of coverage you leave with

Since 2024-12-02 no new plastic insurance cards are issued, and existing cards expired at most on 2025-12-01; reception now runs on Maina-Hokensho or the Eligibility Confirmation Form.⁸⁹ NHI membership is household-based, but proof is issued one per person.⁸

Holders of the linked card receive an A4 information notice that cannot be used alone.⁸ Non-holders receive a card-size Confirmation Form usable alone.⁸ The diagram below keeps the two apart.

Physical card versus Maina-Hokensho linkage

The マイナ保険証 (maina hokenshō, "My Number Card registered for health-insurance use") verifies qualification through the clinic reader instead of a plastic card.⁸⁹ First-time registration takes one of three paths: the face-recognition reader at a clinic or pharmacy, MynaPortal, or a Seven Bank ATM.⁹

The 資格確認書 (shikaku kakuninsho, "Eligibility Confirmation Form") carries qualification details with a printed expiry and is reissued on address, name, or share changes.⁸ The 資格情報のお知らせ (shikaku jōhō no oshirase, "Eligibility Information Notice") has no expiry except ages 70 to 74 and is reissued only on defined field changes.⁸

The Confirmation Form is issued free by the enrolled insurer without application for the first delivery to non-holders.⁸⁹ Where the reader fails, present the linked card with the MynaPortal qualification screen or the notice for residents without smartphones.⁸⁹

The notice alone never certifies a visit

The A4 notice supports the linked card during reader failure but cannot be presented alone. The card-size Confirmation Form alone does certify the visit.⁸

Care before the proof arrives

Insured care requires the Confirmation Form or linked card from the delivery date; Shinjuku states care is insured only from the delivery date onward.⁴ Plan non-urgent visits after the mail arrives.

Emergency or unavoidable care without the proof can be reimbursed afterward for the insured share, including authorized equipment such as surgical corsets.⁵ High counter payments above the monthly ceiling can be reduced in advance by application or refunded afterward.⁵

Household handling

Premiums are calculated per household on prior-year income plus headcount, and the household head bears the payment duty for the whole household.⁵² Members pay from the enrollment month and stop at the month before withdrawal.⁵²

Moves within the ward, moves out, head-of-household or name changes, births, deaths, joining another scheme, and card loss each need notification within 14 days.⁵³ Items affecting the residence record need the registry update too.⁵

Joining an employer plan does not auto-cancel NHI.⁸ The household must file withdrawal and return the proof, or face double billing and benefit-repayment claims.⁸

Premiums and residence-tax coordination

NHI fees use the prior year's income on a per-household basis.⁵² New arrivals with no prior-year Japanese taxable income are assessed near-zero income-rated amounts and pay the per-capita and household-rated floors.²

Even zero- or low-income residents must file a resident-tax report, or for post-2020-01-02 arrivals an NHI premium-related report at the NHI Section, so the reduction check can run; without it the bill can come out higher.² The counter step sets the qualification while the later mailed notice sets the amount (as of 2025-11-19).²

Non-payment draws reminders, employer or bank inquiries, seizure action, full-cost care exposure, and possible residence-status consequences at immigration.² Where payment is difficult, ask the ward office about a payment plan before the due date passes.²

Good to know

File late and you still pay from the due date

The 14-day clock starts at the qualifying event, not at the first doctor visit.¹ New arrivals should treat the NHI counter as part of the same ward-office trip as address registration: register the address, then walk to the insurance counter before leaving the building.³ Premiums run back to the eligibility month for up to two years, and interim bills stay full self-pay unless the delay was unavoidable.³²

One ward procedure does not prove the next ward

Shibuya routes overseas arrivals to the resident-registry section first and mails proofs, Shinjuku allows any branch office with mail delivery in principle, and Osaka mails an issuance notice in 2 to 3 days for counter pickup.³⁴⁷ Counter names, issuance speed, and accepted filing channels move at municipal boundaries.³⁴ Confirm with the office covering the new address rather than generalizing from any single city's procedure.

Keep the termination certificate even after enrollment succeeds

The ward needs the loss date to open NHI, and a missing or delayed certificate stalls the filing.³ Shibuya's MynaPortal-screen fallback exists for exactly this stall, but the paper remains the cleaner path.³ Store it with the premium notices in case the former insurer and the ward reconcile the switch months later.⁴

Register Maina-Hokensho linkage before a sick day forces the issue

Non-holders carry the Confirmation Form alone, while holders carry the linked card plus the portal screen or notice when readers fail.⁸⁹ MynaPortal or Seven Bank ATM registration takes minutes when well, and the same task at a crowded reception during illness is the harder version.⁹ Check registration status at MynaPortal Home before the first clinic visit.⁹

See also

• How Japan's Universal-Coverage System Works
• Health Insurance and Pension for Freelancers
• Who Enrolls in National Health Insurance
• NHI Premium Calculation
• Residence Card: Japan's Foreign-Resident ID
• Your First 90 Days in Japan: The Setup Checklist

References

Footnotes

1. Shinjuku City (Foreign Language Top Page). "Enrolling, Withdrawing and Other Procedures (National Health Insurance)" (English). https://www.foreign.city.shinjuku.lg.jp/en/kurashi/kokuhotodokede/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

2. Toshima City. "National Health Insurance (NHI)" (English, Daily Life Information for Foreign Residents). Updated 2025-11-19. https://www.city.toshima.lg.jp/info/en/insurance.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸

3. Shibuya City. 「手続き・届出 | 国民健康保険」. Updated 2026-04-01. https://www.city.shibuya.tokyo.jp/kurashi/kokuho/kokuho/kokuho_tetsuzuki_todokede.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³ ↩²⁴ ↩²⁵ ↩²⁶ ↩²⁷ ↩²⁸ ↩²⁹ ↩³⁰ ↩³¹ ↩³² ↩³³ ↩³⁴

4. Shinjuku City. 「国民健康保険の届出について」. Updated 2026-08-13. https://www.city.shinjuku.lg.jp/hoken/file02_02_00001.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹ ↩²⁰ ↩²¹ ↩²² ↩²³

5. Shibuya City. "National Health Insurance (NHI) | LIVING IN SHIBUYA" (English). https://www.city.shibuya.tokyo.jp/contents/living-in-shibuya/en/health/insurance.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵ ↩¹⁶ ↩¹⁷ ↩¹⁸ ↩¹⁹

6. International House, Osaka. "How can I enroll in the National Health Insurance program?" 2020-01-09. https://www.ih-osaka.or.jp/english/faq/kokuhokanyuu/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷

7. Osaka City. "Information on the National Health Insurance System" (English guidebook PDF, 2023 edition). https://www.city.osaka.lg.jp/fukushi/cmsfiles/contents/0000414/414584/english2023.pdf ↩ ↩² ↩³

8. Shibuya City. 「加入・脱退の条件、保険証など（資格確認書・資格情報のお知らせ）」. Updated 2026-07-01. https://www.city.shibuya.tokyo.jp/kurashi/kokuho/kokuho/kanyu_hokensyo.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³

9. Digital Agency, Government of Japan. "Use of health insurance card in My Number Card" (English). Updated 2026-02-19. https://www.digital.go.jp/en/policies/mynumber/insurance-card ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸