NHI Premium Reductions and Exemptions

NHI premium reduction in Japan lowers the bill for low-income households and hardship cases enrolled in National Health Insurance.¹² The system runs on two tracks: an automatic cut for households below income thresholds, and an application-based exemption when income collapses through job loss, closure, or disaster.¹³

Confirm current details with official sources

Procedures, fees, and requirements can change. Confirm current details at your municipal ward office or city office NHI counter.

Overview

The 国民健康保険 (kokumin kenkō hoken, "National Health Insurance, NHI") premium is calculated per household from prior-year income plus per-capita and per-household portions, and the head of household pays the total.¹²⁴ Statutory reduction, or 法定軽減 (hōtei keigen, "statutory reduction"), cuts the per-capita and per-household portions automatically when household income falls below set bands.¹ Hardship relief, or 減免 (genmen, "reduction or exemption on application"), requires a filing at the NHI counter and a municipal review.³

Ward offices apply the same national structure with local figures. Threshold supplements, relief ratios, filing windows, and counters differ by municipality, so confirm each number with your own ward before acting.¹³

Statutory Income-Based Reduction

Households whose prior-year (January to December) total income falls below set levels get a 70 percent, 50 percent, or 20 percent cut to the per-capita portion and the average-based (household) portion.¹ The income-based portion is not cut by this track. Only the flat portions shrink.

Higashihiroshima City publishes one municipal example of the underlying calculation: income-based rates of 7.71 percent for the basic amount, 2.89 percent for late-elderly support, and 2.35 percent for long-term care for ages 40 to under 65 (as of 2026-05-19; confirm current figures with your municipal ward office).¹

Per-capita amounts are 33,195 yen, 12,211 yen, and 11,996 yen and per-household amounts are 21,294 yen, 7,841 yen, and 5,814 yen (as of 2026-05-19).¹ Its 70/50/20 bands below then apply to the per-capita and household figures only.

Band	Cut to per-capita plus household portions	Municipal example basis	As of
Band 1, lowest income	70 percent	Higashihiroshima threshold test	2026-05-191
Band 2, middle income	50 percent	Higashihiroshima threshold test	2026-05-191
Band 3, upper qualifying income	20 percent	Higashihiroshima threshold test	2026-05-191

Shinjuku City states its FY2026 band test as 430,000 yen plus 100,000 yen times the number of salary or pension earners minus one for the 70 percent band, with larger per-insured add-ons for the 50 and 20 percent bands (as of 2026-04-28).⁵ Secondary guides quote different supplement add-ons, so treat any single ward's yen supplements as that ward's example and reconfirm your own ward's table.⁶

Children before school age get a further 50 percent cut to the per-capita amount, applied after any 70/50/20 reduction, with no application needed.¹ The record date for judging the band is April 1, or the NHI enrollment date for mid-year enrollees.⁵

How the 7/5/2 thresholds work

The test looks at combined prior-year income of the household head plus all NHI members.¹ Fall below the band line and the per-capita levy (均等割, kintō-wari, "per-capita levy portion") and the household levy (世帯別平等割, setaibetsu byōdō-wari, "per-household levy portion") drop by the band percentage.¹ Earn above all three band lines and no statutory cut applies.

Check the ward table before estimating your band

National structure is shared but yen supplements move by municipality and fiscal year. Read your ward's current NHI reduction table rather than carrying another city's supplements into your estimate.¹³

Why you must declare income even at zero

No declaration means no reduction, even at zero income.¹ The household head and every NHI member, including supported members with no income, must each have declared income on record.¹³

Toshima City calculates NHI from total income with resident tax as the basis and asks even low or no-income residents to file; new arrivals file an NHI Premium-related Report at the NHI Section.² File the declaration first, then expect the band test to run. Shibuya City sends annual NHI invoices in June on a per-household basis, so a missing declaration shows up as a full flat-portion bill.⁴

Hardship Exemption for Income Loss

Hardship relief covers the case statutory reduction cannot: current income has collapsed after the prior-year assessment. Municipalities accept applications for special circumstances such as natural disaster, unemployment, bankruptcy, illness, or welfare entry.¹³ Relief is discretionary and review-based, not guaranteed.³

The application flow below is shared across wards even though ratios and windows move:

Job loss and business closure

People under 65 who lost a job through no fault of their own, such as a contract end, bankruptcy, or dismissal, can apply for a premium reduction.¹ Qualifying salary income is recalculated at 30/100 (30 percent) of the prior-year figure for premium purposes, with relief running from the month after separation through the end of the following fiscal year (as of 2026-04-28; confirm current figures with your municipal ward office).⁵⁶

Shinjuku requires two conditions together: under 65 at separation, and an Employment Insurance eligibility certificate (雇用保険受給資格者証, koyō hoken jukyū shikakushashō, "Employment Insurance eligibility certificate") from Hello Work showing separation reason code 11, 12, 21, 22, 23, 31, 32, 33, or 34 (as of 2026-04-28).⁵ A voluntary quit falls outside this track even when income fell.

Kumamoto frames the same event as a sharp income decline: when annual income fell by more than one-fifth versus the prior year through unemployment or closure with no fault of the person, the income-based portion is cut 10 to 100 percent from the month the cause arose through the fiscal year end (more than one-third decline required when prior-year income exceeded 3 million yen) (as of 2024-12-02).³ Bring papers establishing the facts, cause, and amounts, including closure documents and employment-insurance type and amount where received.³

Voluntary quits need the general hardship track instead

The 30 percent recalculation is reserved for involuntary status proved by the Hello Work code. A voluntary resignation should be filed under general special-circumstances hardship with income-decline evidence instead.⁵³

Disaster and other special circumstances

Disaster relief scales with damage. Kumamoto reduces 20 to 100 percent of premiums for one year from the month after the disaster month, and 10 to 70 percent for floor flooding of an owned house on the same one-year window (as of 2024-12-02).³ Bring the disaster victim certificate (罹災証明書, risai shōmeisho, "disaster victim certificate") from a public office plus proof of any non-life-insurance benefits received.³

Bankruptcy decisions exempt the full income-based portion up to the month before the decision month, and welfare entry exempts premiums up to the month before welfare starts.³ People held in criminal facilities receive custody-period exemptions on application with a certificate of incarceration.³

Higashihiroshima sets the special-circumstances filing window from the day before each payment deadline until seven days before that deadline.¹ Shinjuku excludes premiums whose payment deadlines have already passed from general exemption and asks applicants in hardship to consult by telephone before applying.⁵

How to Apply at the Ward Office

File at the NHI counter, usually the National Health Insurance and Pension Division or the ward office Citizens Affairs Section.¹³ Enrollment, change, and termination notices are due within 14 days of the triggering event, and late filing still leaves backdated premiums owed.¹²⁴

Where and when to file

Go to the NHI counter in the municipality where your resident record sits.¹³ Annual invoices go out in June in Shibuya's schedule, and premiums run from the enrollment month on a household basis with the head as payer.⁴² A move to another municipality means re-enrolling and re-filing there; premiums keep running under the old record until the moving-out notice is filed.²

Ask for the NHI reduction application by name

Counters handle enrollment, billing, and relief at nearby desks with similar forms. Ask for the National Health Insurance premium reduction application and state whether the ground is statutory band, involuntary unemployment, or special-circumstances hardship.³

Documents to bring

Bring the items below as a set. Missing income evidence is the most common reason a relief file stalls.

Document	When required	Notes
NHI premium reduction application form	Always	Available at the NHI counter3
Residence card or equivalent ID, plus My Number Card or notification	Always	Identity and income-record check24
Prior-year income evidence	Always, including zero income	Tax return, withholding slip, or income certificate; declaration must precede relief132
Employment Insurance eligibility certificate with reason code	Involuntary unemployment track	Codes 11, 12, 21, 22, 23, 31, 32, 33, or 34 in Shinjuku practice5
Public damage certificate plus insurance-benefit proof	Disaster track	Disaster victim certificate and benefit details3
Closure, dismissal, or income-decline papers	Business closure or sharp decline	Facts, cause, and amounts; compensation details where relevant3

Decision window and what happens next

Kumamoto conducts a document review with fact-finding as needed, then notifies the result in writing about one month after application (as of 2024-12-02; confirm current timing with your municipal ward office).³ Across municipalities, plan for roughly one to two months from filing to revised billing, since review depth and caseload move by ward.³

Relief applies prospectively from the qualifying month through the fiscal year end in the income-decline framing, not as a blanket refund of old bills.³ Except for custody-related reductions, already-paid premiums are not refunded through this track in Kumamoto practice.³ Relief may still be denied even when special circumstances exist, since the outcome turns on municipal review.³

Good to know

File the income declaration before assuming you qualify

Undeclared households get no 70/50/20 cut even at zero income, and supported members must declare too.¹³ New arrivals should file the NHI Premium-related Report at the NHI Section rather than waiting for a resident-tax cycle to pick them up.² Treat the declaration as step zero of every track in this article.

A hardship filing does not pause the current bill by itself

Shinjuku excludes premiums past their deadline from general exemption, and Kumamoto does not refund already-paid premiums except in custody cases.⁵³ Keep paying billed installments while the review runs unless the counter instructs otherwise in writing. A hardship application is a request for revised billing, not a payment hold.

Moving wards resets the counter you deal with

Threshold supplements, relief ratios, windows, and counters differ by municipality, as the Higashihiroshima, Shinjuku, and Kumamoto figures in this article show.¹⁵³ After a move, re-register the address, re-enroll in the new ward's NHI, and re-file any pending relief there within the 14-day notice discipline.²⁴ Do not carry another ward's yen table into the new ward's estimate.

See also

• Health Insurance and Pension for Freelancers
• What Insurance Doesn't Cover
• Maina-Hokensho: Health Insurance Card Going Digital
• What NHI Covers and What's Excluded

References

Footnotes

1. Higashihiroshima City. The National Health Insurance Scheme (English). Updated 2026-05-19. https://www.city.higashihiroshima.lg.jp/en/4/33850.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

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

3. Kumamoto City. Reduction of National Health Insurance Premiums (English, machine-translated official page). Last update 2024-12-02. https://www.city.kumamoto.jp.e.fm.hp.transer.com/kiji003615/index.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

4. 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

5. Shinjuku City. Information on Shinjuku City National Health Insurance (English guidebook PDF, FY2026 edition). https://www.city.shinjuku.lg.jp/content/000339874.pdf ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹

6. Gaijin Blog. Japan National Health Insurance for Foreigners: Complete 2026 Guide. Published 2026-02-22. https://gaijinblog.com/posts/japan-national-health-insurance-foreigners-guide ↩ ↩²