How premiums are built
A household's National Health Insurance (kokumin kenko hoken, NHI) premium is the sum of up to four portions. Each portion has a rate applied to income, a flat amount for each insured person, and in some cities a flat amount per household. Each portion also has an annual cap.
- Medical portion (iryo-bun). Pays for the household's own medical care.
- 75+ support portion (koki koreisha shienkin-bun). A contribution to the medical system for people aged 75 and over.
- Long-term care portion (kaigo-bun). Charged only for members aged 40 to 64.
- Child-support portion (kodomo kosodate shienkin-bun). New from April 2026 and charged in every city on this page.
| City | Medical | 75+ support | Care (40 to 64) | Child support |
|---|---|---|---|---|
| Tokyo 23 wards (Shinjuku and 19 others) | 7.51% + ¥47,600 per person; cap ¥670,000 | 2.8% + ¥17,600 per person; cap ¥260,000 | 2.43% + ¥17,800 per person; cap ¥170,000 | 0.27% + ¥1,873 per adult; cap ¥30,000 |
| Yokohama | 8.33% + ¥40,870 per person; cap ¥670,000 | 2.62% + ¥13,380 per person; cap ¥260,000 | 2.84% + ¥16,200 per person; cap ¥170,000 | 0.34% + ¥1,770 per adult; cap ¥30,000 |
| Kawasaki | 8.26% + ¥43,261 per person; cap ¥670,000 | 2.89% + ¥15,306 per person; cap ¥260,000 | 2.67% + ¥15,828 per person; cap ¥170,000 | 0.32% + ¥1,742 per adult; cap ¥30,000 |
| Osaka | 9.5% + ¥34,990 per person + ¥33,908 per household; cap ¥660,000 | 3.06% + ¥11,191 per person + ¥10,845 per household; cap ¥260,000 | 2.6% + ¥18,682 per person; cap ¥170,000 | 0.28% + ¥1,841 per adult; cap ¥30,000 |
| Kobe | 7.38% + ¥33,700 per person + ¥21,800 per household; cap ¥670,000 | 2.97% + ¥13,510 per person + ¥8,740 per household; cap ¥260,000 | 2.78% + ¥13,970 per person + ¥6,880 per household; cap ¥170,000 | 0.26% + ¥1,330 per adult + ¥830 per household; cap ¥30,000 |
| Nagoya | 8.83% + ¥50,591 per person; cap ¥670,000 | 2.58% + ¥15,784 per person; cap ¥260,000 | 2.34% + ¥16,120 per person; cap ¥170,000 | 0.26% + ¥1,863 per adult; cap ¥30,000 |
| Fukuoka | 5.58% + ¥19,807 per person + ¥18,664 per household; cap ¥670,000 | 3.14% + ¥10,441 per person + ¥9,838 per household; cap ¥260,000 | 2.61% + ¥10,160 per person + ¥7,751 per household; cap ¥170,000 | 0.28% + ¥1,039 per adult + ¥911 per household; cap ¥30,000 |
| Sapporo | 8.61% + ¥20,550 per person + ¥32,540 per household; cap ¥670,000 | 2.56% + ¥6,330 per person + ¥10,010 per household; cap ¥260,000 | 2.33% + ¥6,020 per person + ¥7,550 per household; cap ¥170,000 | 0.29% + ¥1,100 per adult + ¥1,000 per household; cap ¥30,000 |
What counts as income
The premium uses income (shotoku) for the previous calendar year, which for FY2026 is 2025. Income is not gross pay. For an employee it is gross salary minus the employment income deduction. For 2025 that deduction is at least ¥650,000. A salary of ¥1.9 million therefore gives income of ¥1.25 million. For a pensioner it is gross public pension minus the public pension deduction. That deduction is at least ¥1.1 million from 65 and ¥600,000 before 65. Business income is sales minus expenses, as on a tax return.
The city then subtracts a basic deduction of ¥430,000 for each person and applies the income rate to what is left. Tax deductions for dependants, insurance or medical costs do not reduce the NHI income base. Three cities add their own deductions, which the calculator applies. Yokohama and Kawasaki deduct an amount for each child on the NHI. Nagoya deducts ¥330,000 for each dependant. If you choose salary or pension in the calculator, it converts the gross figure using the National Tax Agency tables and shows the income it used.
Low-income reductions
When household income is low, the flat amounts are cut by 7, 5 or 2 tenths. The income part is not reduced. All eight cities use the national FY2026 lines, and the calculator applies them:
- 7 tenths: household income up to ¥430,000. Add ¥100,000 for each salary or pension earner after the first.
- 5 tenths: the 7-tenths line plus ¥310,000 for each insured member.
- 2 tenths: the 7-tenths line plus ¥570,000 for each insured member.
The test adds up the 2025 income of every insured member and of the head of household. A member aged 65 to 74 with pension income gets a further ¥150,000 off for this test only. Children under 6 then get half off the flat amounts that remain. The city can apply a reduction only when everyone in the household has an income record, and a declaration of zero income counts. Relief for people who lost a job involuntarily, and for disasters, is not included. Ask the ward office about it.
Tokyo's 23 wards
Tokyo's 23 special wards set NHI premiums on a common basis. For FY2026, 20 wards use the same rates, and the calculator takes them from Shinjuku's page. Meguro charges a different income rate for the care portion. Nakano and Edogawa set their own rates. Cities in Tokyo outside the 23 wards, such as Musashino or Hachioji, also set their own rates and are not covered.
Cities not covered
We include a city only when its own website states the FY2026 rates. These are not covered yet:
- Meguro, Nakano and Edogawa wards. Their FY2026 rates differ from the other 20 wards. Tokyo's ward-by-ward list shows the figures, but we have not yet checked them on each ward's own page.
- Other cities. Only the cities above are covered so far. Every city publishes its rates in Japanese on its NHI (kokumin kenko hoken) page, and most have a premium calculator of their own.
Turning 75
On the 75th birthday a resident leaves NHI and moves automatically into the Late-Stage Elderly Medical Care System (koki koreisha iryo seido), with no application. The premium is set by the prefecture's wide-area union, not by the city, and is usually taken from the pension. If one member of a couple turns 75, the other stays on NHI, and the household's NHI premium is recalculated from that month. See MHLW's outline of the Late-Stage system (Japanese). Our guide to NHI after 40 works through a Late-Stage premium for Kanagawa.
Unpaid premiums and visas
The Immigration Services Agency's guideline on changing status and extending the period of stay says that where large or long-running NHI arrears come to light, serious cases are treated like unpaid tax and count against the application. From June 2027 the agency is due to check NHI payment records electronically, under a Cabinet decision of January 23, 2026 (Japanese). If a premium is hard to pay, ask the ward office about deferral or an instalment plan before the due date, and keep the receipts. See the ISA guideline (Japanese) and our notes on healthcare for foreign retirees.
Sources
- Shinjuku City: how the FY2026 NHI premium is calculated (Japanese)
- City of Yokohama: FY2026 NHI premium rates (Japanese)
- City of Kawasaki: FY2026 NHI premium rates (Japanese)
- Osaka City: FY2026 NHI premium notice (Japanese)
- City of Kobe: FY2026 NHI premium rates (Japanese)
- City of Nagoya: FY2026 NHI premiums (Japanese)
- Fukuoka City: FY2026 NHI premium rates (Japanese)
- City of Sapporo: FY2026 NHI premium rates (Japanese)
- National Tax Agency: employment income deduction for 2025 (Japanese)
- National Tax Agency: public pension income (Japanese)
- MHLW: Late-Stage Elderly Medical Care System (Japanese)
- Cabinet Secretariat: measures for foreign nationals, January 23, 2026 (Japanese PDF)
- Immigration Services Agency: guideline for change of status and extension of period of stay (Japanese)
Checked 2026-10-18. Our editorial policy explains how we source and update figures.