Japan Medical Insurance Calculator
Estimate your Japan private medical insurance (iryō hoken) premium. Covers hospitalisation daily benefit (¥5,000–¥15,000/day), surgery lump sums (¥50,000–¥400,000), and optional cancer + advanced therapy riders — on top of your NHI coverage. Free, no sign-up.
Your Profile
Medical Insurance Premium
Monthly Premium
¥7,032
Annual: ¥84,384
Daily Benefit
¥10,000
Surgery Lump Sum
¥200.0K
Kōgaku Monthly Cap
¥80,100
Public Scheme Interaction
Kenpo (健康保険 / Employees' Health Insurance): your employer and you split premiums roughly 50/50; the fund covers 70% of eligible medical costs and you pay the 30% co-pay at the counter. Private medical insurance fills the gap on lost income during hospitalisation, private-room fees (sashigaku-beddai, not covered), and advanced treatments (proton, heavy-ion, immunotherapy) outside the fee-schedule.
Kōgaku Ryōyōhi Seido — High-Cost Medical Cap
Kōgaku Ryōyōhi Seido (高額療養費制度): monthly out-of-pocket medical co-pay is capped at roughly ¥80,100 for an average earner (lower for seniors 70+, higher for high earners). This public cap dramatically limits worst-case exposure — but does NOT cover the private-room daily fee (¥5,000-¥30,000/day sashigaku-beddai), lost income during hospitalisation, or advanced/experimental treatments. Private medical insurance fills exactly those three gaps.
For estimation only. Not professional financial, tax, or legal advice. Consult a qualified advisor before making decisions. Full disclaimer.
Do you need private medical insurance in Japan?
Maybe not as much as you think. Japan's public health insurance (called Kenpo for company workers or Kokuho for everyone else) already pays 70% of your medical bills. A rule called Kōgaku Ryōyōhi Seido (a monthly cap on what you pay out of pocket) keeps your share at around ¥80,100 per month for an average earner.
So what does private iryō hoken (private medical insurance) add? It helps with three real problems. First, lost pay while you are in hospital. Second, private-room fees of ¥5,000 to ¥30,000 a day, which the public system does not cover. Third, newer treatments that Kenpo has not yet approved.
How daily benefits and surgery payouts work
Most policies pay you a fixed amount for each day in hospital. The common choices are ¥5,000, ¥7,000, or ¥10,000 per day. They also pay a lump sum if you have surgery, usually 10, 20, or 40 times the daily amount.
Here is a real example. You pick a ¥10,000 daily benefit with a 40× surgery payout. You have heart bypass surgery and stay in hospital 20 days. The policy pays ¥400,000 for the surgery plus ¥200,000 for the stay. That is ¥600,000 to cover rent, lost wages, and extras.
10-year renewable vs whole-life policies
A 10-year renewable policy is cheap at the start. But the price roughly doubles every 10 years. If your health gets worse, you may not be able to switch to a better deal.
A whole-life (shūshin) policy locks in one monthly price forever. It costs 60% to 80% more at the start. For anyone under 40, the whole-life version usually wins over time.
Cancer rider and advanced-therapy rider
A cancer rider (gan tokuyaku) adds a cash payout if a doctor finds cancer. It is cheaper than a standalone cancer plan but pays less. If you want a dedicated plan, see our cancer insurance calculator.
The advanced-therapy rider (sentan iryō tokuyaku) covers newer cancer treatments. Proton-beam therapy costs about ¥2.5–3 million per course. Heavy-ion therapy runs ¥3.1–3.5 million. This rider costs only ¥100–150 per month, so it is one of the best-value add-ons you can buy.
Plan the rest of your protection
Medical insurance is one piece of the puzzle. You probably also want life insurance to protect your family and an iDeCo pension (a tax-free retirement account) for later. Check what you already have at work before you buy anything new.
Common questions about Medical Insurance
Do I need private medical insurance if I have Kenpo / Kokumin Kenkō Hoken?+
Public health insurance covers 70% of medical costs with a patient co-pay of 30%, and Kōgaku Ryōyōhi Seido (high-cost cap) limits monthly out-of-pocket to ~¥80,000 for average earners. Where private iryō hoken adds value: private-room (sashigaku beddai) fees not covered by public insurance (¥5,000-¥30,000/day), lost income during hospitalisation, advanced treatments, and cancer-specific coverage. For households without sick-pay buffers or where longer hospitalisations would strain cashflow, private medical cover bridges the real gap.
Typical daily hospitalisation benefit (nyūin nichigaku)?+
¥5,000/day is the most common baseline — pays through kōgaku ryōyōhi caps plus private-room fees. ¥10,000/day for higher-earning households who want bigger cushion. Many policies include surgery lump-sums (~¥50,000-¥200,000 per operation, tiered by procedure class) and outpatient benefits. Watch the age-65 daily-benefit cut (some policies halve it) and "limit per single hospitalisation" / "per-year" caps.
Gan hoken (cancer insurance) — separate or combined?+
Cancer is about half of serious Japanese medical events. Gan hoken pays a large diagnosis lump sum (¥1M-¥3M typical) PLUS ongoing treatment benefits — advanced therapies (immunotherapy, proton/heavy-ion radiation) not fully covered by public insurance can cost ¥3M+ out of pocket. Combined medical+cancer policies are convenient; dedicated cancer policies (Aflac, Tokio Marine Nichido) typically offer deeper benefits including 1-in-2 lifetime cancer incidence.
Is Japan medical insurance premium tax-deductible?+
Yes — falls under the seimei hoken ryō kōjo "介護医療" bucket: up to ¥40,000/yr income tax deduction + ¥28,000/yr residence tax deduction. Combined across 3 buckets (life / medical / annuity) up to ¥120,000/yr total income tax. Most households under-utilise by holding everything in one bucket — structure separately to maximise.
What's covered under "advanced treatment rider" (先進医療特約)?+
Senshin iryō tokuyaku pays for treatments officially approved by MHLW as "advanced" but not yet covered by public insurance — proton beam therapy (¥2.5M-¥3M), heavy-ion radiotherapy (¥3M+), some robotic surgeries, specialised bone-marrow procedures. Rider typically costs ¥100-200/month and covers up to ¥20M of advanced treatment. Cheap insurance for low-probability-but-catastrophic events.
Can I claim private hospital room (sashigaku beddai) fees?+
Daily benefit is paid in cash to you regardless of actual room costs — so a ¥10,000/day benefit offsets a ¥8,000/day private-room fee plus ¥2,000 toward other non-covered extras. It's not a reimbursement structure; you control how the cash is spent. This cash-benefit model is a major advantage of Japanese iryō hoken over Western reimbursement insurance.
Japan medical insurance premium benchmarks 2026?+
30-year-old male, ¥5,000/day hospitalisation + ¥100,000/surgery + advanced treatment rider, lifetime: ~¥2,400/mo. Same policy at 40: ¥3,100/mo, at 50: ¥4,800/mo, at 60: ¥7,500/mo. Add cancer rider (¥1M diagnosis + treatment benefits): +¥800-¥1,500/mo. Lifenet, Orix Life, Rakuten Life undercut traditional insurers by 20-35% online.