Japan Medical Insurance Calculator
Calculate Japan private medical insurance (iryō hoken) premium and benefits. Hospitalisation daily benefit, surgery lump-sums, cancer riders on top of Kokumin Kenkō Hoken.
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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.
Why buy private medical insurance (iryō hoken) in Japan?
Japan's Kenpo / Kokuho public scheme already covers 70% of eligible medical costs — and the Kōgaku Ryōyōhi Seido (高額療養費制度) caps your monthly out-of-pocket co-pay at roughly ¥80,100 for an average earner. So why bother with private iryō hoken? Three reasons: (1) lost income during hospitalisation, (2) sashigaku-beddai private-room fees (¥5,000-¥30,000/day, entirely uncovered by public insurance), and (3) advanced / experimental treatments outside the Kenpo fee-schedule.
Daily hospitalisation benefit and surgery lump sum
Policies pay a daily hospitalisation benefit (nyūin nichigaku / 入院日額) — ¥5,000, ¥7,000, or ¥10,000 are the common tiers — plus a surgery lump sum priced as 10×, 20×, or 40× the daily benefit depending on procedure severity. A ¥10,000 daily benefit with 40× surgery multiplier pays ¥400,000 on major surgery (cardiac bypass, organ transplant) plus ¥10,000 for every hospitalised day — a meaningful cushion against the real, non-medical costs of a hospital stay.
10-year renewable vs shūshin (whole life) medical
10-year renewable medical is cheaper at entry but re-underwrites every decade — premium roughly doubles each renewal and, if your health has declined, a fresh policy at equivalent rates may be impossible. Shūshin medical locks your monthly premium for life but costs 60-80% more at entry. For anyone under 40, shūshin medical is usually better long-run value.
Cancer rider and advanced-therapy rider
A cancer rider (gan tokuyaku) bolts a separate diagnosis lump sum onto your medical policy — cheaper than standalone gan hoken but with lower limits. The advanced-therapy rider (sentan iryō tokuyaku) covers proton-beam (~¥2.5-3M per course), heavy-ion (~¥3.1-3.5M), and immune-checkpoint therapies not fully reimbursed by Kenpo. It costs only ~¥100-150/month and is one of the best-value add-ons available.
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.