There have been news reports about the advance payment system for health insurance premiums, aimed at non-Japanese residents.
Let’s take a look at how this will change and review the details of the changes.
Introduction of Prepayment System
The advance payment system for national health insurance for foreign residents is not a “nationwide mandatory system,” but rather a “new mechanism that local governments can choose to implement.”
On October 29, 2025, the Ministry of Health, Labor and Welfare notified local governments of a model ordinance that would allow foreign residents and others to prepay their National Health Insurance premiums. If municipalities amend their ordinances, they can introduce prepayment as early as the following fiscal year (FY 2026).
The target group is defined as “household heads who were not registered as residents in Japan as of January 1 of the previous fiscal year”—that is, people moving to Japan from abroad (including not only non-Japanese nationals but also Japanese nationals who had previously returned to their home country).
Municipalities Scheduled to Implement System
Whether to require advance payment and for how many years is a decision left to each local government.
Shinjuku Ward has already announced its plans. Starting in fiscal year 2026, the ward intends to require new foreign residents to pay one year’s worth of premiums in a lump sum, in principle.
It has been described in the media as “rare even on a national scale,” and is currently being treated as a “pioneering model.”
I have also looked into municipalities in Osaka Prefecture, including Osaka City, but we are still waiting to see how things develop.
“Prepayment”: Form and Amount
The basic model envisioned is a system where customers pay for a year’s worth of service in advance when signing up. Many explanations state that the maximum amount that can be paid in advance is “up to one year’s worth.”
The method for calculating the amount itself is the same as under the conventional National Health Insurance system; it is calculated using the criteria listed below, and the treatment is simply to “require payment before the original due date.”
- Income from the year before last
- Number of household members and subscriber composition
- Rates, Flat-Rate Portion, and Equal-Share Portion by Local Government
In other words, the operational concept is as follows:
- Foreign nationals who moved to Shinjuku Ward in May 2026 must enroll in the National Health Insurance
- Eligibility begins: Insurance premiums are calculated starting from the month of enrollment (May).
- Explanation: At the service counter, staff were informed, “Since your household is eligible for advance payment, you will need to pay this year’s fees in a single lump sum.”
- The general idea is that you are required to make a lump-sum payment in June (the first installment) covering the entire fiscal year (from May through the following March).
Include in your Income Tax Deductions
For the National Health Insurance premium paid in advance, the full amount is treated as deductible in the “year of payment” for the social insurance premium deduction (following the same principle as annual payments). Therefore, making this payment can help reduce your taxable income for both income tax and resident tax.
From the perspective of addressing delinquency, it has been reported that a system denying changes or renewals of residence status to delinquent payers is scheduled to be introduced around June 2027, in conjunction with the advance payment system; therefore, this may also have implications for the practical administration of residence status.
One area where decisions have not yet been made—and where there are differences among local governments—is whether advance payment should be “mandatory” or “generally requested.” Since many local governments are taking a wait-and-see approach, developments are yet to come.
