Written by
John Spencer
John Spencer is the founder of Compare Expat Plans, where he focuses on helping people compare health plans for life abroad. He emphasizes clear information, neutral analysis, and practical decision support.
Our Top Picks
Japanese expats are typically concentrated in the US, UK, Singapore, and Southeast Asia—often on corporate assignments. Your insurance needs depend on whether you're company-sponsored or moving independently. Here's what we recommend:
- Cigna Global: Best overall for Japanese expats. Japanese-language support, strong global networks, reliable service.
- Tokio Marine: Japanese insurer with international products. Familiar brand, Japanese service, includes Japan coverage.
- Bupa Global: Premium option with excellent networks, especially good for the US and UK.
- AXA Global: Strong coverage with Japanese support available. Good for corporate expats.
- Allianz Care: Good European coverage at competitive prices, though Japanese support is limited.
Corporate Expats
If your company is sending you abroad, check what coverage they provide first. Many Japanese corporations arrange group coverage through Tokio Marine, Mitsui Sumitomo, or similar. Individual insurance may supplement rather than replace corporate coverage.
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Leaving Japanese Insurance
Japan has two main insurance systems: Employee Health Insurance (健康保険/Shakai Hoken) and National Health Insurance (国民健康保険/Kokumin Kenko Hoken). Here's what happens when you leave:
Employee Health Insurance (Shakai Hoken)
If you're leaving employment in Japan, your Shakai Hoken ends when your employment ends. Corporate expats on overseas assignments may continue under their company's scheme—confirm with your HR department.
National Health Insurance (NHI)
NHI is linked to your residence registration (住民票). When you submit your moving-out notice (転出届) at your local ward office, your NHI coverage ends. You cannot maintain NHI while living abroad.
Transition Period
Arrange international coverage before cancelling your Japanese insurance. There should be no gap. If you're moving on a specific date, have your international policy start that same day.
Private Japanese Insurance
Private insurance (民間保険) from companies like Nippon Life, Dai-ichi Life, or Sompo Japan may continue abroad with limitations. Check your specific policy—international coverage is often restricted to short-term travel.
Nenkin Pension System
Japan's pension system (年金) has implications for expats abroad:
Voluntary Continuation
Japanese citizens abroad can voluntarily continue National Pension (国民年金) contributions. This protects your pension entitlement and is worth considering if you plan to return to Japan or want to maximize your pension.
Social Security Agreements
Japan has Totalization Agreements with many countries including the US, UK, Germany, and Australia. These prevent double contributions and help coordinate pension rights between countries.
Lump-Sum Withdrawal
Non-Japanese leaving Japan permanently may be eligible for a lump-sum withdrawal of their pension contributions. Japanese citizens typically maintain their pension rights rather than withdrawing.
Before You Leave
Visit your local ward office (区役所/市役所) and the Japan Pension Service (年金事務所) before leaving. They can explain your specific situation and help you decide whether to continue voluntary contributions.
Quick Comparison
| Provider | Japanese Support | US Network | Japan Coverage | Starting Price |
|---|---|---|---|---|
| Cigna Global | Yes | Strong | Add-on | $200/mo |
| Bupa Global | Limited | Excellent | Add-on | $220/mo |
| Allianz Care | Limited | Good | Add-on | $190/mo |
| AXA Global | Yes | Good | Add-on | $210/mo |
| Tokio Marine | Full (Japanese) | Good | Included | $230/mo |
Detailed Reviews
Cigna Global
Cigna Global offers comprehensive international coverage with Japanese-language support. Their Global Health Plan comes in three tiers with coverage up to unlimited. Strong networks in the US, UK, and Asia make this suitable for most Japanese expat destinations.
Japanese-speaking staff are available for support and claims. Direct billing works at major hospitals worldwide. Japan coverage can be added for visits home.
Best for: Japanese expats who want reliable global coverage with Japanese-language support.
Tokio Marine
Tokio Marine is Japan's oldest and largest insurance company. Their international health products are designed specifically for Japanese expats, with fully Japanese service and documentation. Japan coverage is included automatically.
The familiar brand and Japanese service appeal to many expats. Coverage is comprehensive, though pricing may be higher than international competitors.
Best for: Japanese expats who prefer dealing with a Japanese insurer and want seamless Japan coverage.
Bupa Global
Bupa Global offers premium international coverage with excellent US and UK networks—popular destinations for Japanese expats. Service quality is high, and plans are comprehensive including mental health and maternity.
Japanese support is limited compared to Cigna or Tokio Marine. Best for expats comfortable with English.
Best for: Japanese expats who want premium coverage and are comfortable with English service.
AXA Global
AXA Global offers strong international coverage with Japanese support available through their Asian operations. Good option for corporate expats or those in Asia-Pacific destinations. Plans are comprehensive with good flexibility.
Best for: Japanese expats in Asia who want solid coverage with available Japanese support.
Compare Your Options
Get quotes from Japanese and international insurers to compare pricing and service levels for your specific destination.
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Returning to Japan
Returning to Japanese healthcare is straightforward but requires proper registration:
Re-registering Residence
Submit your moving-in notification (転入届) at your local ward office within 14 days of return. Bring your passport, landing stamp, and residence card if applicable.
Rejoining Health Insurance
If you're employed, you'll be enrolled in Shakai Hoken through your employer. Otherwise, register for National Health Insurance at your ward office. NHI is mandatory for all residents not covered by employment-based insurance.
Premiums Calculation
NHI premiums are based on your previous year's income. If you had no Japanese income while abroad, your first-year premiums will be low but will adjust based on subsequent income.
Transition Coverage
Keep your international insurance active until Japanese coverage begins. Registration at the ward office establishes coverage from that date, but getting your new insurance card takes 1-2 weeks.
Common Questions
Can I keep NHI while abroad?
No. NHI requires residence registration in Japan. When you submit your moving-out notice, NHI coverage ends. You need international health insurance abroad.
Should I continue nenkin contributions?
If you plan to return to Japan, yes—it protects your pension entitlement. If permanently leaving, evaluate based on years contributed and totalization agreements.
Is Japanese-language support necessary?
It depends on your English comfort level. In medical emergencies, native language support reduces stress. For routine matters, English may be sufficient.
My company is sending me abroad—do I need insurance?
Check with HR first. Many Japanese companies provide group coverage for overseas assignments. You may need additional coverage depending on what your company provides.
What about coverage when I visit Japan?
Most international insurers offer Japan coverage as an add-on. Tokio Marine includes it automatically. Without coverage, you'll pay full prices (no NHI discount).
How does Japanese healthcare abroad compare?
Japan's system is among the world's best and most affordable. Most other countries are more expensive. International insurance ensures you maintain quality access abroad.
Final Verdict
Japanese expats should prioritize comprehensive international coverage to replace Japan's excellent but non-portable healthcare system. Cigna Global is our top recommendation for reliable coverage with Japanese-language support. Tokio Marine is ideal for those who prefer a Japanese insurer with familiar service.
Bupa Global offers premium coverage for those comfortable with English service, while AXA Global provides good Asian coverage with available Japanese support.
Before leaving, visit your ward office and pension office to understand your options. Consider voluntary pension contributions if you plan to return. And ensure continuous coverage with no gap between Japanese and international insurance.
