Japan is tightening its immigration and healthcare rules, and foreign visitors and residents need to pay close attention. Starting soon, tourists who have unpaid medical bills from previous visits may be denied entry. Foreign nationals living in Japan could also face penalties, including visa rejection, if they fail to pay health insurance or pension premiums. The announcement came after a high-level government meeting on Friday, where Prime Minister Shigeru Ishiba and his ministers discussed ongoing issues related to Japan’s rapidly growing number of foreign visitors and workers
What’s Changing and Why?
As more foreigners visit and live in Japan, some new problems have emerged. One of the most serious is the growing number of unpaid medical bills left behind by tourists. In many cases, these unpaid costs are covered by Japanese taxpayers. This has led to frustration among the public and politicians alike.
To fix this issue, the government is now taking stricter action. Under the new policy:
- Foreign tourists with unpaid medical fees may be denied entry into Japan in the future.
- Foreign residents who do not pay into Japan’s national health care or pension system may have their visa extensions denied.
Although exact timelines for when the changes will start haven’t been confirmed, officials say implementation plans are already being discussed.
Prime Minister Ishiba made it clear that while Japan will continue to welcome foreign visitors and residents, it won’t tolerate people who take advantage of the system. “If our current systems are unable to address the realities of globalization and fail to dispel public anxiety, then drastic reforms must be undertaken
Foreign Workers and Employers Also Affected
The new rules will also affect employers of foreign workers, especially those under the “specified skilled worker” visa program. Companies that haven’t been paying required health care and pension premiums for their foreign employees could lose the right to hire them.
This is a big move aimed at holding not just individuals—but also host organizations—accountable.
The Prime Minister said a new liaison office would be created within the Cabinet Secretariat to oversee these multi-ministry issues. This office will help enforce the new rules and support smooth communication between different government departments.
Foreign Residents: Know Your Responsibilities
Currently, any foreign national staying in Japan for more than three months is required to enroll in the National Health Insurance system (Kokumin Kenkō Hoken). Foreign workers who are employed full-time by Japanese companies usually get health insurance through their employer, which also covers their dependents.
But many others—like international students, part-time workers, and freelancers—must enroll on their own. Unfortunately, many don’t realize this or ignore the bills when they arrive. As a result, payment rates among foreign residents are low.
According to a government survey done between April and December 2024, only 63% of foreign residents who were supposed to pay the premiums actually did. That’s much lower than the 93% rate for Japanese citizens.
The government now wants to spread better awareness and education around taxes and health insurance obligations. A proposal submitted to Prime Minister Ishiba on Thursday by the Liberal Democratic Party (LDP) called for more active communication in multiple languages so foreign residents better understand their responsibilities.
What’s Next?
These new rules are part of a larger reform effort included in Japan’s annual “honebuto” economic policy guidelines. These guidelines set the tone for the national budget and major government priorities.
Officials are still working out how and when these policies will go into effect. But one thing is clear: Japan is making changes to ensure that foreign residents and tourists contribute fairly to the systems they benefit from.
FAQs
1. I visited Japan before and needed hospital care. If I didn’t pay, will I be stopped from entering again?
Yes, under the new rules being discussed, if you left Japan with unpaid medical bills, you may be denied entry during your next visit. It’s important to settle any outstanding payments to avoid issues in the future.
2. Do I really need to join Japan’s health insurance if I’m just a student or freelancer?
Yes. If you stay in Japan for more than three months, you must enroll in the National Health Insurance system—even if you’re a student or working part-time. Ignoring it could affect your ability to renew your visa later on.
Japan remains a welcoming country, but it expects everyone—whether visiting or living there—to follow the rules. These new changes aim to protect public services, ensure fairness, and strengthen trust between foreign residents and the communities they join.
Source:https://www.japantimes.co.jp/news/2025/06/06/japan/foreign-residents-health-care/
