When I leave, does my health insurance switch automatically?

No. It does not switch automatically. Once you leave, the company plan stops, so you must choose and apply for 任意継続, National Health Insurance, or family dependent coverage yourself. Doing nothing leaves you uninsured, with medical costs falling entirely on you.

Which is cheaper, 任意継続 or National Health Insurance?

The premium depends on your former salary, your municipality and your household, so which is cheaper differs per person. Because 任意継続 has a ~20-day deadline, there isn't much time to deliberate. Ask both for their premiums early and compare.

I missed the 20-day 任意継続 deadline.

In principle you can no longer choose 任意継続 after the deadline. You would then join National Health Insurance, or become a family dependent if you qualify. Contact your municipality's NHI counter right away so you don't have an uninsured gap.

I'm starting a new job right away — do I still need to do anything?

If you join the new company's plan immediately with no gap, 任意継続 or NHI is generally unnecessary — the new company handles the insurance. But if there's even a few days' gap, check how you'll be covered during it.

Insurance / Pension

退職後の保険切替: Switching Health Insurance After Leaving a Job in Japan

This document relates to switching to a new health insurance when you leave a company and lose (資格喪失) your company health plan. Once you leave, the company plan no longer works, so you must choose and apply for one of three options yourself: ① 任意継続 (voluntary continuation of your former plan), ② joining your municipality's 国民健康保険 (National Health Insurance), or ③ becoming a dependent on a family member's plan. ⛔ 任意継続 in particular has a short deadline — generally within 20 days of losing coverage — and you cannot choose it after that. Doing nothing leaves you uninsured, and medical costs during that gap can fall entirely on you. Check exact deadlines and amounts on your documents and each office's guidance.

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Who receives it

People who leave a job or whose contract ends, and thus lose their company health plan (協会けんぽ or a health-insurance society). At departure, the company may hand you (or later send) a 健康保険資格喪失証明書 (certificate of loss of insurance eligibility), which you need for the next step. Nationality does not matter — if you keep living in Japan you need public medical insurance. If you already have a new job and immediately join the new company's plan, this switch is generally unnecessary.

What to do

1After leaving, get a document from the company showing when you lost eligibility, such as a 健康保険資格喪失証明書 (needed for the next step).
2Decide among the three options (任意継続, National Health Insurance, family dependent) by comparing premiums and conditions.
3⛔ To choose 任意継続, apply to your former health plan (協会けんぽ / society) generally within 20 days of losing eligibility. This deadline is strict.
4To choose National Health Insurance, take the loss-of-eligibility certificate to your municipality's NHI counter and enrol (the post-departure filing also has a target deadline).
5To become a family dependent, apply through the family member's employer. If unsure which is best, ask each office yourself.

About the deadline

⛔ The critical one is the 任意継続 deadline: generally you must apply within 20 days of losing eligibility (the day after your last day), or you can no longer choose it. Switching to National Health Insurance also has a target deadline (such as within 14 days of leaving) — filing may still be possible after, but delay can mean paying the full medical cost during an uninsured gap or being billed premiums retroactively. Either way, act as soon as possible after leaving so you have no coverage gap. Confirm exact deadlines with each insurer's counter or guidance.

Common misunderstandings

When I leave, does my health insurance switch automatically?: No. It does not switch automatically. Once you leave, the company plan stops, so you must choose and apply for 任意継続, National Health Insurance, or family dependent coverage yourself. Doing nothing leaves you uninsured, with medical costs falling entirely on you.
Which is cheaper, 任意継続 or National Health Insurance?: The premium depends on your former salary, your municipality and your household, so which is cheaper differs per person. Because 任意継続 has a ~20-day deadline, there isn't much time to deliberate. Ask both for their premiums early and compare.
I missed the 20-day 任意継続 deadline.: In principle you can no longer choose 任意継続 after the deadline. You would then join National Health Insurance, or become a family dependent if you qualify. Contact your municipality's NHI counter right away so you don't have an uninsured gap.
I'm starting a new job right away — do I still need to do anything?: If you join the new company's plan immediately with no gap, 任意継続 or NHI is generally unnecessary — the new company handles the insurance. But if there's even a few days' gap, check how you'll be covered during it.

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