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Retiring in Japan

Residency routes, healthcare and pension tax · JPY

Routes to residency

Healthcare

Foreign residents in Japan staying longer than 3 months on a non-tourist visa are required to enrol in a public health insurance scheme: either employer-based Social/Employees' Health Insurance (Shakai Hoken) if employed, or National Health Insurance (Kokumin Kenko Hoken, NHI) administered by the municipality if not covered by an employer plan. Enrolment is based on residency registration, not nationality or prior contributions.

No extended qualifying period is specified; residents must apply for NHI at their local municipal office upon establishing residency, and coverage generally begins from the date of enrolment/residency registration.

Private health insurance is a condition of residency in Japan.

Public insurance (NHI or Shakai Hoken) typically covers about 70% of medical costs, with premiums for NHI based on income, assets, household size and municipality; private supplemental insurance is optional and used to cover the remaining out-of-pocket share or non-covered services, but is not itself a substitute for the mandatory public enrolment.

US Medicare: US Medicare does not cover medical care received in Japan; Medicare generally only pays for care outside the United States in very limited exceptions (e.g., certain emergencies near the US border), none of which apply to routine or emergency care in Japan.

Pension income tax

Japan taxes foreign pension income of its residents.

Individuals classified as 'permanent residents' for Japanese tax purposes (broadly, those with a domicile in Japan or who have resided there for more than 5 of the last 10 years) are taxed on worldwide income, including foreign pensions. 'Non-permanent residents' (foreign nationals without Japanese nationality who have lived in Japan 5 years or less in the last 10) are taxed on Japan-source income plus any foreign-source income, such as a foreign pension, that is paid in or remitted to Japan.

There is a US income tax treaty with Japan.

Under Article 17(1) of the US-Japan income tax treaty, private pensions and US Social Security are generally taxable only in the recipient's country of residence; the technical explanation confirms this rule for pensions, similar remuneration, and annuities, though the US 'saving clause' allows the US to continue taxing its own citizens regardless of residence, and government-service pensions are subject to separate source-country rules.

Sources: Japanese Health Insurance: A Guide for Foreigners · Japan Health Insurance for Foreigners: NHI Enrollment, Costs & What Expats Need to Know (2026) · Taxpayers and the scope of taxable income - National Tax Agency · Japan - Individual - Foreign tax relief and tax treaties - PwC Tax Summaries · Technical Explanation, U.S.-Japan Income Tax Treaty

Checked Oct 2026

Customs & etiquette

• Shoe removal indoors — Shoes are removed before entering homes, many traditional restaurants, temples, schools, and even some hospitals, and slippers are typically provided instead. This reflects the strong value placed on cleanliness when moving from outdoor to indoor spaces.
• Chopstick etiquette — Chopsticks carry symbolic weight in Japan, and several common gestures are considered disrespectful or associated with funeral rites. Use a chopstick rest when not eating, hold chopsticks properly, and avoid using them as toys or utensils for anything but eating.
• No eating while walking — Eating or drinking while walking down the street (tabearuki) is generally viewed as socially inappropriate outside of designated food-stall areas. It is best to consume food where you bought it or find a bench or seating area first.
• Tipping is not customary — Tipping is not a standard practice in Japan and is generally unnecessary in restaurants, taxis, or hotels. Excellent service is considered part of the standard job, and attempting to tip can sometimes cause confusion or be politely refused.
• Bowing as greeting — Bowing (ojigi) is the standard greeting in most Japanese social and business contexts, with a moderate bow (keirei, around 30 degrees) used for meeting clients and partners. Visitors are not expected to master the nuances, but a slight bow of the head shows respect and effort.
• Gift-giving customs — Gift-giving (omiyage) is an important part of Japanese social and business culture. Gifts should be given and received with two hands, and the specific numbers and wrapping matter as much as the gift itself.

Religion

Shintoism 48.6% · Buddhism 46.4% · Christianity 1.1% · other 4%

Other countries in East Asia & Pacific

Australia · Cambodia · Indonesia · Malaysia · New Zealand · Philippines · Singapore · South Korea · Thailand · Vietnam

Reference information compiled from the sources cited above and reviewed by hand. Immigration, healthcare and tax rules change and are applied at the authorities' discretion — confirm with the consulate, an immigration adviser or a tax adviser before making plans. Nothing here is tax or immigration advice.

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