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💴 Money, Tax & Insurance

What to Do When You Lose Social Insurance Coverage

Procedures within 14 days of leaving your job can protect you

📖 6 min read📅 2026-04-26
What to Do When You Lose Social Insurance Coverage

"I had a 39°C fever but couldn't go to the hospital"

Nat (26) from Bangkok, Thailand was shivering in her room late at night in February 2024, sending a LINE message to her mother.

"Mama, I have a fever. But I can't go to the hospital. I don't have insurance."

The message showed "read." Five minutes later, her mother called. "Why don't you have insurance? How?" Nat couldn't answer.

She had left her job on January 31, 2024. She had quit a company she'd worked at for four years to take her next step. Starting March 1, her new job was already arranged. "It's just one month," she thought.

The day after she quit, the company contacted her: "Please return your insurance card." Nat didn't think deeply about what that meant. "Company insurance is over, and I'll be enrolled at the new place next month" — that was all she had in mind.

That one-month gap was the trap.

On February 12, her body felt heavy. By the next day, her temperature had passed 38°C. She tried to go to a nearby clinic, and the receptionist said something she can't forget: "Without an insurance card, the full cost is out of pocket. Initial consultation fee and tests: at least ¥7,000–¥8,000. Prescriptions and medicine are extra."

Nat checked her wallet. ¥4,500 in cash. Her bank account was nearly empty after rent.

"I'll come back," she said, and left the clinic.

On the bus home, tears came. Not from frustration — from humiliation. She had worked honestly in Japan for four years. Paid health insurance, pension, income tax — all of it. And yet with a 39°C fever, she couldn't go to the hospital.

She went home and took over-the-counter fever medicine under the covers, shivering. The fever didn't drop the next day either. On day 3, she called a colleague who said, "You could have signed up for national health insurance. Did you not do any procedure when you quit?"

"No one told me there was a procedure to do."

When she left the company, no one said "Please complete the procedure within 14 days." The company only asked for the insurance card back. The next steps had to be figured out on her own.

When you leave a company or lose social insurance coverage — knowing what to do within 14 days can prevent a situation like Nat's.

❓ Frequently Asked Questions
Q.
What happens to my health insurance when I leave a company?
A.
From the day after you resign, you can no longer use your company's health insurance card. After that, you need to choose either: ① switching to National Health Insurance (Kokumin Kenko Hoken), or ② voluntary continuation of your previous company's health insurance (for up to 2 years). Both require a procedure within 14 days after resignation. If you delay, medical costs during the gap period become 100% out-of-pocket.
Q.
Which should I choose — National Health Insurance or voluntary continuation?
A.
The basic approach is to compare the premium amounts. ① National Health Insurance: premium determined by prior year income (varies by municipality). ② Voluntary continuation: approximately twice the amount deducted at your previous job (because you now cover the company's share). In general, if your prior year income was low, National Health Insurance tends to be cheaper. Ask your municipality office to calculate an estimate.
Q.
Do I need to do anything about my pension after leaving a company?
A.
Yes. You need to switch from the Employees' Pension (Kosei Nenkin) to the National Pension (Kokumin Nenkin). Do this within 14 days after resignation at your local municipality office. Unpaid periods can affect your future pension amount and lump-sum withdrawal calculation.
Q.
What about social insurance for part-time or short-term work?
A.
If working hours are under 30 hours per week, you may not be eligible for company social insurance. In that case, you need to enroll in National Health Insurance and National Pension yourself. Note: At companies of a certain size, the obligation to enroll workers with 20+ hours per week in social insurance now applies.
Q.
Can foreigners enroll in National Health Insurance?
A.
Yes. If you have a valid residence status of 3 months or more, you can enroll in National Health Insurance just like Japanese citizens. Procedures are done at the municipality office in your area. You will need your Residence Card and residency certificate (Juminhyo).
🤝 Where to get help (free, multilingual, anonymous OK)
Japan Health Insurance Association (Kyokai-kenpo)
For voluntary continuation procedures, contact here. Application must be within 20 days of resignation (not 14 days — note the difference).
🌐 Japanese　⏰ Mon–Sat 9:00–17:00
📝 Contact via web →
📞 0120-793-212
Municipal National Health Insurance Office
For switching to National Health Insurance and calculating premiums. You can complete the procedure at your local city/ward/town/village office.
🌐 Varies by municipality (some multilingual support available)　⏰ Weekdays 9:00–17:00
📝 Contact via web →

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