What to Do When You Lose Social Insurance Coverage

Procedures within 14 days of leaving your job can protect you

"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.