Key Takeaways

• Preventive Care Push: Japan is emphasizing annual health check-ups ("健診") in 2025 as a key to early disease detection and cost control, making these examinations crucial for all residents (including foreign workers).

• Universal Rule: Employers must provide a yearly health examination (定期健康診断) to every employee by law – even a company with one worker is obligated. The company bears the full cost of these examinations.

• Strict Enforcement: Companies face fines up to ¥500,000 for failing to ensure staff get their annual checkup. Employees are also required to attend the examination, which helps catch issues early.

• Rising Participation: Nearly 60% of eligible 40–74 year-olds took advantage of free health screenings in 2023, the highest ever (Japan's goal is 70%+). Younger adults are also encouraged, as lifestyle-related diseases are increasing even in the 30s–40s with few early symptoms.

• Low Cost to Individuals: Basic check-ups are free or company-paid in most cases. City-sponsored examinations for National Health Insurance members cost nothing out-of-pocket. Even full "Ningen Dock" comprehensive examinations (optional) average ¥30,000–¥60,000 for a day course – pricey, but sometimes partially subsidized by insurers or city programs.

• Key 2025 Trend: Health screening is going high-tech. As of 2025, your examination results can be accessed online via Japan's MyNa Portal (with a My Number card). This integration of digital health records reflects Japan's push for easier follow-up and personal health management.

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Why Health Screening Matters in 2025

Japan's healthcare policy in 2025 puts strong emphasis on preventive medicine and early detection. Annual health screenings have become a centerpiece due to both legal changes and social trends: the Industrial Safety and Health Act mandates regular examinations for workers, and the government has expanded community check-ups to reduce lifestyle-related diseases.

Post-pandemic, there's renewed awareness of preventive health – the national screening rate hit a record ~60%. Yet officials aim higher, with a 70% target to curb rising cases of diabetes, heart disease, and other chronic conditions.

In contrast to a decade ago (when check-ups were sometimes skipped), today's environment incentivizes 100% participation through free programs and digital access to results. Early detection can mean the difference between a simple lifestyle adjustment and costly major treatment, so 2025's trend is clear: don't skip your annual health check.

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Company-Mandated Annual Health Examinations (定期健康診断)

What It Is

For anyone employed full-time in Japan, the annual health check is a routine but important event. By law, employers must have a doctor conduct a health checkup once a year for all staff (usually coordinated through the company or an external medical institution).

This examination typically includes measuring height, weight, and waist, checking vision and hearing, a chest x-ray, blood pressure, blood test and urine tests, and a doctor's consultation. The goal is to catch issues like high blood pressure, high cholesterol, diabetes ("lifestyle diseases") early, even if you feel fine.

In recent years there's been an uptick in young employees (30s, 40s) being flagged for such conditions that have no obvious symptoms at first – hence the emphasis on not missing these examinations.

Who Pays & Why It's Important

The cost is fully covered by the employer or their health insurance association, so the employee typically pays nothing. It's considered part of workplace safety obligations.

Aside from legal compliance, companies benefit from healthier employees and lower sick leave.

Tip: If you're a foreign employee, don't worry – these examinations are for you too. Many large firms in Tokyo, Saitama, Kanagawa, etc. arrange on-site screenings or send you to a partner clinic during work hours.

The process is usually straightforward (often with some basic forms about your medical history to fill out). If language is a barrier, ask HR for an English translation of the questionnaire or assistance – some clinics provide English materials or translators for foreign staff.

Key Requirement

Attendance is mandatory. Both the company and the worker have a duty under the law to make sure the examination happens.

If you're absent on the scheduled day, your employer will typically ask you to reschedule at an approved clinic.

Remember, the company isn't prying for personal details – they're primarily ensuring you're fit for work and advising you if anything needs follow-up. (By law, companies must keep health examination records, but they handle this information confidentially.)

Common pitfall to avoid: assuming you can opt out because you feel healthy. Skipping a required checkup not only puts your employer in a bind legally, but you might miss early warnings.

One case: a young employee who "felt fine" discovered high blood pressure in a routine examination and prevented a potential stroke through early treatment.

In short – take the 30 minutes to an hour for your annual check-up; it could save your life.

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Local Health Check-ups for Residents (市区町村健診)

What They Are

Japan also offers community-based health screenings for those not covered by a workplace examination – for example, self-employed people, students, freelancers, part-timers, and retirees.

These are often called "特定健康診査" (Tokutei Kenshin) or "市区町村健診", and are usually run by your city, ward, or town office.

If you're enrolled in National Health Insurance (国民健康保険) and between 40 and 74 years old, you'll be invited each year for a Tokutei Kenshin (a screening focusing on metabolic syndrome risks).

Younger residents (e.g. 16–39) and seniors 75+ have similar check-up programs under different names (often "○○市民健診" or "後期高齢者健診").

Foreign residents with National Health Insurance are fully included – local governments make efforts to reach out to everyone, sometimes with info in multiple languages.

For instance, Minato City in Tokyo runs its specific health check program each year from July 1 to November 30, and Saitama City likewise offers the "Nobinobi Kenshin" in a similar mid-year window (with cost free).

Kanagawa prefecture cities (like Yokohama, Kawasaki) have their own free check-ups for residents – the pattern is similar nationwide.

Mark your calendar, as these screenings typically have an annual window (often summer to fall) to get them done. If you miss the window, you may have to wait until the next year unless you arrange a private examination.

Cost and Coverage

Good news – it's usually free.

Local resident health check-ups come at no charge or a token fee, heavily subsidized by the government.

For example, basic city check-ups in Tokyo wards cost ¥0 for the standard set of test items.

You'll receive a "受診券" (voucher) by mail or you might need to request one from the city office to take to a clinic. That voucher proves you're eligible and covers the clinic's fees.

Without it, the examination would cost around ¥10,000–¥15,000 (the actual cost paid by the city is roughly ¥14,000 per person for the standard tests).

Practical tip: Watch your mailbox in spring – many cities send check-up coupons around April or May to residents.

If you move to a new city or didn't get a coupon, contact your ward/city hall's health section.

In many places you can apply online or by phone to get the screening ticket.

Also note that if you have a job with social insurance, you won't use the city's program (to avoid duplication) – instead, you'll do the company examination or an insurer-provided one.

But if you or your spouse switch to National Health Insurance mid-year, you become eligible for the next available local check-up.

What's Included

The local health check is similar to the workplace examination in measuring vitals (BMI, blood pressure measurement) and doing blood and urine analysis, but it's particularly geared toward metabolic syndrome.

They'll measure your waist circumference, body mass index, and check cholesterol, blood sugar, liver function, etc., looking for signs of "メタボ" (metabolic issues).

If you're over 40, this aligns with national efforts to reduce diabetes and heart disease.

Some programs also add a questionnaire about lifestyle.

Tip: Many city programs also bundle or coordinate optional cancer screenings (for example, breast, cervical, colorectal cancer screenings) either free or at low cost.

Pay attention to any additional coupons or notices for cancer checks – you might be able to get these done along with your general health check-up or via a separate appointment.

It's a great value since these tests (like a colon cancer stool test or chest x-ray for lung cancer) can be lifesaving.

After the Check-up

You'll receive results, usually a detailed printout, within a few weeks (or on the spot if the clinic provides immediate feedback).

If any value is outside the normal range, the result will be flagged. The report often categorizes findings by urgency: for example, "要医療" (medical attention needed) for anything requiring a doctor's follow-up, or "要指導" (health guidance advised) for less urgent issues.

Critical requirement: if you get a "needs medical treatment" result, don't ignore it – the city will often advise you to see a doctor ASAP.

In fact, local health centers sometimes follow up to ensure at-risk individuals get counseling (特定保健指導) for lifestyle improvements, which is also provided free.

Ignoring such follow-up is a common mistake; it can turn a mild condition into a serious illness.

Instead, take advantage of the guidance – you might get to consult with a nutritionist or nurse who can help you adjust your diet and exercise, all at no cost.

By engaging in this, you're likely to stay healthier and possibly avoid medications.

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Optional Comprehensive Examinations (人間ドック)

What & Why

Beyond the standard check-ups, Japan is famous for "Ningen Dock" – comprehensive health examinations that go into greater depth.

These are optional and not mandated, but many people (typically in their 30s or 40s and up, or those with family health risks) choose to do a Ningen Dock annually or every few years.

A Ningen Dock usually involves everything in a normal health checkup plus additional test items: e.g. abdominal ultrasound, more extensive blood work, an electrocardiogram for heart, sometimes lung function tests, barium swallow or endoscopy for stomach screening, etc.

It often comes as a package where you spend a half day or full day at a specialized center or hospital, moving from station to station for tests.

Some deluxe plans even include CT/MRI scans or a stress test. The idea is to uncover any hidden issues early – cancers, coronary artery disease, etc. – through a thorough screening.

Cost

Unlike basic health checks, Ningen Dock is not covered by public insurance (since it's preventive, not diagnostic).

This means you pay out-of-pocket. Prices vary widely based on how extensive a checkup course you choose and the hospital's level.

A typical day-course Ningen Dock costs ~¥40,000–¥60,000 on average for a fairly comprehensive package. Simpler ones might be around ¥30,000, while high-end or specialized docks (including cancer screening with MRI, etc.) can exceed ¥100,000.

For example, a basic one might include ultrasound and chest CT and run ¥50k, whereas adding a full body MRI or genomic tests could push it much higher.

If you stay overnight for additional testing (some do 1–2 day packages for overnight screening), expect higher costs.

However, check for subsidies: many employer health insurance unions (健保組合) subsidize Ningen Dock for their members, especially once you hit a certain age like 35 or 40.

Similarly, some cities or National Health Insurance funds offer partial rebates – e.g. Saitama City provides an ¥11,000 subsidy for NHI members doing a private Ningen Dock.

It's worth looking into these programs; you often need to apply in advance to get a discount coupon to use at the hospital.

Is it Worth It?

If you're generally healthy and already doing the free annual health check, a Ningen Dock is not strictly necessary, but it can give peace of mind and catch things standard examinations might miss (like certain cancers or early-stage organ issues).

Many Japanese companies actually offer their executives or long-term employees Ningen Dock examinations as part of benefits.

For foreign residents, it's a personal choice.

Tip: If you decide to undergo a Ningen Dock, choose a reputable hospital (many have English support or bilingual summary reports – for example, St. Luke's in Tokyo and some Red Cross hospitals have English "dock" programs).

Plan to fast the night before and possibly collect stool samples in advance (if a colon cancer test is included).

After the examination, you usually get a detailed report book. Some hospitals will explain results in English or provide a translated summary for an extra fee.

Note that if a serious issue is found, and you proceed to treatment, the diagnostic portion might then be covered by insurance – for instance, if your dock finds something and you immediately need further tests or surgery, those subsequent medical costs can go through insurance.

Also, while you can't claim Ningen Dock fees on regular health insurance, if a disease is discovered and treated as a result, the tax office may allow the dock fee to count toward medical expense deductions. It's a small silver lining in case something significant is found.

Real-world example: A 45-year-old expatriate in Tokyo decided to undergo a Ningen Dock at a private clinic in Minato Ward. He paid ¥80,000 for a deluxe medical checkup course including a colonoscopy and MRI. The tests revealed a small asymptomatic colon polyp, which was removed on the spot – likely preventing a future cancer. The expense was high, but he felt it was worth it for the thorough check.

If you have a family history of something like cancer, these comprehensive health examinations can be very valuable. On the other hand, if you're young and on a budget, sticking to the free basic health check and addressing any symptoms as they arise might be reasonable.

Always balance cost with personal health needs.

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Best Practices

To make the most of Japan's health screenings and avoid common pitfalls, keep these best practices in mind:

Don't Skip Your Check-Up: One of the biggest mistakes is ignoring or delaying your annual health examination. Many serious conditions (high blood pressure, high blood sugar, etc.) start silently. Missing your check-up could mean you only discover an illness at a late stage.

Follow Preparation Instructions: Not fasting, ignoring stool sample kits, or missing forms can lead to re-tests or inaccurate results.

Bring Necessary Documents: Insurance card, vouchers, or city coupons – without them, you might have to pay.

Ask for Clarification: Don’t hesitate to ask questions or request English materials.

Follow Up: If your report says “要医療” (needs medical care), act immediately.

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Risk or Mistake	Potential Impact	How to Avoid
Skipping your annual health check because you "feel healthy"	Could miss early signs of silent issues (e.g. hypertension, diabetes) that may worsen without treatment	Mark check-up dates on your calendar and attend every year; remember many illnesses have no symptoms early on.
Not following pre-examination instructions (fasting, etc.)	Inaccurate results (e.g. blood sugar or cholesterol might read high) or needing a re-test	Carefully read the prep sheet. Typically fast 8+ hours before blood draw, avoid alcohol the night before, and complete any home test kits as instructed.
Ignoring an abnormal result on your report	Condition can progress to a serious stage (small issue becomes big due to no follow-up)	If result says "要医療" (needs medical care), promptly consult a doctor. Use your health insurance and bring the report – don't adopt a wait-and-see approach.
Language barrier during examination or results review	Misunderstanding doctor's advice or missing details of results	Proactively ask for clarification or English materials. Some clinics have English-speaking staff; you can also use translation apps for written results or ask a bilingual friend/colleague to help interpret.
Going to an unapproved clinic for city check-up	Might have to pay full price (not covered by the program)	Use the list of designated medical institutions provided by your city/ward. Only specified hospitals can do the free/subsidized examinations. Check the city website or call to confirm which clinics participate.

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Checklist

• Enroll in Health Insurance
• Know Your Check-up Route
• Apply or Schedule
• Prepare Documents
• Follow Pre-examination Instructions
• At the Clinic/Exam Site
• After the Exam
• Review and Act
• Lifestyle Follow-up
• Keep Records

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FAQ

Q1: Are annual health check-ups mandatory in Japan?

A1: For employees, yes – annual health examinations are legally required and your employer must ensure you get one.

If you're not employed (or a dependent), check-ups are not "mandatory" by law, but they are strongly encouraged and offered free through National Health Insurance.

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Q2: How much do these health check-ups cost?

A2: The basic answer is little to nothing out of pocket.

Company-mandated examinations are paid by the employer (no cost to the employee).

City/NHI health check-ups are free in most municipalities.

If you opt for a comprehensive Ningen Dock, that you pay yourself – typically ¥30,000–¥60,000.

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Q3: I'm a foreign resident – can I use these health check services?

A3: Absolutely, yes.

The health screenings are for all people living in Japan, regardless of nationality.

If you're employed, you’ll get the same company health examination as Japanese coworkers.

If you're on National Health Insurance, your city will include you in their check-up notices.

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Q4: What exactly do they check in a standard health examination?

A4: A standard annual checkup (一般健診) usually covers:

• Physical measurements (height, weight, BMI, waist circumference)
• Vitals (blood pressure, pulse)
• Vision and hearing test
• Urine and blood tests
• Chest x-ray
• Doctor consultation

Additional items may include ECG, stool test, PSA, and cancer screening depending on age and gender.

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Q5: Do I need to do anything special to prepare for the health check-up?

A5: Typically, fasting from the night before and bringing any required samples or paperwork is required. Avoid alcohol the night before and wear easy-to-remove clothes.

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Q6: Will my company see my health check results?

A6: Employers receive a summary for compliance but not your detailed private data. Medical confidentiality is protected by law.

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Q7: What if my check-up finds something seriously wrong?

A7: You'll be directed to a hospital or specialist for follow-up. The good news – once you move from screening to treatment, insurance covers it. Early detection means better outcomes and lower costs.

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