Printed on your letter

国民健康保険料督促状・催告書

kokumin kenkō hoken-ryō tokusokujō, saikokusho

National Health Insurance reminder and demand letters

Last checked: 8 October 2026

These letters mean a National Health Insurance (kokuho) payment was not received by its deadline. The first is a formal reminder (督促状). If it stays unpaid, more letters follow, often called 催告書. Pay by the date printed on the letter, or contact your city office before that date.

What to do now

Find the date on the slip and pay by then. If you cannot pay it all, call the number on the letter before that date.

What it is: 督促状: the formal reminder that a premium is overdue. 催告書 and similar letters: later demands, some warning that property may be seized.
Who sends it: Your city or ward office: the 国民健康保険 section, or its tax or collection section.
When it arrives: The 督促状 comes a few weeks after a missed deadline: Toyokawa, for example, sends it within 20 days. Later letters come only if it stays unpaid.
Deadline: The date printed on the letter or its payment slip (指定期限). In Shinjuku, for example, property may be seized if it is still unpaid 10 days after the reminder was sent.

How to read it

Tap a number to see what it means. Yellow marks the amount and the deadline.

Simplified drawing. The exact layout differs by city.

Some cities explain their reminder in other languages. Toshima, for example, has a numbered guide to its 督促状 in English, Chinese, Vietnamese, Burmese and Nepali.

Step by step

Check which payment is unpaid and the total. If you already paid, compare with your receipt: in Edogawa, it takes about 2 weeks for a payment to reach the ward.
Pay with the slip in the letter by the date printed on it.
If you pay by direct debit and that month’s debit is still to come, do not use the slip, so that you do not pay twice. Toshima, for example, says this on its reminder.
Keep the receipt part of every slip. When you apply for permanent residence, Immigration asks for copies of your receipts for the last 2 years, to show that nothing was paid late.
If you cannot pay in full, call the number on the letter before the date and ask about paying in parts (分割納付). Sapporo, for example, asks you to have papers about your living situation, income and assets ready.

Ways to pay

Convenience storeOnly if the slip has a barcode. Toshima, for example, limits it to ¥300,000 per slip.
Bank, post office or city office counterAt the banks listed on the slip, or at the city office.
Smartphone payment appsWhere the city accepts them and the slip has a barcode. Toshima, for example, accepts PayPay.

Where you can pay differs by city. The slip lists the places that accept it.

If you do not pay

Late fees (延滞金) are added under your city’s rules. Setagaya and Shinjuku count them from the day after the original deadline: 2.8% a year for the first 3 months, then 9.1% (2026). Yokohama charges them only if you miss the date on the reminder (指定期限), counting from the next day at 9.1%. Toshima bills them separately after you pay.
More letters come, such as a 催告書 or a notice before seizure (差押事前通知書). Saitama, which collects kokuho as a tax, says these letters are not required by law, and that seizure can come before one is sent.
The city can seize your savings, salary, life insurance or other property. Yokohama says it may do so without warning.
In principle after 1 year unpaid without a special reason, and after a notice, you pay the full cost at the clinic first. You can claim the insured share (特別療養費) back later, but the city may use it for the unpaid premiums (Chuo). Kobe, for example, swaps your 資格確認書 for one marked 特別療養. Children up to the end of March after they turn 18 are not affected. If you need care and cannot pay the full cost, tell the city: it may give you a normal certificate with a shorter validity.
After 1 year and 6 months, money the city would pay you, such as refunds of high medical costs, is withheld and may be used for what you owe (Kawasaki). Kobe may do this from 1 year. In Chuo Ward, you also cannot apply for the certificate that caps hospital costs (限度額適用認定証).
Unpaid premiums can count against you at Immigration. For renewal or change of status, cases such as large or long-unpaid amounts are treated as a negative factor when judged to be in bad faith (悪質). For permanent residence, Immigration’s current guideline says that premiums not paid by the original deadline are in principle counted against you, even if paid later. A revised guideline applies to applications made from 1 April 2027. Under it, a past failure to pay properly, such as having had savings or other assets seized for unpaid taxes or premiums (滞納処分), is in principle counted against you even if nothing is unpaid when you apply, and this is in principle judged for your household as a whole.
From 1 April 2027, permanent residence can be cancelled for deliberately not paying taxes or social insurance. One example Immigration gives is not contacting the office about payment despite reminders. It does not apply when there is an unavoidable reason and you are not at fault. Unless Immigration finds that you should not stay in Japan, it changes your status to another one instead, and it expects this to be long-term resident (定住者) in most cases.

If you cannot pay

If money is tight or your situation has changed, ask your office first.

Contact your city office before the deadline. Many cities let you pay in parts (分割納付). In Setagaya, reminders still come while you pay in parts.
If you cannot pay because of a disaster, illness or closing a business, ask about postponement (徴収猶予). Osaka allows up to 6 months.
A reduction (減免) usually lowers only payments that are not yet due. In Osaka, you apply by the deadline of the month you want reduced, so it rarely lowers the overdue amount, but it can lower later payments. Osaka gives no reduction if anyone in the household has not declared their income.
Paying the unpaid premiums in full, or a large part of them, brings back normal cover at the clinic.
If paying all at once would make your life or business very hard, ask about 換価の猶予: more time before seized property is sold. In Osaka, you apply within 6 months of the original deadline, for up to 1 year in principle, and you must show a sincere intention to pay. Collateral is in principle required.

Common questions

I already paid. Why did I get a 督促状?

Payments take time to reach the city. Hiroshima, for example, makes its reminders from payment records 10 to 14 days before sending. Check your receipt. If you paid, Edogawa and Hiroshima say you can throw the letter away.

What is the difference between 督促状 and 催告書?

The 督促状 is the reminder required by law. A 催告書 is a later letter that each city designs; Saitama says it is not required by law. Some, such as a 差押事前通知書, warn that seizure is close.

Is a coloured envelope more serious?

Envelope colours differ by city, and we could not confirm any nationwide colour code. Read the name of the letter instead. Kobe’s envelope for its demand letter (催告書兼確定延滞金通知書), for example, says 至急開封 URGENT.

Will Immigration know that I did not pay?

Immigration says it may use information it asks other public offices for about whether you have paid. According to the Ministry of Health, Labour and Welfare (MHLW), MHLW and Immigration are also preparing a system so that, from June 2027, Immigration can check your kokuho payment records, with your consent, when you renew or change your status. Under MHLW’s plan, if you do not consent, you would be asked for a payment certificate. Under the same plan, if premiums are unpaid, you would need to pay, or agree a payment plan (分納誓約書 and similar), and show proof. Without that proof, the plan says renewal or change of status would in principle not be allowed. We could not find a notice from Immigration itself about this.

I joined my company’s health insurance. Why do I still get these letters?

Leaving National Health Insurance is not automatic. Tell your city office within 14 days. If you do not, premiums keep being billed and reminders keep coming (Setagaya).

I agreed a payment plan. What if I cannot keep it?

Contact the office before the next date. Nagoya, for example, says it moves to seizure if a payment promise is not kept.

Show this at the counter

Show this to the staff if you go to the office in person.

国民健康保険料（税）の督促状（催告書）が届きました。日本語があまり分かりません。いくら、いつまでに払えばよいか教えてください。分割で払えるかも相談したいです。

In EnglishI received a reminder (demand letter) for my National Health Insurance premium (or tax). I do not understand much Japanese. Please tell me how much I need to pay and by when. I would also like to ask if I can pay in parts.

Official sources