Japan's Mandatory Health Checkups for Foreign Workers: What's Required, Costs, and English Support

If you work in Japan, you’ll notice that health checkups aren’t optional — they’re part of working life.Even if you feel healthy, your employer or local city office will ask you to undergo an annual health checkups (kenko shindan /健康診断).

For many foreigners, this feels strict at first, but the system reflects Japan’s focus on preventive healthcare and worker safety.

This guide explains what’s required by law, how the system works, and how foreign residents can make the most of it — not just to comply, but to be supported.

This blog covers:

1.        Why Health Checkups Are Mandatory

2.        When Checkups Happen — and What They Include

3.        Preventive Medicine — Catching Problems Early

4.        What If You Need Further Tests?

5.        Health Checkups for Non-Company Workers

6.        Mandatory Stress Check System — Mental Health Matters Too

7.        Routine Checkups vs. Ningen Dock – What’s the Difference?

8.        Q＆A

9.        Wrap-Up: Don’t Just Comply — Take Advantage

1. Why Health Checkups Are Mandatory

Under Japan’s Industrial Safety and Health Act (労働安全衛生法), employers must provide medical examinations to all employees.

These checkups serve two goals:

• To ensure employees can work safely, and

• To detect early signs of illness or stress before they become serious.

While the law obliges you to take the checkups, it also protects you: your employer cannot discriminate or refuse to hire you because of medical conditions identified during your checkup.

🩺 A Personal Note on Everyday Habits

My husband’s experience shows how naturally Japan encourages healthier living. He walks more than he did in the U.S., eats smaller portions (Japan-sized), and enjoys more vegetables and fish, less meat. Back in Illinois, a “regular” ice cream sundae could feed two people.

We’ve also appreciated how easy it is to access medical care. In Japan, you can visit almost any clinic or hospital without worrying about networks or referrals. —boosted by programs like High-Cost Medical Expense Benefit.

These simple habits — together with accessible care and regular checkups — quietly sustain Japan’s remarkable longevity.

🩺 Japan’s Longevity and the Role of Health Checkups

Japan’s life expectancy owes much to this system of regular health checkups and early disease prevention.
According to data released in July 2025 by the Ministry of Health, Labor and Welfare (MHLW), the average life expectancy in 2024 reached 81.09 years for men and 87.13 years for women — among the longest in the world.
(Source: MHLW Abridged Life Tables 2024)

For comparison, the Centers for Disease Control and Prevention (CDC) reports that in the United States, life expectancy at birth in 2023 was 78.4 years overall, 75.8 years for men, and 81.1 years for women.
(Source: CDC – FastStats: Life Expectancy)

See also:

How to Get Medical Care in Japan as a Foreigner (Real Tips + Free Hospital List)

2. When Checkups Happen — and What They Include

In Japan, medical checkups are an essential part of employment and workplace safety.

🔁 a. New Hire Health Checkup

When you start a new job in Japan, you’ll be asked to submit a medical report issued within the past three months or undergo a company-arranged health checkup.

In most cases, the employer covers the cost. Some companies may ask employees to pay upfront and get reimbursed later, while others have direct billing arrangements with designated clinics.

The examination confirms your overall health and serves as a baseline for your employment record. It typically includes:

What’s included:
A standard checkup usually covers the following:

• Health history – review of medical and work history, subjective and objective symptoms

• Physical measurements – height, weight, waist circumference, vision, and hearing

• Basic tests – blood pressure, urine test, and chest X-ray

• Heart and blood tests – ECG (electrocardiogram), liver function, blood sugar, lipid, and anemia tests

Note: Employers cannot legally deny employment solely based on medical findings unless the condition poses a clear safety risk for specific duties (for example, operating heavy machinery).

And unlike in many other countries, drug testing is not part of the standard employment health check in Japan.

🔁 b. Annual Health Checkup (定期健康診断)

Once a year, your company arranges — and pays for — your annual health checkup.
If you’re enrolled in your company’s Health Insurance Association (協会けんぽ or 健康保険組合), most or all of the cost is covered.

Some plans also allow dependent family members to receive checkups at a subsidized rate — check with your HR department for details.

What’s included:  The same items as the standard new-hire checkup as above.  Depending on your age and gender, additional screenings such as mammography or other age-specific tests may be included. You can also add optional tests at your own expense if you wish to check specific health concerns.

When: Most companies schedule checkups sometime between April and March, aligned with Japan’s fiscal year. After April, you’ll receive detailed information from your health insurance provider, followed by guidance from HR.  

Where: Some companies hold on-site checkups, while others allow employees to choose from approvedclinics/hospitals.

Results: Results are typically sent within 1–2 weeks (or up to a month during busy seasons). If you receive your results directly, submit a copy to HR — employers are legally required to collect 100% of results from all employees.

Practical Tips:

• Some companies grant a half or full day of paid leave for the checkup.

• Book early — February to March is the fiscal year-end rush, and appointments fill up fast.

• Check if there are any restrictions on eating or drinking the day before your health check.

Note: You cannot skip or refuse the annual checkup; it’s a legal requirement under Japan’s Industrial Safety and Health Act.

🔁 c. Special Health Checkup (特殊健康診断)

This checkup is mandatory for employees who regularly handle hazardous substances or materials. It must be conducted at the time of job assignment and at least once every six months thereafter.

3. Preventive Medicine — Catching Problems Early

Japan’s system is designed around the idea that early detection saves lives and money.
Rather than waiting until you’re sick, your company’s checkup screens for potential issues such as diabetes, high cholesterol, or stress-related illness.

Many foreign employees underestimate this aspect. In Japan, regular checkups are not seen as invasive — they’re considered a form of care from both employer and society.
The focus is on prevention, not punishment.

Here are the most recent top 3 causes of death for Japan and the U.S., along with source links:

Sources:

Japan Ministry of Health, Labour and Welfare – Vital Statistics: Leading Causes of Death (E03 Table)

U.S. Centers for Disease Control and Prevention (CDC) – FastStats: Leading Causes of Death

Real story:

Alex, an UK accountant based in Tokyo, was hesitant to get a health check due to the language barrier. But the screening caught prediabetes early — no symptoms, just a timely warning. With a few lifestyle tweaks, he regained his energy.

The insurance-covered follow-up was a game-changer compared to the long waits back home with the NHS.

4. What If You Need Further Tests?

Your health check results may indicate that a follow-up or detailed examination (精密検査) is recommended. This does not necessarily mean you have a disease—it’s a precautionary step to rule out any hidden health risks.

In most cases, the cost of follow-up tests is covered by your health insurance, not your employer.

Tip: If you find Japanese medical forms difficult, use Google Translate or ask your HR department for help making the appointment. Some clinics can arrange English-language assistance if you request it in advance. Bring My Number Card for seamless billing.

Your employer may ask you to confirm that you completed the follow-up test.
While companies in Japan have a legal duty to ensure workplace safety (anzen hairyo gimu), you are not legally required to submit your medical results or to take the additional test itself.

However, for your own health management and peace of mind, it’s wise to complete the follow-up as soon as possible and report back to your employer that you’ve done so.

Useful Information for Language Barriers

List of medical institutions that accept foreign patients
(Ministry of Health, Labor and Welfare)
The list is in Japanese, so ask your HR department for help navigating it.

Hotline:
Tokyo English Lifeline (TELL) — for free, confidential support and medical advice
📞 03-5774-0992

5. Health Checkups for Non-Company Workers

Even if you’re self-employed, a freelancer, or between jobs, Japan’s National Health Insurance (国民健康保険)offers annual health checkups through your local city office.
You’ll receive an invitation or subsidy ticket by mail each year with information on participating clinics.

These city-sponsored checkups are often low-cost or free, depending on your age and income.

They cover similar basics: height, weight, blood pressure, blood and urine tests, chest X-ray, EKG, and cancer screenings for eligible age groups.

How to book:

1. Check which medical institutions are designated by your city for health checkups.

2. Choose a clinic or hospital, and make an appointment.

3. Bring your invitation or subsidy ticket from the city office on the day of your checkup.

4. Your results will be mailed to your home or the clinic within a few weeks.

This service is especially valuable for spouses, students, and retirees—a great example of how Japan’s healthcare system supports all residents, not just full-time employees.

6. Mandatory Stress Check System — Mental Health Matters Too

Since December 2015, companies in Japan with 50 or more employees have been required to conduct an annual stress check.
A 2025 law revision will expand this rule to smaller workplaces (under 50 employees), expected to take effect around May 2028.

You’ll fill out a confidential questionnaire about your workload, relationships, and emotional wellbeing.
Individual answers aren’t shared with management — only summarized group data.

If your stress level is found to be high, you can request a private consultation with a company doctor (産業医), or ask HR if  free EAP counseling is available as benefits.

Employers use the results to improve work environments and prevent burnout.

For foreign employees who may feel hesitant to discuss mental health at work, this system offers a safe and structured way to seek support — a reflection of Japan’s growing focus on psychological wellbeing in the workplace.

7. Routine Checkups vs. Ningen Dock + Inbound Ningen Dock

If you’ve already completed your annual company medical check, you might wonder why Japan also offers something called a “Ningen Dock” (人間ドック) — a comprehensive, up to two days health screening.

The difference lies in depth, purpose, and cost.

• Routine employer or city checkups are mandatory, focused on compliance and basic prevention.

• Ningen Dock programs, on the other hand, are optional premium checkups offered by hospitals and clinics specializing in preventive medicine. They include advanced screenings — abdominal ultrasound, endoscopy, CT/MRI scans, cardiac tests, or women’s health options — designed to detect early-stage cancers or lifestyle diseases before symptoms appear.

For foreigners, language support is usually available at major hospitals such as Juntendo, St. Luke’s, and Tokyo Midtown Clinic. Programs are offered in English or Chinese, and international coordinators help with booking and results.

Cost: ranges from about JPY50,000 – JPY150,000 (USD 300–1,000), depending on the package.

🌏 Inbound Ningen Dock — A New Trend

In recent years, Japan has seen a steady rise in foreign visitors coming specifically for Ningen Dock checkups, not just for sightseeing. Hospitals now promote “Inbound Dock” plans tailored for overseas clients, with multilingual staff, interpreters, and visa-support options. Most inbound participants currently come from Asian countries such as China, Taiwan, Thailand, and Singapore, but the number of visitors from North America is also increasing.


Their main motivation is access to Japan’s advanced imaging and early-detection technology, combined with shorter waiting times and Japan’s reputation for precision and hospitality.

Even for foreigners already living in Japan, it’s possible to join these inbound programs if you prefer English-language service, bundled diagnostics, or concierge-style assistance.

8. Q&A

Q1. What if I’m overseas or on leave when my company holds its checkup?
A1. You can take it at an approved clinic and submit the results.

Q2. Can I use my own doctor instead of the company clinic?
A2. Check if your health insurance approved doctor/facility.  Typically, the insurance covers major clinics/hospitals.

Q3. Can my employer fire me for poor health results?
A3. No. The results are used to protect you, not penalize you. Dismissal due to illness requires clear, job-related justification under Japanese labor law.

Q4. Are family members required to take checkups?
A4.  They’re not required by law, but highly recommended. Many health insurance plans subsidize checkups for spouses and dependents.

If your dependents are students, schools usually provide annual health checkups — from nursery and kindergarten through university.

Q5. What if I can’t read my results in Japanese?
A5. You can use Google Translate for both paper-based and online results, as most checkup reports follow standardized medical formats.

Q6. Myth: Results go to immigration.
Busted!  Your health check results are confidential and not shared with immigration or visa authorities. They’re used only for workplace safety and employee wellbeing.

9. Wrap-Up: Don’t Just Comply — Take Advantage

Japan’s mandatory health checkups may seem bureaucratic at first, but they’re actually a valuable benefit — an easy, affordable way to stay on top of your health.

Remember:

• Employer covers the cost

• Follow-up care is insured

• Discrimination based on results is illegal

• Privacy and confidentiality are core legal requirements

• Family members can join

• Mental health counts, too

Think of Japan’s system as a cultural strength that values collective wellbeing.
Use it to ask questions, build trust, and take proactive steps for your health.

💡 Tip for newcomers:

Schedule your annual checkup around the same month each year, keep a copy of your results, and track improvements over time. You’ll not only stay compliant — you’ll stay healthy, supported, and informed.

Questions or experiences to share? Comment below — Jager and I ’d love to hear from you!