If you’re an employer in Japan with foreign staff on your team, you may be wondering whether the annual health checkup requirement actually applies to them. The short answer is yes — and the obligation falls squarely on you as the employer. This guide breaks down exactly what Japanese law requires, what the checkup covers, who pays, and how to make the process work smoothly for employees who need their results in English.
\\n\\n\\n\\nLast updated: March 2026. Medically reviewed by the medical team at SAKURA International Clinic Asakusa.
\\n\\n\\n\\n\\nWhether you manage a small international team or a large company with hundreds of overseas hires, understanding your responsibilities around the mandatory health check Japan foreign worker rules isn’t optional — it’s the law.
\\n\\n\\n\\nFrequently Asked Questions
\\n\\n\\n\\nAre health checkups mandatory for foreign workers in Japan?
\\n\\n\\n\\nYes, under Japan’s Industrial Safety and Health Act, employers must provide annual health checkups (定期健康診断) to all employees, including foreign workers. This applies to full-time employees and part-time workers who meet certain hour thresholds. Employers who fail to provide checkups face fines up to ¥500,000.
\\n\\n\\n\\nWhat does the mandatory health check include in Japan?
\\n\\n\\n\\nThe legally required checkup includes 11 items: height, weight, vision, hearing, chest X-ray, blood pressure, urinalysis, blood tests (anemia, liver function, lipids, blood sugar), and a doctor’s consultation. Employers may add extra tests. The entire process typically takes 1–2 hours at a designated clinic or mobile checkup unit.
\\n\\n\\n\\nWho pays for the mandatory health checkup in Japan?
\\n\\n\\n\\nThe employer pays 100% of the mandatory annual health checkup cost. This is a legal obligation under Japanese labor law — employees should never be charged. The checkup must also be conducted during work hours, and employees should be paid for the time spent. Average employer cost is ¥8,000–¥15,000 per employee.
\\n\\n\\n\\nCan I refuse a mandatory health checkup in Japan?
\\n\\n\\n\\nWhile technically you can decline, employers are legally obligated to ensure all employees complete the checkup. Persistent refusal could result in disciplinary action under company policy. Results are confidential — employers receive only a summary of fitness for work, not detailed medical information. The checkup is free and takes only 1–2 hours.
\\n\\n\\n\\nWhat happens if my health check results are abnormal?
\\n\\n\\n\\nIf results show abnormalities, you’ll receive a recommendation to see a specialist for further examination (要精密検査). Your employer must provide follow-up support, including time off for additional medical visits. About 55% of Japanese workers have at least one abnormal finding — most are minor issues like slightly elevated cholesterol or blood pressure.
\\n\\n\\n\\nIs It Really Mandatory? Yes — Here’s the Law
\\n\\n\\n\\nSome employers assume the annual health checkup only applies to Japanese employees, or that it becomes optional for part-time or short-term foreign workers. This is a common and costly misunderstanding.
\\n\\n\\n\\nJapan’s Industrial Safety and Health Act, Article 66 requires employers to conduct health examinations for all workers — regardless of nationality. The law makes no distinction between Japanese nationals and foreign employees. If someone works for your company in Japan, you are legally obligated to arrange a health checkup for them.
\\n\\n\\n\\nSpecifically, the obligation applies to:
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- Full-time employees (both Japanese and foreign nationals) \\n
- Part-time workers who work 75% or more of the hours of a full-time employee \\n
- Workers on fixed-term contracts that are expected to last at least one year \\n
If your foreign employee fits any of those categories, the employee health check Japan law applies — no exceptions. The checkup must be conducted at the time of hiring and then at least once every 12 months thereafter.
\\n\\n\\n\\nIt’s also worth knowing that workers themselves have a legal obligation to participate. If an employee refuses to attend a checkup, that doesn’t remove your liability as an employer for failing to arrange one.
\\n\\n\\n\\nWhat’s Required in the Annual Health Check
\\n\\n\\n\\nThe standard annual health examination (定期健康診断, teiki kenkō shindan) includes 11 legally mandated items. These are set by the Ministry of Health, Labour and Welfare, and every checkup must cover all of them:
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- Medical history review — past illnesses, surgeries, and any work-related health concerns \\n
- Subjective and objective symptoms — how the employee currently feels, reviewed by a doctor \\n
- Height, weight, BMI, and waist circumference \\n
- Vision test — both near and distant vision \\n
- Hearing test — at 1,000Hz and 4,000Hz \\n
- Blood pressure measurement \\n
- Blood tests — checking lipids (LDL, HDL, triglycerides), blood sugar (glucose or HbA1c), and liver function (GOT, GPT, γ-GTP) \\n
- Urinalysis — testing for sugar and protein \\n
- Chest X-ray \\n
- Electrocardiogram (ECG/EKG) — for employees aged 35 and over, or those with specific risk factors \\n
- Anemia blood test — for employees aged 35 and over \\n
The ECG and anemia tests are sometimes omitted for younger workers at certain facilities — but if your employee is 35 or older, they must be included. It’s always safer to confirm with the clinic beforehand that all required items will be covered.
\\n\\n\\n\\nSome industries — such as those involving hazardous chemicals, radiation, or night shift work — require additional examinations on top of the standard 11. If your company operates in one of these sectors, check with an occupational health specialist or labor attorney to confirm what extra screenings apply.
\\n\\n\\n\\nWho Pays for It?
\\n\\n\\n\\nThe employer pays. This is clearly established under Japanese labor law and is not negotiable.
\\n\\n\\n\\nYou cannot legally require your employees to pay for their own mandatory annual checkup. If you’ve been deducting the cost from salaries, or asking employees to pay out of pocket and submit receipts, that arrangement doesn’t comply with the law’s intent — and it could expose your company to penalties.
\\n\\n\\n\\nIn practice, most employers handle this one of two ways:
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- Corporate contracts with clinics: The company arranges checkups at a designated facility and pays the clinic directly. \\n
- Employee reimbursement: The employee attends a clinic of their choice, pays upfront, and the company reimburses the full amount after receiving a receipt. \\n
Either method is acceptable, as long as the cost is fully covered by the company. The typical cost for a standard annual checkup in Tokyo ranges from ¥5,000 to ¥15,000, depending on the facility and whether additional tests are added.
\\n\\n\\n\\nOne more thing: work time used for the health checkup should generally be treated as paid time. While the law doesn’t explicitly mandate this in all cases, most labor guidance — and common practice among responsible employers — treats the examination as part of the workday.
\\n\\n\\n\\nWhat Happens If Your Employer Doesn’t Provide One?
\\n\\n\\n\\nIf you’re a foreign employee reading this and your employer hasn’t offered you a health checkup, you’re not alone — and you do have options.
\\n\\n\\n\\nEmployers who fail to conduct mandatory health examinations can be fined under the Industrial Safety and Health Act. The penalty is relatively modest (up to ¥500,000 per violation), but repeated failures or deliberate non-compliance can attract attention from the Labor Standards Inspection Office (労働基準監督署).
\\n\\n\\n\\nHere’s what you can do as an employee:
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- Ask HR directly: Sometimes the omission is an oversight, especially in smaller companies or those new to hiring foreign staff. A polite written inquiry often resolves the issue quickly. \\n
- Check your employment contract: Health examinations may be referenced there, which gives you a written basis for your request. \\n
- Contact the Labor Standards Inspection Office: If your employer refuses or ignores your request, you can file a complaint with your local Labor Standards Inspection Office. Complaints can be made anonymously. \\n
- Arrange your own checkup: If you need the health certificate for visa or residence purposes and can’t wait, you can attend a clinic independently — though reimbursement from an uncooperative employer may require further steps. \\n
For employers: the cost of non-compliance — including potential fines, employee relations issues, and the administrative burden of being investigated — far exceeds the cost of simply arranging the checkup in the first place.
\\n\\n\\n\\nGetting Your Results in English
\\n\\n\\n\\nOne of the most common pain points for foreign workers in Japan is receiving health checkup results entirely in Japanese — with no explanation of what the numbers mean, what’s normal, and what requires follow-up.
\\n\\n\\n\\nThis is where it pays to choose a clinic that specifically serves international patients. An English-language explanation of your results can make a huge difference, especially when values are flagged as outside the normal range and you’re trying to figure out whether to be concerned.
\\n\\n\\n\\nWhat to look for when arranging an English-friendly checkup:
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- Staff who can conduct consultations in English \\n
- Written results provided in both Japanese and English (or English only, if needed for overseas insurance or visa applications) \\n
- A doctor available to explain abnormal findings in plain language \\n
- Medical certificates in English, if required by your employer or a government agency \\n
For employers setting up corporate arrangements, choosing a clinic that can handle English communication also reduces the administrative burden on your HR team — fewer translation requests, fewer misunderstandings about scheduling, and happier employees.
\\n\\n\\n\\nIf you’re looking to set up a corporate health partnership for your team, visit our corporate health services page to learn about options for companies with international staff.
\\n\\n\\n\\nHealth Checkup Options for Self-Employed Foreigners
\\n\\n\\n\\nIf you’re self-employed, a freelancer, or working as an independent contractor in Japan, the employer mandate under Article 66 doesn’t apply to you in the same way — because you are both the employer and the worker. But that doesn’t mean health checkups are irrelevant.
\\n\\n\\n\\nHere’s what self-employed foreign residents in Japan should know:
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- National Health Insurance (NHI) subscribers may be eligible for a subsidized basic health checkup through their local municipal office. These are typically available once per year and cost little or nothing depending on your municipality. \\n
- Specific health checkups (特定健診) are provided by your health insurance for those aged 40–74 and aim to screen for metabolic syndrome risk factors. \\n
- Private checkups at clinics like SAKURA International are available to anyone regardless of employment status and can be arranged at your convenience without waiting for municipal scheduling. \\n
For freelancers and entrepreneurs applying for long-term visas — such as the highly skilled professional visa, business manager visa, or permanent residency — having documented evidence of good health can also strengthen your application. A comprehensive private checkup with an English medical certificate covers both your personal health and your administrative needs in one visit.
\\n\\n\\n\\nIf you’re on a spouse visa or dependent visa and want a checkup that’s not tied to your employer, you can attend independently. Some foreigners also get checkups here as preparation before extended travel, to confirm vaccinations are up to date, or simply as part of taking their health seriously while living abroad.
\\n\\n\\n\\nThe bottom line: whether you’re employed, self-employed, or somewhere in between, the mandatory health check Japan foreign worker framework is worth understanding — because it sets the baseline for what a thorough annual exam looks like, even if you’re arranging yours independently.
\\n\\n\\n\\nA Note on Language and Documentation
\\n\\n\\n\\nFor self-employed foreigners especially, it’s worth thinking ahead about documentation. If you ever need to show proof of a health exam — for a visa renewal, an insurance application, or a business client — having a Japanese-language result sheet may not be enough. Requesting an English summary or a formal medical certificate at the time of the exam is much easier than trying to get one retroactively.
\\n\\n\\n\\nSome clinics charge extra for English documentation. Others include it as standard. It’s always worth asking before you book.
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Related Pages
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- Corporate Health Services for International Companies in Japan \\n
- Health Checkups in English at SAKURA International Clinic \\n
- Health Insurance in Japan for Expats — What You Need to Know \\n
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Need Help? We’re Here for You.
\\n\\n\\nSAKURA International Clinic Asakusa is open every day, 9:00–17:00, just one minute from Asakusa Station. Walk-ins welcome. All consultations in English.
\\n\\n\\n\\n\\n\\nComprehensive consultation: ¥55,000 (includes exam, prescription, basic tests, and medical certificate if needed).
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