Foreign residents in Japan can expect significant changes to healthcare costs in 2026, as the government moves forward with plans to make childbirth free under public health insurance while simultaneously reducing prescription drug prices. According to NHK, the Ministry of Health, Labour and Welfare (MHLW) has decided to introduce a new system that will cover standard childbirth costs entirely through public medical insurance, eliminating out-of-pocket expenses for families. This represents a major shift from the current system, where parents must pay upfront and then claim reimbursement through the lump-sum birth allowance program. Currently, expectant parents in Japan receive a lump-sum birth allowance of 500,000 yen per child through their health insurance, but actual delivery costs often exceed this amount, particularly at private hospitals or in major cities like Tokyo. Many foreign residents have reported paying between 600,000 and 800,000 yen for standard deliveries, creating a financial burden at an already challenging time. Under the new system, the MHLW will establish standardized childbirth costs that will be fully covered by public health insurance nationwide. The ministry is currently working to determine what constitutes "standard" childbirth expenses and will develop a framework for implementing this coverage. This change aims to support Japan's declining birth rate by removing financial barriers to having children, a concern that affects both Japanese citizens and foreign residents planning families in the country. For expats enrolled in Japan's National Health Insurance (kokumin kenko hoken) or Employees' Health Insurance (shakai hoken), this policy change means childbirth will become significantly more affordable. However, details about implementation timing, what specific services will be covered under "standard" costs, and how additional services or complications will be handled remain under discussion. Simultaneously, the MHLW announced that prescription drug prices will decrease in fiscal year 2026. According to a government survey released by NHK, market prices for medications purchased by medical institutions are averaging 4.8% below the government-set prices. This gap indicates that the official drug price schedule needs adjustment to reflect actual market conditions. The drug price component of medical fees (shinryou houshu) will be reduced accordingly next fiscal year. This adjustment is part of Japan's biennial review system for medical fees, which ensures that healthcare costs align with market realities. For foreign residents, this means lower costs for prescription medications, whether paying out-of-pocket or through insurance co-payments. Japan's healthcare system requires most residents to pay 30% of medical costs as co-payments, with the government covering the remaining 70% through public insurance. Lower drug prices will therefore benefit both patients through reduced co-payments and the national healthcare system through decreased overall expenditure. These changes come as Japan grapples with rising healthcare costs driven by an aging population and increasing medical expenses. The government is attempting to balance making healthcare more accessible and affordable while ensuring the sustainability of the public insurance system. Foreign residents should note that eligibility for these benefits requires enrollment in Japan's public health insurance system, which is mandatory for all residents staying longer than three months. Those planning to have children in Japan should stay informed about implementation details as the MHLW finalizes the standardized childbirth coverage framework. Expats currently expecting or planning pregnancies may want to consult with their healthcare providers and insurance administrators about timing and coverage specifics. While the childbirth coverage expansion represents positive news for families, the exact rollout schedule and detailed guidelines will be announced as the ministry completes its policy framework throughout 2025. These healthcare reforms demonstrate Japan's commitment to supporting families and maintaining accessible medical care for all residents, including the foreign community that contributes to the nation's workforce and society.