According to the Immigration Guideline Changes (March 2009), you would be required to present proof of enrolment "social insurance" if you want to renew your visa. So your visa would be linked to enrolment in government-approved health insurance (kokumin
kenko hoken, shakai hoken, or shigaku kyosai).
Being enrolled in a private travel insurance scheme would not satisfy immigration.
However, as of February 2010, the wording has now been revised to read:"In order to promote signing up for social insurance, foreign residents will be asked to present their health insurance card starting April 1, however renewal applications or change of visa
status applications will not be rejected for failing to present the card."
™For further information about
National Health Insurance (kokumin kenko hoken ) and Employees' Health & Pension Insurance
(shakai hoken) see the Health Insurance section of our Daily Living Guide.