"My fever won't go down." "My tooth hurts." "I fell and cut myself." What do you actually do in Japan when something like this happens?

Japanese healthcare is consistently ranked among the best in the world. The two things that matter most are: being enrolled in insurance, and knowing where to go.

This guide covers the basics of the insurance system, which type of clinic to visit for which symptoms, the visit process, and what to do when language is a barrier — everything a foreign resident needs to know.

Health insurance in Japan — you pay 30%

Japan operates a system called Universal Health Coverage (Kokumin Kaihoken). Every resident is legally required to enroll in some form of public medical insurance.

Types of insurance

Type Who it covers
Employer Health Insurance (Shakai Hoken) Company employees and their dependents
National Health Insurance (Kokumin Kenkō Hoken) Self-employed, freelancers, students, unemployed
Late-stage Elderly Healthcare System Anyone aged 75+

Foreign residents are no exception. If you stay in Japan longer than 3 months, you must enroll in National Health Insurance (or your employer's Social Health Insurance if you work for a company). Without insurance, you pay 100% of the bill at the hospital — often several thousand to tens of thousands of yen per visit.

Out-of-pocket share at the counter

Age Your share
Under 6 (pre-school age) 20%
6–70 30%
70–74 20% (30% if income matches working-age levels)
75+ 10% (20% above certain income; 30% if working-age income)

In other words, if a treatment costs ¥10,000, an adult presenting their insurance card pays only ¥3,000 at the counter.

What you need to enroll

Bring the following to the National Health Insurance counter at your city ward office:

  • Passport
  • Residence Card (Zairyū Card)
  • Certificate of Residence (jūminhyō) — not needed if you've already filed your move-in notice
  • Something with your My Number (My Number Card or notification card)

The most efficient approach is to enroll in National Health Insurance the same day you file your move-in notice — both happen at the same counter.

Some people think "the premiums look expensive, I'd rather skip it." But enrollment is a legal requirement. If you skip it and then get seriously ill, you'll be billed for past premiums and asked to pay 100% of the medical costs. Always enroll.

"Maina Hokenshō" — the digital insurance card (since December 2024)

As of December 2024, paper health insurance cards are no longer being newly issued. Instead, you use your My Number Card as a digital health insurance card — known as Maina Hokenshō.

Benefits of Maina Hokenshō

  • Doctors can see your prescription history and health screening results, preventing duplicate medications
  • The high-cost medical expense cap applies automatically (no advance paperwork)
  • No need to switch cards when you move or change jobs

If you don't have a My Number Card

You'll receive a "Qualification Confirmation Certificate" (Shikaku Kakunin-sho), which works the same way as a traditional paper card.

Clinic or hospital? — Where to go

There are two main types of medical facilities in Japan.

1. Clinics (small practices)

  • Internal medicine, pediatrics, dermatology, dentistry — typically run by 1 to a few doctors
  • Usually accept walk-ins (no appointment needed)
  • Located near homes and offices
  • Your first stop for mild symptoms, chronic conditions, and first-time visits

2. General hospitals and university hospitals (large facilities)

  • Multiple specialties and many specialist doctors
  • Where you go for serious illness or surgery — usually by referral
  • Appointments required (except for emergencies)

Don't go straight to a big hospital — it's expensive

Visiting a large hospital with 200+ beds without a referral letter triggers a non-insurance "referral surcharge" (senteiryōyōhi) — at least ¥7,000 for a first visit (¥5,000 for dental).

For something like a cold, the standard route is: visit your local clinic first, and if they decide you need it, they'll write a referral letter to a larger hospital.

What a clinic visit looks like

  1. Reception: Hand over your insurance card (or Maina Hokenshō) and ID. First-time patients fill out a medical questionnaire.
  2. Wait in the lobby until your name is called. Wait times range from 30 minutes to 2 hours.
  3. See the doctor: Describe your symptoms. If tests are needed, you'll be sent to another room.
  4. Pay at the counter — your share, by cash or card.
  5. Pick up a prescription: If you need medication, take the prescription to a dispensing pharmacy (different from a regular drugstore — look for chōzai yakkyoku).

Prescriptions expire in 4 days

A prescription must be filled at a pharmacy within 4 days of issue, including weekends and holidays. After that, you'll need a re-issue, which costs another visit and fee.

Generic medications save money

At the pharmacy, just say "generic onegaishimasu" and they'll switch you to a cheaper version with the same active ingredient (unless your doctor specifically blocked it). For long-term medications, this adds up to substantial yearly savings.

Quick reference: which type of doctor for which symptom?

Symptom Where to go
Fever, cough, runny nose Internal medicine clinic (naika)
Child's fever or seizure Pediatrics (shōnika)
Tooth pain or lost filling Dentist (shika)
Eye pain or blurred vision Ophthalmology (ganka)
Ear pain, dizziness, sinus issues Ear, nose & throat (jibiinkōka)
Skin itching, rash, acne Dermatology (hifuka)
Broken bone, sprain, back pain Orthopedics (seikei geka)
Mental health, insomnia Psychiatry / psychosomatic medicine
Menstrual issues, pregnancy questions Gynecology / OB-GYN
Sudden adult fever at night #7119 (Adult Emergency Consultation)
Child suddenly sick at night #8000 (Pediatric After-hours)
Life-threatening (unconscious, heavy bleeding) 119 (ambulance)

#7119 and #8000 are free

A nurse will assess your urgency. When you can't decide whether to call an ambulance, call here first — it's the safest move. More local governments now offer multilingual support.

Calling 119 for an ambulance

  • The ambulance ride is free (medical treatment is billed separately)
  • Dial 119 and say "Kyūkyū desu" ("This is an emergency")
  • You'll be asked your address, symptoms, age, and gender
  • If you can't say the address, describe nearby buildings, signs, or vending machine numbers
  • Many municipalities now provide multilingual support — English, Chinese, Vietnamese, and others

Calling an ambulance as a "free taxi" has become a serious problem in Japan, because it delays response to people who genuinely need it. When in doubt, call #7119 first.

Solutions when language is a barrier

"I'm not sure I can describe my symptoms in Japanese" — this is the single biggest reason foreign residents delay seeing a doctor.

1. Find a multilingual medical facility

  • JNTO Japan Visitor Hotline: 365 days, 24 hours, in English, Chinese, Korean, and Japanese. Helps locate medical facilities and handles emergencies. Call 050-3816-2787.
  • AMDA International Medical Information Center: Weekdays 10:00–15:00, in English, Chinese, Thai, Vietnamese, and other languages. Provides medical consultation and referrals to multilingual hospitals (Tokyo: 03-6233-9266).
  • Each prefecture's medical information network: Search "[prefecture name] tagengo iryōkikan" ("multilingual medical institutions").

2. Use translation apps and symptom cards

Google Translate and VoiceTra (a free multilingual app developed by the Ministry of Internal Affairs) work at the counter. Some local governments distribute free multilingual "symptom sheets" you can hand to staff.

3. Interpreter services

Most large general hospitals offer free medical interpretation (by phone or in person). When booking, just say "tsūyaku ga hoshii desu" ("I'd like an interpreter").

Hours and appointments — what's standard

  • Hours: Most clinics are open weekdays 9:00–12:30 and 15:00–18:00 (with a lunch break). Saturday mornings only; closed Sundays and holidays.
  • Appointments: First-time visits often accept walk-ins. Web booking is increasingly common.
  • Patient ID card: A clinic-specific card given on your first visit. Show it at reception each subsequent visit. Apps like "EPARK" and "Medika" can manage these digitally.

Useful systems worth knowing about

High-cost Medical Expense System (Kōgaku Ryōyōhi)

When your monthly medical costs exceed the cap (which depends on income and age), the excess is refunded later. With Maina Hokenshō, the counter payment itself stops at the cap automatically.

Medical expense deduction

If your annual medical costs (Jan–Dec) exceed ¥100,000, you can lower your income tax and resident tax by filing a tax return. Even over-the-counter medications may qualify. Keep your receipts.

Self-medication tax system

If you spend over ¥12,000 in a year on certain marked over-the-counter medications and have had a health screening, you can lower your taxes.

FAQ

Q. Can tourists enroll in Japanese health insurance?

A. No — short-term visitors on tourist visas cannot enroll in public insurance. Always buy travel insurance in your home country before departure. Without it, an appendectomy in Japan can cost over ¥1 million.

Q. How much are the premiums?

A. Social Health Insurance is roughly 10% of salary, split with your employer (so your share is about 5%). National Health Insurance depends on the prior year's income and household composition, and varies by city — roughly ¥17,000/year for a single unemployed person, around ¥250,000/year at a ¥3 million annual income.

Q. If I forget my insurance card, do I pay full price?

A. Yes — by default you pay 100% at the counter. In most cases, bringing the card to the hospital later gets you a refund of the difference, though some hospitals require a separate "medical expense reimbursement" procedure.

Q. Are there hospitals where they speak English?

A. Many in major cities. Try searching "[area name] english speaking clinic" or use JNTO's multilingual medical search. Free booking sites like "Doctorsfile" and "Caloo" also indicate language support.

Q. What's the difference between getting cold medicine at a hospital vs. a drugstore?

A. For mild symptoms, drugstore over-the-counter medications are usually enough (many stores have a pharmacist on hand to consult). Go to a doctor if symptoms last more than 3 days, you have persistent high fever, or you have trouble breathing.

Q. What do I do if I become pregnant?

A. First, see an OB-GYN. Once pregnancy is confirmed, file a pregnancy notification at your ward office. You'll receive a Maternal and Child Health Handbook (boshi kenkō techō) and free coupons for prenatal checkups. At delivery, you'll also receive the Childbirth Lump-sum Allowance (¥500,000).

Q. I'm on long-term medication from home. Can I continue it in Japan?

A. Bring your medication and prescription (in English) to an internal medicine clinic. If the same active ingredient is sold in Japan, they can prescribe it. If not, they'll discuss alternatives.

Final thoughts

Japan's medical system is, financially speaking, surprisingly accessible — as long as you have insurance. The only real obstacles are language and "not knowing what to do."

Three things you can do today:

  1. Confirm you're enrolled in health insurance
  2. Identify one clinic near your home or workplace
  3. Save #7119 and 119 in your phone's emergency contacts

Just doing these makes a sudden illness far less stressful.

At Nihongo-tomo, we offer free vocabulary lists for symptoms, medications, and body parts — exactly the words you need at a hospital. Studying them in advance makes the conversation with your doctor much easier.

References / 参考・出典

All institutional details and figures in this article are accurate as of May 2026. For the latest information, consult each agency's official website.