Japan – Doctors

How does the healthcare system in Japan work, and does it cover expats?

Japan’s universal healthcare framework has been in place since 1961. Rather than a purely tax-funded model like the United Kingdom’s NHS — where central government revenue covers most costs — Japan uses a social insurance structure broadly comparable to Germany’s statutory health insurance or Australia’s Medicare: residents pay premiums, and the government provides additional subsidies on top. The outcome is near-total coverage, with every resident legally obliged to hold some form of health insurance.

More than 3,000 health insurance funds are distributed across three main schemes: employer-based health insurance, the residence-based National Health Insurance (NHI), and a separate scheme for those aged 75 and above. Employees at Japanese companies are enrolled in Employees’ Health Insurance (Kenko Hoken), while the self-employed, unemployed, retired, and students are generally covered by National Health Insurance (Kokumin Kenko Hoken).

Japan’s social insurance system delivers near-universal coverage but limits eligibility to residents who have been in the country for at least three months. This means short-term visitors, temporary residents, and those without documentation are excluded. Expats holding a valid residence permit of one year or more must enrol in NHI unless they are already covered through an employer scheme or the late-stage elderly programme.

When enrolled in either NHI or Social Health Insurance (SHI), the Japanese government covers 70% or more of medical costs. The scope of coverage includes medically necessary outpatient consultations, inpatient care, a broad range of dental treatments, and prescription drugs listed on the national fee schedule. Items that fall outside coverage — such as most routine adult health checks, cosmetic procedures, and private hospital room upgrades — are paid entirely by the patient.

For up-to-date and authoritative information on who qualifies for coverage, visit the Ministry of Health, Labour and Welfare (MHLW). Your nearest city or ward office can also offer municipality-specific guidance on joining the NHI scheme.

How do you find and register with a doctor in Japan?

Japan does not use a GP registration model in the same way many other countries do — there is no centralised list to choose from, and no single doctor is assigned to your area by default. Japan ranks among the highest OECD countries for doctor visits per capita, and patients are free to approach virtually any facility, usually without a waiting list or a mandatory referral to access specialist care. In practice, this means you can walk into most clinics unannounced and receive treatment the same day.

Local primary care clinics — referred to as “kurinikku” — tend to be more affordable and quicker than major hospitals. Unless you need emergency treatment or highly specialised care, these are the ideal starting point for most foreign residents. If you do wish to consult a specialist at a large hospital, obtaining a referral letter from a local clinic beforehand can save money, since hospitals commonly charge an extra fee for patients arriving without a referral.

To join the National Health Insurance scheme — the essential first step toward subsidised healthcare — you must register at your city or ward office. The documents required typically include your Residence Card, passport, proof of address, financial records, and documents for any dependants you wish to add. Exact requirements can differ between municipalities, so it is advisable to check with the relevant service counter before attending.

You are required to enrol in NHI within 14 days of establishing your address in a municipality. Upon completing the application, you will receive a My Number Card, which acts as proof of enrolment and serves as your primary means of accessing healthcare services in Japan. You must present this card whenever you attend a clinic or hospital for treatment.

As of December 2024, Japan has stopped issuing traditional health insurance cards. For those who do not yet hold a My Number Card, a Health Insurance Eligibility Certificate has been available from 2 December 2024 as an alternative. When attending a clinic for the first time, bring either your My Number Card or eligibility certificate, your Residence Card or passport, and a summary of any relevant medical history.

Many clinics are closed on weekday afternoons, weekends, and public holidays. Before making a trip, check opening hours online or call ahead to avoid finding the facility shut. Your local ward office can point you toward nearby clinics, and the MHLW maintains a searchable medical facility database at iryou.teikyouseido.mhlw.go.jp.

How do you pay for a doctor’s appointment in Japan?

Japan’s healthcare system is financed through a combination of resident premiums, employer contributions, and government subsidies, making it a social insurance model rather than one where care is free at the point of use. Medical services are not free for foreign nationals in Japan, even those enrolled in a public insurance scheme. Insured individuals are responsible for covering 30% of the costs they incur from medical services.

The standard patient co-payment is 30% for those aged 6–69 (as of 2025). Children under 6 generally pay 20%, adults aged 70–74 pay 20% (or 30% if classified as high-income earners), and those aged 75 and over pay 10% (or 30% for high-income individuals). These rates remained unchanged in 2025. Expats enrolled in a public insurance scheme pay the same co-payment rates as Japanese residents.

For a routine clinic visit, out-of-pocket costs are typically modest — around ¥3,000–¥5,000 (roughly $20–$35) as of 2024–2025. A specialist consultation at a large hospital may run ¥5,000–¥10,000. Prescription costs are also low for most insured patients, with many common medicines costing only a few hundred yen. Always confirm current charges directly with your clinic or through the MHLW, as fees are set by a national schedule that is revised periodically.

Protection against very high monthly bills is available through the High-Cost Medical Expense Benefit: when your out-of-pocket spending in a given month exceeds the threshold for your income bracket, the excess is reimbursed. You can apply in advance for an Eligibility Certificate for Ceiling-Amount Application to avoid large upfront payments at the point of care. For most non-elderly adults, the monthly cap is approximately ¥80,100 (plus 1% of costs exceeding ¥267,000), as of 2025. The MHLW website has the most current income-based thresholds.

NHI premiums are recalculated each fiscal year based on the previous year’s income and household size. Newly arrived foreign residents with recently issued Residence Cards may initially be assessed at a lower estimated premium until full tax records become available. Premium payment slips are sent by your city or ward office several times throughout the year and can be paid at convenience stores, municipal offices, banks, or via automatic bank transfer.

Employees of Japanese companies covered under Employee Health Insurance have premiums deducted directly from their monthly salary, with the employer managing enrolment on their behalf in most cases.

Do you need private health insurance to see a doctor in Japan?

Health insurance enrolment is mandatory in Japan, and failing to comply may affect your ability to renew your visa or adjust your residency status. For most expats who have been in Japan longer than three months, public insurance — either employer-based (SHI) or municipality-based (NHI) — forms the required foundation. Private insurance is not legally required as a replacement for public coverage, but it is commonly taken out as a supplement.

Many residents choose to carry supplemental private insurance to cover the 30% co-payment left over after the public system’s contribution, as well as services excluded from public coverage such as orthodontic treatment. Private health insurance can be layered on top of the existing national plans to fill these gaps. Many expats opt for international health insurance policies that offer broad, portable benefits usable anywhere in the world.

Private or international health insurance is particularly relevant for expats who travel regularly for work, those seeking English-language medical services, or individuals who are in Japan for a period too short to qualify for public scheme enrolment. You are required to enrol in a health insurance plan within two weeks of moving to Japan. Since joining SHI or NHI takes time and paperwork, having independent coverage in place while your public insurance application is processed is a sensible precaution.

For guidance on health insurance requirements as they relate to visa and residency conditions, consult the Immigration Services Agency of Japan, which publishes detailed information on the obligations attached to different residence statuses.

How do you transfer your medical records to a doctor in Japan?

Japan does not yet operate a fully integrated international digital health record system, so bringing your medical history into the country takes advance planning. The most important thing to do before you leave your home country is to obtain a written medical summary from your doctor — often called a patient summary or GP letter — covering your diagnoses, current medications, known allergies, and any notable procedures or test results.

The Ministry of Health, Labour and Welfare (MHLW) provides multilingual materials to support foreigners attending clinics and hospitals, and many standard forms are available in bilingual versions. That said, records from overseas are almost always written in your home country’s language. Having essential documents professionally translated into Japanese before your first appointment is strongly recommended. Services such as MedicTranslate specialise in translating prescriptions, medical records, and similar documents into Japanese, and can also advise on clinics experienced in treating foreign patients.

If you take regular medications, bring a written list or your original pill packaging to show the doctor or pharmacist. Knowing the generic (non-brand) name of each drug is especially valuable, since Japanese brand names often differ from those used in other countries — for instance, referring to “atorvastatin” rather than the brand name “Lipitor” reduces the chance of confusion or accidental duplication.

Japan has a medication record booklet called the “Okusuri-techo” (お薬手帳). Each time you fill a prescription, the dispensing pharmacy records the details in this booklet, creating a cumulative log that is useful when you visit different pharmacies. The Okusuri-techo helps guard against duplicate prescriptions and risky drug combinations. Pharmacies offer two formats free of charge: a paper booklet and a digital version via an app called Okusuri Plus. Starting your medication record from your very first pharmacy visit in Japan is advisable.

Japan is also making progress toward digitalising health records. The Mynaportal government system enables residents to view certain health data — including insurance claims information — through their My Number Card. Visit the MHLW website for the latest updates on the scope and capabilities of this digital health infrastructure.

What should expats know about language barriers and finding a doctor in Japan?

The vast majority of Japanese clinics and hospitals operate in Japanese, which can present real difficulties for foreign residents trying to book appointments, interpret medical information, or describe their symptoms accurately. Hospital support services exist to help bridge this gap through interpretation, language assistance, and guidance at various stages of the medical encounter. This challenge is most pronounced in rural and regional areas, where experience with international patients tends to be less developed.

In larger urban centres — particularly Tokyo, Osaka, Kyoto, and Nagoya — a number of clinics and hospitals have dedicated international patient departments and staff who speak English. Many embassies in Japan maintain lists of English-speaking doctors on their official websites. Expat communities are another valuable resource, with members frequently sharing recommendations for multilingual physicians on online forums and social media groups. Identifying an English-speaking GP or paediatrician close to your home before you fall ill is strongly advisable.

Several directories can assist you in locating suitable care. Japan Healthcare Info (JHI) is an extensive directory covering English-speaking clinics and hospitals throughout the country. Tokyo Medical Assistance focuses on English-friendly healthcare providers in the capital, while GaijinPot Health compiles recommendations for English-speaking doctors in major cities. DoctorFind is an online listing of English-speaking practitioners and clinics, with a particular focus on the Tokyo and Kanagawa areas.

Most local governments publish searchable databases of nearby hospitals and clinics online, including filters for language support. However, this information is not always current, and the presence of English-speaking staff on any given day cannot be guaranteed. Calling ahead to verify availability before you visit is always worthwhile.

The AMDA International Medical Information Center provides both a telephone consultation service and an over-the-phone interpretation service for patients already at a hospital or clinic. Its website lists available languages and service hours, covering English, Chinese, Korean, Portuguese, Spanish, Thai, Vietnamese, and others.

The Dr. Passport smartphone app allows users to store their medical history, document symptoms, and streamline communication with doctors, pharmacists, and hospital staff. Supporting 12 languages, the app lets you enter your current concerns to show directly to a healthcare provider during your appointment.

To keep wait times manageable and costs contained, medical consultations in Japan are often very short. It is not unusual for a primary care or specialist visit to last just 3–10 minutes, with doctors seeing a very high volume of patients each day. Preparing a written list of your symptoms and questions in advance — ideally in Japanese — will help you make the most of the limited time available.

What do expats need to know about prescriptions and medication in Japan?

In Japan, prescribing and dispensing medication are handled as two distinct steps. After your consultation, you pay your share of the clinical fee and receive a written prescription. You then take that prescription to a separate pharmacy to collect your medicine. This separation of the prescribing and dispensing functions is standard practice across Japan, and differs from countries where clinics or hospitals dispense medication directly on site.

Medications obtained abroad are not automatically accepted by Japanese pharmacies. Any drug must be re-prescribed by a licensed Japanese physician working within the nationally approved formulary. Some substances that are legal and readily available in other countries may be restricted or entirely banned in Japan — this applies particularly to certain painkillers, stimulants, and some ingredients found in cold and allergy remedies. Before travelling to Japan with a supply of medication, check with the MHLW or the nearest Japanese consulate or embassy to confirm whether your medicines require a prior import certificate (“Yunyu Kakunin-sho”), especially if you are bringing more than a two-month supply.

Residents enrolled in Japan’s NHI are covered for most consultations and prescription drugs, paying the standard 30% co-payment on the total bill. Out-of-pocket costs for prescription medicines are generally modest — many common drugs cost only a few hundred yen with insurance coverage (as of 2024–2025). Always verify the current co-payment rates with the MHLW or your insurer, as the national fee schedule is subject to periodic revision.

Generic versions of many drugs are available in Japan, and opting for generics can meaningfully reduce pharmacy costs for long-term residents. Pharmacists are required under Japanese pharmacy regulations to inform you whether a generic equivalent exists for your prescription, so do not hesitate to ask.

Pharmacies provide the Okusuri-techo medication record booklet in both paper and app form, free of charge. You should bring it to every medical appointment. Presenting your Okusuri-techo can also reduce your administration charge by ¥120 (i.e., ¥40 after applying the 30% co-payment). Building a complete and accurate medication history in your Okusuri-techo from the outset is particularly important if you consult multiple doctors or specialists.

How do I register for National Health Insurance in Japan? (Step-by-step)

1. Register your residence. Within 14 days of arriving in Japan or relocating to a new municipality, register your home address at your local city or ward office. Completing this step is a prerequisite for NHI enrolment.
2. Gather your documents. Prepare your Residence Card, passport, proof of address, and any financial documents required. If you are adding dependants to your application, bring their documents as well. Requirements differ between municipalities, so check with your ward office in advance.
3. Visit your local city or ward office. Bring your documents to the relevant city or ward office. Each municipality has its own office responsible for processing NHI applications.
4. Complete the NHI application form. Fill in the National Health Insurance application at the office counter, taking care to ensure all details are accurate and complete.
5. Receive your insurance credentials. Once your application has been processed, you will receive a My Number Card confirming your enrolment and entitling you to access healthcare services in Japan. If you do not yet have a My Number Card, ask for a Health Insurance Eligibility Certificate to use in the interim.
6. Await your premium bill. No payment is collected at the office on the day of enrolment. A premium bill will be sent to you once your details have been processed.
7. Set up payment. Many municipalities offer automatic bank withdrawal as a payment option for foreign residents, which helps prevent missed payments and is particularly useful for those still learning Japan’s billing and payment systems.

Frequently asked questions

What should I do in a medical emergency in Japan?

If you face a medical emergency, call 119 to request an ambulance. Even if the dispatcher does not speak fluent English, saying “ambulance” or “hospital” will communicate the urgency of your situation. If you are uncertain whether an ambulance is needed, calling #7119 first will connect you with a non-emergency medical advice line that operates in Tokyo and several other prefectures. For cases that are serious but not immediately life-threatening, attending an emergency outpatient clinic (kyukyu-byoin) is generally the most appropriate course of action.

Will pre-existing conditions be covered under Japan’s public health insurance?

Neither NHI nor SHI applies exclusions for pre-existing conditions. From the moment you are enrolled, you are entitled to coverage for any medically necessary treatment, including conditions that predated your arrival in Japan. This encompasses outpatient care, hospitalisation, many dental treatments, and prescription medicines on the national fee schedule. Be aware, however, that supplemental international private insurance policies may include their own pre-existing condition exclusions, so read any additional policy documents carefully before committing.

How long does it take to be enrolled in NHI and get my insurance card?

Provided you arrive at the ward or city office with all the necessary documents, enrolment is completed on the same day. You must register within 14 days of moving into your municipality. Your My Number Card or Health Insurance Eligibility Certificate confirms your coverage immediately upon enrolment. Be aware that delaying registration does not eliminate the premiums owed — you may be billed retroactively from the month you first became eligible.

What happens to my health insurance if I lose my job or change employer in Japan?

If you move into employer-based insurance (社保), you should withdraw from NHI promptly to avoid overlapping coverage. Conversely, if your employer insurance ends through redundancy or a job change, you must re-enrol in NHI within 14 days. Inform your ward office of the change and bring supporting documents such as an insurance termination certificate. Acting quickly when your employment situation changes should ensure there is no break in your coverage.

Can I see a specialist directly, or do I need a referral in Japan?

In most cases, no referral is required to see a specialist in Japan, and appointments can often be arranged within days or even the same day. This stands in contrast to healthcare systems that impose weeks-long waits or require a gatekeeper’s approval before specialist access. However, presenting yourself at a large hospital without a referral letter typically triggers an additional first-visit charge, so seeing a local clinic first and obtaining a referral is usually the more cost-efficient approach.

Are there hardship provisions if I cannot afford my NHI premiums?

Municipalities have the authority to offer payment deferrals, instalment plans, or premium reductions for residents experiencing financial difficulty. In the event of an emergency such as a natural disaster, it may also be possible to apply for a partial exemption from co-payments. Reach out to your city’s health insurance office to discuss your options. Residents with low incomes in Japan may be eligible to have the base NHI premium reduced by as much as 70% by completing the relevant procedure at City Hall.

Is dental care covered under Japan’s public health insurance?

Many dental treatments are included within Japan’s public health insurance coverage under the national fee schedule. Standard procedures — including fillings, extractions, and treatment of periodontal disease — are generally covered, with the usual 30% co-payment applying. Cosmetic treatments such as teeth whitening, orthodontic work, and dental implants fall outside public coverage and are paid entirely out-of-pocket. Costs for private dental procedures vary considerably between providers, so always request a written cost estimate before any treatment begins.

Can I bring my regular medications into Japan from abroad?

Personal-use quantities of many medications may be brought into Japan, but the rules are strict. Certain substances that are legal and widely sold in other countries — including some over-the-counter cold remedies, stimulant-based drugs, and opioid painkillers — are either tightly controlled or prohibited under Japanese law. If you plan to bring more than a two-month supply of any prescription medicine, or any substance that could be classified as controlled, you may be required to obtain a prior import certificate (“Yunyu Kakunin-sho”) from the MHLW before you travel. Always check the MHLW’s official guidance or contact a Japanese consulate in advance to avoid problems at customs.