What Options Are Available For Chronically Ill Expats In Japan?

The Japanese are among the healthiest people on the planet, due partly, it is thought, to their healthy diet and assiduousness in seeing a doctor on a regular basis. It is also often attributed to their excellent national health service. If you are an expat with a chronic illness, you should not find it too difficult to access the treatment that you need during your time in Japan. We will look at some of your options below.

How does the Japanese healthcare system work?

According to the OECD criteria, healthcare expenditure in Japan is high, over 10% of GDP, and healthcare itself is of a high standard, with outcomes comparable to those experienced in the USA. The average life expectancy is around 83 years. Medical staffing levels are also comparable to those in the States.

As an expat, you will be registered with one of the forms of national health insurance – this is mandatory – and will be able to access public healthcare. Many expats also choose to take out private health insurance, and you may wish to do this as a ‘belt and braces’ approach if you have a chronic condition. Although public healthcare is very good, you may experience difficulties outside of urban areas in finding English-speaking medical personnel, and you may also find that a private clinic is better able to cater to your specific needs.

The Japanese healthcare system and chronic illnesses

The rates of chronic illnesses, such as obesity, heart disease and dementia, are low in Japan compared to in many Western nations. A recent report published by the Centres for Disease Control and Prevention says that approximately 65% of the patients who were surveyed had three or more co-occurring diseases: hypertension, coronary heart disease, and peptic ulcer disease in men (12.4%) and hypertension, dyslipidemia, and peptic ulcer disease in women (12.8%). According to a survey on national health and nutrition conducted by the Ministry of Health, Labour, and Welfare, more than 10 million Japanese people were also “strongly suspected to have diabetes” in 2016.

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Chronic illnesses, such as obesity, heart disease and dementia, are less common in Japan than in many Western nations

Japan faces the challenge of an ageing population, which results in a heavier disease burden when it comes to chronic illnesses. However, the public health system is well versed in dealing with most chronic illnesses, as is the private sector. You may also wish to access alternative therapies, such as traditional Chinese medicine.

Applying for disability/sickness benefit

Many employees use up their vacation leave if they get ill, but if you are working for an international company, you may be able to negotiate a sick leave package with them. Under certain circumstances, you may be entitled to the injury and sickness allowance, for which national insurance will pay you an amount equal to two-thirds of your average standard monthly salary over the most recent 12-month period. You may be able to claim more. This can start from your fourth consecutive day off. You will need a doctor’s letter and must prove that your illness or injury is preventing you from carrying out your job.

Private cover for chronic illnesses

Most expats take out private health insurance to cover their stay in Japan. If you choose to do this, remember to make sure that your insurance has a clause covering your particular condition.

You should find that your local private clinic is capable of dealing with your particular condition.

There are also some steps that you can take to safeguard your own health while in the country:

• Discuss any country-specific challenges with your GP before you fly
• Make sure you have enough medication to cover your initial stay in Japan
• Ask your GP to issue you with a letter stating that you need your specific medication (and check which substances are currently banned in Japan, which has strict drug policies); you may need to have this translated
• Keep your medication in its packaging
• Ask your travel companion, if you have one, to carry spare supplies of medication for you, in case you become separated from your luggage
• Bring details of any technical equipment that you need (such as an insulin pump,) in case you need to phone for advice
• Learn some basic phrases in Japanese relating to your condition

Most expats take out private health insurance to cover their stay in Japan

Expats with diabetes recommend checking your blood sugar levels often to adjust to your new diet. You will need to see a doctor before you can get diabetes-related supplies, such as insulin, but most pharmacies will be able to supply this at low cost. They also suggest that, if you are intending to travel in Japan, you should work out the quantity of supplies that you will need, and then double this to be on the safe side. This is good advice for anyone who needs to regularly take medication.

Expats with Celiac disease report having difficulties in Japan, because of the prevalence of soy in the diet. Some say that making a list of foods that you are allergic to, translating this into Japanese, and carrying it with you can be helpful. You can also obtain gluten-free soy and tamari travel packs. Some expats suggest that renting a place with kitchen facilities, rather than eating out every night, is a good idea, as this gives you more control over what you eat. Although it can be relatively easy to have a low gluten diet in the country, having a zero gluten diet is another matter.

Before you go to Japan, you should do some basic research into its climate, as this can affect some chronic conditions, such as asthma. The country has a tropical climate, with two monsoon seasons. It is therefore extremely humid, which can have an impact upon your breathing.

When you arrive in Japan, make sure that you register with your local GP – this is likely to be in the private sector.


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