Healthcare in Japan: A guide to the Japanese healthcare system

How come Japanese people have the world’s longest life expectancy? Well, it’s a range of factors actually, including their healthy diet, but the country’s impressive healthcare system is another key reason. Here’s our guide to what you need to know if you’re heading to Japan.

Quick facts on the healthcare system in Japan

• Public, private or universal health insurance: universal public healthcare.
• Population % covered by health insurance: it’s compulsory, so 100% should have coverage, although a small fraction goes without.
• Average cost of an emergency room visit: Japan Health Info (JHI) recommends bringing ¥10,000-15,000 if you’re covered by health insurance.
• Average cost of a doctor’s visit: JHI recommends bringing ¥5,000-10,000.
• Average cost of public health insurance for 1 person: around 5% of your salary.
• Number of pharmacies: over 53,000, or almost 42 per 100,000 people. There are more pharmacies than convenience stores.
• Number of hospitals: just under 8,500.

Money in Japan is denominated in yen - that’s written as JPY in trading markets. The symbol you’ll see is ¥, or 円 in Japan itself. It’s never easy to compare costs between currencies because the global exchange market is constantly changing. But an online currency converter can give you the latest figures to find out what your money’s currently worth in yen.

At the time of writing, this is approximately what the yen is worth internationally:

• ¥10,000 = £71
• ¥10,000 = €76.70
• ¥10,000 = US$91.62
• ¥10,000 = AU$115.18

Average cost of healthcare in Japan

Is healthcare free in Japan?

Healthcare isn’t free but it’s relatively inexpensive. In addition to having to pay monthly premiums into the public health insurance system, Japanese citizens pay 30% of their medical bills themselves - bills that are closely regulated by the state, so that they never become unaffordable.

The website Japan Healthcare Info has some advice on average costs - you might be looking at around ¥10,000-15,000 at the emergency room or ¥5,000-10,000 at the clinic, although it depends on the treatment you need, so it’s hard to predict.

Getting money into Japan will be crucial at the beginning of your stay there, or even before. Wise can get your money into Japan at the rate you’ll find on Google or XE, with only one simple, upfront fee to pay. That can save you a lot of money in unnecessary, unfair bank fees. And if you get a Borderless multi-currency account, you don’t even need a Japanese bank account before you can start to hold money in yen - and up to 27 other currencies. That means you can start your trip knowing exactly how much money you have in terms of yen, without needing to fret over ever-shifting international exchange rates.

Japan’s medical system: Public, private, universal, national, state, single payer - which is it?

Japan has universal public healthcare: it’s a legal requirement for all Japanese citizens to have the health insurance provided by the state. This coverage is quite thorough and entitles people to choose their own clinics and hospitals from any of the vast majority that are part of the system. International private healthcare is the only option for short-term visitors and other private options are available in Japan to supplement the public coverage. But the system is structured around public healthcare. Here are the different types of Japanese health insurance that are available.

Social Health Insurance (SHI)

SHI is the public healthcare system for everyone who’s employed full-time by a medium to large company. While a few subtly different types exist depending on the type of job you have, it offers much the same set of benefits across the board. You and your employer contribute equally to SHI, each paying around 5% of your salary.

National Health Insurance (NHI)

NHI is for everyone else - students, freelancers, people who work for small companies, and a lot of foreigners find themselves signing up for this in the early stages of their visit. Your contribution is based on your yearly income and might cost you a little more than SHI would - although the first year is often very cheap. You have to sign up for it yourself at your local office that’s run by the regional administration.

While every member of a family has to sign up, costs are charged to the ‘head of the household’. NHI offers largely the same coverage as SHI.

Nursing insurance

A further 1.65% of your earnings go towards nursing insurance if you’re aged between 40 and 65.

International health insurance

Japanese hospitals don’t tend to accept this themselves, so if you’re covered by an international insurer you might need to pay the hospital yourself and claim money back afterwards. Make sure you know your policy and what it covers you for.

Private health insurance

Because the public system is both compulsory and quite thorough, private health insurance isn’t as all-encompassing as it is in some countries. However, policies are available to supplement public insurance via money towards the 30% of bills you have to pay, and lump sums in the event of serious medical need.

Signing up for the healthcare system in Japan

SHI is low-maintenance for you as it’s administered through your work. NHI requires you to sign up at your local office once you have your residence card - this can take a few months. Because NHI is run by local authorities, you’ll have to do this again if you move to another area.

Once you’re registered, you’ll get sent a medical card. Carry this with you - if you don’t have it at the clinic or hospital, you’ll have to pay the full bill and you’ll only be able to claim money back later on.

In case of an emergency in Japan

If possible, it’s best to go to a clinic first - or, out of regular hours, an emergency clinic. Even they might not be open all the time, though. Check locally to find the best place to go.

Hospitals change their services outside office hours as well, so it’s worth finding out which ones near you will be open during the night and at weekends. If you can call ahead to tell them you’re coming, do so. If you need an ambulance, the number is 119. Some operators should speak English if you’re in Tokyo. The cost of ambulance transportation is free, but the care you’ll receive isn’t.

Japan Health Info’s guide to emergency services is worth a close read.

Hospitals in Japan

The vast majority of hospitals accept standard Japanese health insurance and will bill you the standard 30%, so the financial side of your hospital visit shouldn’t be so stressful. Bear in mind though, that they often cost more if you don’t have a referral from a doctor. Also, they tend to prefer cash payments to card.

You’ll need to check each hospital’s schedules, as they can vary substantially. You might need an appointment before turning up, or you might not. And there might only be a few hours each day during which you can visit for the first time. If you come without a referral, you might be turned away and have to go elsewhere.

You might end up staying a while - even routine operations typically require a few days in a hospital bed. A hernia operation, for instance, can put you in hospital for 5 days.

Doctors and specialists in Japan

Unlike in many countries, there’s no system of general practitioners (GPs) in Japan. Instead, people head straight to a specialist, operating at a clinic. There are many different specialists available, so it pays to do your research, and checking to see who speaks English might be useful too. Japan Health Info’s list of specialisms is a great place to start.

You should double check with your local clinic, but you’ll often find that they don’t require appointments: you can simply walk in and join a queue. Watch out for irregular opening hours though, including lunch breaks. Like in hospitals, cash is preferred and fees are generally not high.

Health insurance in Japan: Costs and plans

You can read our guide to Japanese health insurance for a thorough briefing on the system, but if you’re moving there permanently then the plan you choose will be determined by your circumstances. No need to spend long evenings poring over a thousand brochures.

Temporary health insurance for tourists

If you’re there temporarily on the other hand, it certainly pays to do your research and find the right international health insurance policy.

There are a number of options to choose from if you’re looking for international health insurance or travel insurance, although it’s worth checking if they will work in Japan and know how the system there works. Comparison websites will be a good way in if you don’t have a policy already: try Comparethemarket or MoneySupermarket, for instance.

Useful medical phrases in Japanese

Useful links

• Japan Healthcare Info has a lot of English-language information on its website and also offers to provide help for English speakers in Japan.
• AMDA International Medical Information Center is another site with useful information on Japanese healthcare in English and other European languages.
• The Ministry of Health, Labour and Welfare's official English-language site has various PDFs with information about the healthcare system.

The Japanese are understandably proud of their healthcare system. It’s not perfect though, and is arguably a victim of its own success, with medical treatment so popular that hospitals often become unsustainably busy. But once you’re set up in Japan, the benefits of its healthcare system should be plain to see.