An Expat’s Guide to Japan’s Health Care System

Have you ever wondered why the Japanese people have the longest life expectancy in the world? In fact, a Japanese man, Masazo Nonaka, has recently made it in the Guinness World Record as the world’s oldest living man at age 112. While there are a variety of factors to be considered such as a healthy diet and other lifestyle practices, Japan’s outstanding healthcare system also plays an important role in this feat.

If you’re thinking of moving here in Japan, then you must at least have an idea about the country’s healthcare system and the medical services that you can avail as an expat living here. Read on…

Everything You Need to Know about Japan’s HealthCare System


Quick Facts:

  • Japan has universal public healthcare.
  • Japan’s healthcare insurance is mandatory for all citizens so everyone should have coverage except for a small number of the population who goes without.
  • According to the Japan Health Info (JHI), the average cost of an emergency room visit would be around JPY 10,000 – 15,000 for those with health insurance coverage.
  • As per the JHI, the average cost of a doctor’s visit would be around JPY 5,000 – 10,000.
  • The average cost of public health insurance for a person in Japan would be roughly around 5% of the person’s salary.
  • There are over 53,000 pharmacies in Japan or about 42 per 100,000 people. By that estimate, there are actually more pharmacies than convenience stores here in Japan.
  • Total number of hospitals: A little under 8,500.

Is Healthcare Free in Japan?

It would be quite silly to think that healthcare is free anywhere in the world. However, in Japan, healthcare is relatively cheaper because it is regulated by the State. All citizens of Japan are required to pay their monthly premiums in the public health insurance system, and are required to shoulder 30% of their medical bills, which isn’t really so bad as the government wants to make sure that healthcare services remain affordable at all times.

For expats, getting money into Japan would be very important when you’re starting your life here. This brings up the topic on signing up with a reliable International Money Transfer (IMT) for your stay here in Japan to save up on unnecessary and unfair fees charged by banks on top of the inconsistent exchange rates.

Japan’s Medical System

The most important thing to know is that Japan has a universal public healthcare, meaning, all citizens of Japan are required to pay a monthly premium to fund the state’s health insurance so that all citizens can be accommodated by State’s public health insurance system. The coverage of the state’s health insurance is quite thorough and extensive, allowing people to pick their clinic or hospital of choice available in the insurance’s healthcare network. However, those who are visiting or are only here for a short stay are left with international private insurance as well as other private options for their healthcare needs. This is mainly because Japan’s healthcare system focuses on public healthcare. Here are some types of public healthcare available:

Social Health Insurance (SHI)

This type of insurance falls under the public healthcare system and is available for everyone who is employed full time by a medium to large company. While there are a few variations according to the type of job an employee has, the scheme works pretty much the same across the boards in terms of benefits. In this type of scheme, you and your employer equally share the premium costs of the insurance which approximately amounts to 5% of your earnings.

National Health Insurance (NHI)

Students, part-time workers, employees from small companies, as well as foreign workers, are pretty much covered by the NHI scheme. The members’ contributions are based on his/her annual income, and while the package might cost a bit more than the SHI premium, the NHI fees are relatively cheap during the first year. To sign up, you will have to personally apply at the local office manned by the regional administration. While every individual member of the family has to sign up, costs are typically apportioned to the ‘head of the household’. The NHI coverage are widely similar to that of the SHI.

Nursing Insurance

For people aged 40 to 65, another 1.65% of your income automatically goes to this type of insurance.

International Health Insurance

While this is not widely accepted by most hospitals here in Japan, having an international health insurance can prove to be still useful, too. In the event that you do get hospitalized here, you may have to pay for your medical expenses first then have your insurance reimburse your expenses. And because this may take some time, make sure that you know what you are covered for as well as the requirements needed when filing for a claim.

Private Health Insurance

As mentioned, Japan’s public health system takes much priority and support from the Government, so private health insurances in Japan may not be at par with the public program, but they are still available to supplement public insurance through the 30% of the medical costs that everyone has to pay, or through lump sums in case a serious medical event arises.

How to Sign Up for Healthcare in Japan

The SHI is considered to be simple and quite easy to shoulder since your premiums are already allocated from your work whereas you will need to personally sign up for the NHI at the local office near your place of residence once you have received your residence card, which can take up a few months. Since the NHI is regulated by local authorities, you will need to sign up once again should you decide to move to another place.

After you’ve successfully registered, you will be issued a medical card that you will need to bring with you all the time. In the event that you visit a clinic or a hospital, you will need to provide this card so that you won’t be charged the full bill, and you won’t have to file for a claim to reimburse your payment later on.

What to Do in Case of an Emergency in Japan

In case of an emergency, you should visit your local clinic first but if it happens beyond regular clinic hours, you can go directly to an emergency clinic. But as a general precaution, it is best to do a little research first as some clinics may not be available round the clock. Check out your area to know your local clinics and hospitals you can go to.

It’s also important to note that even hospitals may not offer certain services beyond regular hours. Therefore, you need to know which ones are open at night or even during weekends, since there’s no telling when you might need to seek medical help. If it’s possible to contact them before your visit, do so. Should you need the services of an ambulance, the number to dial is 119. An English-speaking operator may be available to serve you if you are in Tokyo. Transportation by ambulance is free, but the medical care you will get comes with a fee.

The Cost of Health Insurance in Japan

This really depends on how long you plan to stay here in Japan (short-stay or permanent) as well as your circumstances. If you plan to stay here for long, you may want to consider any of the insurance types laid out above, but if you are a tourist planning a short vacation here in Japan, then you may do some research on the best travel health insurances in your country, and the coverage you can avail once you get here in Japan.

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