Healthcare and Insurance in Tokyo

2025年7月26日 Tokyo Relocation Guide

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Healthcare and Insurance in Tokyo: What Every Foreigner Should Know

Healthcare and Insurance in Tokyo: What Every Foreigner Should Know

Japan is renowned for its world-class healthcare system, characterized by exceptional quality, high efficiency, and affordability—especially when compared to systems in the United States or Europe. For foreigners relocating to Tokyo, understanding how the system works and how to access it—especially in English—is essential. From enrollment in national insurance programs to finding English-speaking doctors, this comprehensive guide will walk you through every step of managing your health and well-being in Tokyo.

1. Overview of Japan’s National Healthcare System

Japan’s healthcare system is universal. Every legal resident is required to enroll in one of two primary forms of health insurance. Whether you’re working full-time, freelancing, studying, or in between jobs, there is a system designed for your circumstances.

Employee Health Insurance (Shakai Hoken / 社会保険)

If you’re employed full-time by a company in Japan, you’ll be automatically enrolled in Employee Health Insurance. This is handled by your employer, and the monthly premium is split between you and the company. Your share is automatically deducted from your paycheck.

Shakai Hoken includes:

Medical insurance
Pension contributions
Long-term care insurance (if you’re aged 40 or older)
Unemployment insurance

The monthly cost depends on your salary, but the coverage is excellent. It typically covers 70% of your medical expenses, from routine doctor visits to hospital stays and surgeries.

National Health Insurance (Kokumin Kenkō Hoken / 国民健康保険)

If you’re self-employed, working part-time, freelancing, unemployed, or a student, you’ll need to enroll in the National Health Insurance system at your local city or ward office.

The premium is based on your previous year’s income, and it’s calculated annually. If you’re new to Japan with no income from the prior year, your premiums will likely be minimal.

This insurance also covers 70% of most medical services, including:

Outpatient care
Hospitalization
Surgery
Prescription medication
Maternity care
Mental health services

2. How to Enroll in National Insurance

Upon arrival in Tokyo, you’re required to register your address at your local ward office. Once you’ve completed that step, you must enroll in the appropriate health insurance plan within 14 days.

Required documents for enrollment:

Residence Card (在留カード)
Passport
My Number (Individual Number) card or notification slip
Proof of employment or income (if available)

Once enrolled, you’ll receive a health insurance card (保険証) which you must present at clinics, hospitals, and pharmacies.

3. Understanding Medical Costs in Japan

Medical care in Japan is affordable, especially when you’re covered by national health insurance. Here’s what to expect in terms of out-of-pocket costs:

Service	Average Cost (After Insurance)
Doctor Visit	¥1,000 – ¥3,000
Specialist Visit	¥2,000 – ¥5,000
Prescription Medicine	¥500 – ¥2,000
Blood Test	¥1,000 – ¥3,000
Dental Cleaning	¥1,000 – ¥3,000
One-Night Hospital Stay	¥10,000 – ¥20,000

These prices can vary, but compared to Western healthcare systems, the difference is dramatic.

4. Finding English-Speaking Clinics and Hospitals

One of the most common concerns for foreigners is the language barrier in medical settings. While many Japanese doctors have studied abroad or can understand some English, fluency is not guaranteed.

Fortunately, Tokyo has many hospitals and clinics that cater to foreigners:

Top English-Friendly Medical Facilities in Tokyo:

Tokyo Midtown Medical Center (Roppongi) – General practitioners and specialists; English support available.
St. Luke’s International Hospital (Tsukiji) – One of the most advanced hospitals in Japan with a dedicated international department.
Tokyo Medical and Surgical Clinic (Shiba Park) – Offers full English-speaking services for a wide range of conditions.
Himawari Tokyo Medical Information Service – Free multilingual phone service (Tel: 03-5285-8181) to help locate nearby English-speaking facilities.

Tip: Always call ahead to verify language support and make an appointment.

5. Emergency Services

In case of a medical emergency, Japan has a reliable and efficient ambulance system.

Emergency Numbers:

119 – Fire and ambulance (no cost for ambulance)
110 – Police

Ambulances are free, but they will only transport you to the nearest suitable hospital. Japan doesn’t have a “choose your hospital” emergency policy like in some countries.

Many major hospitals offer:

24-hour emergency reception
Late-night clinics (especially in Minato, Shinjuku, Setagaya wards)

Pro Tip: Save the Japanese phrases for your symptoms or use a medical translation app in case English is not available on arrival.

6. Private and International Health Insurance Options

If you’re only staying in Japan for a short time or want broader coverage (e.g., access to private hospitals or services abroad), consider international health insurance.

Top International Providers:

Cigna Global – Highly flexible global plans with Tokyo coverage
GeoBlue – Great for U.S. citizens with global mobility
AXA International – Reliable and widely accepted in Asia

Some international schools, companies, and embassies offer corporate or group health plans that are more comprehensive than national options.

7. Health Insurance for Newcomers

Many newcomers experience a gap between arrival and full insurance coverage. Here’s how to handle it:

Temporary Coverage Options:

Travel Insurance: Good for your first few weeks—check if it covers outpatient care.
Private Expat Insurance: Apply before arrival or in your home country.
Backdated Enrollment: In some cases, national insurance can be backdated to your move-in date—ask your ward office.

Be sure to avoid being uninsured while living in Japan, as medical costs without insurance can be significant—even a simple X-ray could cost over ¥10,000 out-of-pocket.

8. Preventive Care and Checkups

Preventive care is well-established in Japan, especially for people employed full-time.

What’s Typically Included:

Annual health checks (健康診断 / kenko shindan)
Blood tests, BMI, cholesterol, blood pressure
Cancer screenings (colorectal, cervical, breast)
Vision and hearing tests

Most companies provide this annually, and national insurance holders can request subsidized checkups through their local ward.

9. Dental and Vision Care

Dental and vision care are not free but are generally affordable under national insurance.

Dental Services:

Routine cleanings
Cavity treatment
Tooth extractions
Some prosthetics (crowns/bridges)

Most services are partially covered (30% copay), but cosmetic treatments like whitening or orthodontics are not.

Vision Services:

Eye exams are covered if ordered by a physician
Glasses and contact lenses are not covered under insurance

10. Mental Health Services in Tokyo

Mental health care in Japan is available but somewhat limited in English. However, Tokyo offers a growing number of resources for foreigners:

English-Speaking Therapists & Clinics:

Tokyo Mental Health (Shinjuku, Hiroo) – Counseling and psychiatric services
TELL Counseling (Tokyo English Lifeline) – Crisis line and therapy
International Mental Health Professionals Japan (IMHPJ) – Directory of certified therapists

Note: Mental health services are only partially covered under insurance, and private therapists may charge between ¥10,000–¥20,000 per session.

11. Maternity and Pediatric Care

Japan is one of the safest countries for childbirth, and pediatric care is widely accessible.

Maternity:

Prenatal checkups are partially covered
Municipalities offer maternity vouchers (up to ¥100,000)
Birth is typically through hospitals, not home births

Pediatric Services:

Vaccinations are government-subsidized
Regular growth monitoring and checkups
Pediatricians are found in most neighborhoods

Municipal “Mother and Child Health Handbooks” are provided in English upon request.

12. Additional Pro Tips for Foreigners

✅ Always carry your health insurance card and residence card

✅ Register with a family doctor or clinic early, not only when you’re sick

✅ Pharmacies (薬局) are separate from clinics—bring your prescription there

✅ Keep a list of your current medications in Japanese and English

✅ If you have chronic illness or require medication from abroad, bring documentation

✅ Use apps like “MediPhone,” “Japan Healthcare Info,” or “Google Translate” for support

Final Thoughts

Healthcare in Tokyo is modern, reliable, and surprisingly accessible—even for foreigners. While the initial paperwork and procedures may seem complex, the long-term benefits—affordable care, advanced treatment options, and a wide range of services—are significant. Whether you’re moving to Tokyo for work, study, or family life, securing your health insurance and learning how to use the system early will give you peace of mind and a strong foundation for a healthy life in Japan.

Frequently Asked Questions: Healthcare and Insurance in Tokyo

1. Am I required to enroll in Japanese health insurance?

Yes. All residents of Japan—including foreigners with long-term visas—are legally required to enroll in either Employee Health Insurance (Shakai Hoken) or National Health Insurance (Kokumin Kenkō Hoken). This ensures universal coverage across the country.

2. What’s the difference between Employee and National Health Insurance?

Employee Health Insurance is provided through your employer and includes additional benefits like pension contributions. National Health Insurance is for self-employed individuals, part-timers, students, or those without an employer. Both cover 70% of most medical costs, including doctor visits and hospitalization.

3. How do I register for health insurance in Tokyo?

After registering your address at your local ward office, visit the insurance counter to enroll in health insurance. You’ll need your residence card, passport, My Number, and proof of income if applicable. Registration must be completed within 14 days of moving into your residence.

4. How much do I need to pay for insurance each month?

Premiums vary depending on your income. For National Health Insurance, the local ward office calculates your premium annually based on the previous year’s income. For Employee Health Insurance, your employer deducts your portion directly from your salary and pays half.

5. What should I do if I get sick and don’t speak Japanese?

Seek out international clinics with English-speaking doctors. Tokyo has several, including Tokyo Medical and Surgical Clinic and St. Luke’s International Hospital. You can also call the Tokyo Medical Information Service “Himawari” at 03-5285-8181 for assistance finding English-speaking providers.

6. Are ambulance services free in Tokyo?

Yes, ambulance transportation is free in Japan, but it only takes you to the nearest appropriate medical facility. Dial 119 in case of a medical emergency. It’s recommended to have a translation app or medical phrases prepared if Japanese isn’t your strong point.

7. Can I use my travel insurance instead?

Travel insurance is suitable for short stays or for covering you before you register with the national system. However, long-term residents are required to enroll in a national plan. Some travel insurance plans also exclude pre-existing conditions or outpatient care, so review the terms carefully.

8. What does Japanese health insurance cover?

It covers 70% of most services: general medical visits, hospitalization, prescription medications, surgeries, maternity care, and some mental health services. You pay the remaining 30% at the point of service. Preventive care like cancer screenings and checkups may also be subsidized or free.

9. Are dental and vision services included?

Basic dental services—like cleanings, fillings, and extractions—are partially covered. Cosmetic treatments (e.g., whitening, orthodontics) are not. Eye exams are covered only if deemed medically necessary, and glasses or contacts are not covered by the public insurance system.

10. What if I move within Japan or change jobs?

If you change your job, you must switch from Employee Insurance to National Insurance or vice versa. When moving to a different city or ward, you’ll need to re-register your address and re-enroll at the new ward office. Always update your information promptly to avoid penalties or gaps in coverage.

11. Are mental health services available in English?

Yes, but limited. Tokyo offers access to international counselors and therapists through services like TELL and Tokyo Mental Health. Some therapists are covered under insurance, but many private sessions may cost ¥10,000–¥20,000 per hour.

12. How do I find a pediatrician or maternity clinic?

Most neighborhoods in Tokyo have local pediatricians and maternity clinics. Look for clinics with “産婦人科” (obstetrics and gynecology) or “小児科” (pediatrics) on the signboard. English-speaking options exist, but call ahead to confirm. Your ward office may provide a list of clinics that accept insurance and offer multilingual care.

13. What documents do I need when visiting a doctor?

Always bring your health insurance card (保険証), residence card, and a list of medications you currently take. If visiting a new clinic, you may also be asked to fill out a medical questionnaire. Some facilities offer these forms in English; others may not.

14. Can I opt out of national insurance and use only private insurance?

No. Long-term residents are legally obligated to join either national or employee insurance, even if they hold international or private insurance plans. Private insurance can complement national coverage but cannot replace it for legal purposes.

15. Where can I get help in English for healthcare navigation?

Several organizations offer support in English, including the Tokyo Metropolitan Government’s Himawari service, embassy health desks, and community centers. If you’re a student or employed by a global company, your school or HR department may also assist in finding doctors, booking appointments, or handling paperwork.

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