Introduction
When you get a fever in Japan, which hospital should you go to? How much will it cost? Can you explain your symptoms in Japanese? Many people who have just started life in Japan worry about these three things before they ever get sick.
Japanese hospitals have a reputation for being expensive, but with insurance, costs stay low. A cold treated at a neighborhood internal medicine clinic usually comes to a few thousand yen for the visit and medicine combined. Even after major surgery, there is a monthly cap on what you pay. Many clinics also take walk-ins on the same day, and you rarely wait months to see a specialist.
There are still a few things you need to know. There is no system for choosing a family doctor first, there are several types of insurance, and since August 2026 old insurance cards can no longer be used to see a doctor. This guide walks through everything in order, from what to prepare before your visit to insurance, costs, and getting care in English, based on information as of October 2026.
This article summarizes general information. Premiums, copays, and detailed conditions vary depending on your type of insurance and the municipality you live in. For actual procedures, check with your city or ward office or your employer.
What to Bring to the Hospital
Plenty of people reach the reception desk and only then realize they forgot their insurance card or don’t have enough cash. Bring these four things.
| What to bring | Notes |
|---|---|
| My Number Card insurance card (マイナ保険証) or an Eligibility Confirmation Document (資格確認書) | These replace the insurance card. Without either, you may have to pay the full cost that day |
| Residence card | You may be asked for it to confirm your identity |
| Cash | Some clinics do not accept credit cards or e-money, so bring extra |
| Medication notebook (お薬手帳) and symptom notes | Write down the medicines you take, any allergies, and when your symptoms started to make the visit go smoothly |
Paper Insurance Cards Are No Longer Accepted
Health insurance cards stopped being issued on December 2, 2024, and the one-year transition period ended on December 1, 2025. The special rule that allowed expired cards also ended at the end of July 2026. To see a doctor now, you need one of the following.
- My Number Card insurance card: A My Number Card registered for use as a health insurance card. You place the card on the card reader at reception
- Eligibility Confirmation Document: A document your insurer sends free of charge to people who don’t have a My Number Card insurance card, without any application. You show it at the counter just like a paper insurance card
For how to get a My Number Card and register it as an insurance card, see the article below.
Visa & Legal
How to Get a My Number Card in Japan: Apply, Pick Up, Renew
Applying for a My Number Card in Japan? See the four ways to apply, photo rules, PIN setup, pickup steps, and the expira…
Read related article
If you want to follow how the rules for old insurance cards changed over time, this article is also worth a look.
Living in Japan
Your Old Insurance Card Stops Working July 31, 2026. Here’s How to Switch to the My Number Insurance Card
Japan's grace period for expired health insurance cards ends July 31, 2026. After August 1, you'll need the My Number In…
Read related article
(Source: Ministry of Health, Labour and Welfare, "Using the My Number Card as a Health Insurance Card")
How Health Insurance Works in Japan
Everyone who lives in Japan is required to be enrolled in health insurance. There are two main types, and which one you join depends on how you work.
| Employee insurance (社会保険, Shakai Hoken) | National Health Insurance (国民健康保険, NHI) | |
|---|---|---|
| Who it covers | People who work at a company for a certain number of hours or more | Students, freelancers, people without work, part-timers who can’t join employee insurance, and others |
| Premium | About 5% of your salary (slightly higher for ages 40 to 64). Your employer pays roughly the same amount. Deducted automatically from your pay | Based on factors such as last year’s income. You pay yourself by payment slip or bank transfer |
| Enrollment | Handled by your employer | You go to your city or ward office yourself |
| When you are sick and off work | You may receive a sickness and injury allowance (傷病手当金, about two-thirds of your salary) | Generally not available |
Employee insurance also has a sickness and injury allowance: if you are off work because of illness or injury and your salary stops, you can receive about two-thirds of your pay. NHI usually has no such allowance.
Part-time workers (including arubaito) may be enrolled in employee insurance if they meet conditions such as weekly working hours and the size of the employer. If your work situation changes, check with your employer.
NHI is for people whose period of stay is longer than 3 months. In your first year in Japan you often have no Japanese income from the previous year, so your premium may be lower. However, even with no income, the reduction does not apply unless you file an income declaration with your municipality. Check the amount with your city or ward office. In your second year the premium is calculated from the previous year’s income, so it may rise considerably compared with the first year.
Some municipalities also ask people who join NHI within a year of arriving to pay up to a full year of premiums in a lump sum.
Money & Finance
Charged a Full Year of Health Insurance the Moment You Arrive?! What Foreign Residents in Japan Can’t Afford to Miss: NHI Prepayment (2026)
Enrolling in Japan's NHI as a new arrival? You may be asked to pay up to a full year of premiums upfront. Here's what to…
Read related article
You Pay 30% of Medical Costs at the Counter
With either type of insurance, you pay 30% of the medical cost at the hospital counter, and insurance covers the other 70%. For children before elementary school, the share is 20%. Depending on where you live, there may also be subsidies that make children’s medical care even cheaper.
If you are not insured or can’t present anything that replaces an insurance card, you pay the full cost (100%) yourself. Some hospitals charge even more than that. When your insurance changes because you moved or changed jobs, check early that no procedure has been missed.
(Source: Japan Health Insurance Association, "FY2026 Premium Rates" / Japan Health Insurance Association, "Sickness and Injury Allowance" / Shinjuku City, "Reduction of National Health Insurance Premiums" / Ministry of Health, Labour and Welfare, "Patient Copay Rates and High-Cost Medical Expense Limits")
What Happens at a Hospital Visit
Knowing what happens in what order makes your first visit much less stressful. A Japanese hospital visit generally goes from reception to a medical questionnaire, the consultation, payment, and then the pharmacy.
- Reception: Hand over your insurance card (My Number Card insurance card or Eligibility Confirmation Document) and briefly state your symptoms. At a hospital you are visiting for the first time, they will make you a patient card (診察券)
- Fill out the medical questionnaire: Write your name, address, symptoms, when they started, allergies, and any medicines you take
- Consultation: When your name is called, go into the exam room. Be specific about “where, since when, and how it hurts.” Always mention allergies and medicines you take
- Payment: Pay at reception after the consultation. If you need medicine, you will receive a prescription (処方箋, the paper that lets you get medicine)
- Pharmacy: Hand the prescription to a pharmacy and pick up your medicine. You may be asked to show your insurance card
A clinic consultation for a cold often lasts only 5 to 10 minutes. The wait in the waiting room is often longer than the appointment itself.
Take Your Prescription to a Pharmacy Within 4 Days
A prescription is a paper on which the doctor writes which medicines you need. Some medicines can’t be bought without one, and it is valid for 4 days including the day it is issued. It’s safest to go to the pharmacy the same day. At the pharmacy, a pharmacist will explain how to take your medicine. If you go back to the same pharmacy within 3 months and show your medication notebook, the medicine cost is a little lower (by a few dozen yen).
(Source: Ministry of Health, Labour and Welfare, "Validity Period of Prescriptions")
Clinics vs. Large Hospitals
Japan has no system where you must first see an assigned doctor. Instead, you choose the department that fits your symptoms and go to a clinic.
| Symptoms | Department to visit |
|---|---|
| Fever, sore throat, stomach trouble | Internal medicine (内科) |
| Skin rash, itching | Dermatology (皮膚科) |
| Pain in bones, joints, or muscles; injuries | Orthopedics (整形外科) |
| Earache, runny nose, hay fever | Ear, nose, and throat (耳鼻科) |
| Eye pain, itchy eyes | Ophthalmology (眼科) |
| Fever or illness in a child | Pediatrics (小児科) |
If you don’t know where to go, internal medicine is a safe place to start. If needed, they can refer you to a specialist hospital.
Hospitals That Charge Extra Without a Referral Letter
Large hospitals focus on surgery, hospital stays, and treatment of serious illness. If you go without a referral letter (紹介状, a letter addressed to the hospital and written by a clinic doctor), you may be charged an extra fee called the Selective Medical Fee (選定療養費) on top of the first-visit fee.
- At large hospitals designated by the government, such as university hospitals (some hospitals with 200 or more beds), a first visit without a referral letter carries an extra charge of 7,000 yen or more
- The amount differs by hospital, and some charge 7,700 yen or 11,000 yen
- It usually does not apply if you arrive by ambulance. However, in some areas, you may be charged if the hospital decides your case was not urgent
If you already know which hospital you’re going to, it’s worth checking the Selective Medical Fee on its official website or at the reception desk beforehand.
If you want to be treated at a large hospital, going to a neighborhood clinic first and asking for a referral letter if needed is the easier route, both in cost and in waiting time.
(Source: Ministry of Health, Labour and Welfare, "Overview of the FY2022 Medical Fee Revision")
Medical Costs and the High-Cost Medical Expense Benefit
The government sets the price of consultations and medicine, so differences between hospitals are fairly small. Large hospitals, however, may add extra charges. Amounts vary with your symptoms and tests, but a cold treated at an internal medicine clinic often comes to a few thousand yen for the consultation and medicine combined.
There Is a Cap Even When Medical Costs Get High
Even if surgery or a hospital stay makes your medical bill large, there is a cap on what you pay in a month. This is the High-Cost Medical Expense Benefit (高額療養費制度). The cap depends on your income and was revised in August 2026.
- For people with an annual income of about 3.7 million to 7.7 million yen (until July 2027): the monthly cap is “85,800 yen + (medical costs – 286,000 yen) x 1%.” From August 2027, the income brackets will be divided more finely
- If medical costs are 1 million yen, your out-of-pocket cost is about 93,000 yen
- A cap over the 12 months from August to the following July was also introduced (530,000 yen for this income bracket). The amount above the cap is refunded by your insurer later
With a My Number Card insurance card, if you consent to share your cap information with the hospital, your payment at the counter is limited to the cap from the start. With an Eligibility Confirmation Document, apply before a hospital stay or surgery: for employee insurance, ask for a Limit Application Certificate (限度額適用認定証), and for NHI, ask for an Eligibility Confirmation Document that shows your cap category.
Differential bed charges (extra fees for a private room), meals during a hospital stay, and self-pay treatments not covered by insurance are not covered by this benefit.
(Source: Ministry of Health, Labour and Welfare, "For Those Using the High-Cost Medical Expense Benefit" / Ministry of Health, Labour and Welfare, "Patient Copay Rates and High-Cost Medical Expense Limits")
How to See a Doctor in English or Another Language
Having a 40-degree fever and having to explain your symptoms in Japanese is a painful thing to imagine, but if you prepare ahead of time you can stay calm.
Prepare Your Medical Questionnaire in Advance
The biggest language hurdles at a hospital are the questionnaire and the consultation. If you’re not confident in Japanese, here are some options.
- A service that creates a multilingual questionnaire: YOLO MEDICAL from YOLO JAPAN is a free questionnaire-creation service that supports 17 languages. Answer the questions, and in about 5 minutes you get a questionnaire automatically translated into Japanese. You show that screen at the hospital
- Translation apps: Prepare a note of your symptoms in Japanese on your smartphone. Showing the screen to the doctor often gets the message across
- Ask at reception: Larger hospitals sometimes have questionnaires in English and other languages
Find Hospitals That Support Other Languages
These resources help you find hospitals where English is spoken.
- JMIP-certified medical institutions: You can search by region for institutions certified as ready to receive patients from overseas
Japan Medical Service Accreditation for International Patients (JMIP)
- Municipal medical institution lists: Local governments such as Tokyo publish lists of medical institutions that can support other languages
- Embassy websites: Embassies such as those of the United States and the United Kingdom have lists of English-speaking hospitals
In Tokyo, you can search the JMIP site for certified hospitals in Tokyo. Still, it is not unusual for the doctor to speak English while reception is Japanese only. Before your visit, call or check the official website to confirm whether they can see you in English and whether you need an appointment.
If you aren’t confident in Japanese, choose a hospital where you can book online or by email instead of by phone. Some large hospitals may ask you to bring an interpreter, so check in advance.
Pharmacies and Over-the-Counter Medicine
Medicine falls into two groups: prescription medicine issued at a hospital, and over-the-counter medicine you can buy at a pharmacy or drugstore. Antibiotics, strong painkillers, and similar drugs can’t be bought without a doctor’s prescription.
For mild symptoms, many people use over-the-counter medicine from a drugstore. If you tell the pharmacist your symptoms, they can pick a suitable product. Well-known examples include “Eve” and “Bufferin” for headaches and period pain, “Pabron” for colds, and “Ohta’s Isan” for stomach trouble.
Bringing Medicine From Overseas
Ordinary prescription medicine can be brought into Japan without any procedure for up to a one-month supply. It is safest to carry the prescription and an English description of the medicine as well. However, medicines that count as narcotics need advance permission even in small amounts. Medicines containing stimulant ingredients (such as Adderall in the United States) can’t be brought in under any circumstances. For ordinary medicine, consult the Pharmaceutical Affairs Inspection and Guidance Division of the Regional Bureau of Health and Welfare (地方厚生局). For narcotics and psychotropic drugs, consult the Narcotics Control Department of the Regional Bureau of Health and Welfare (地方厚生局麻薬取締部).
(Source: Japan Customs, "Bringing Medicines Into Japan" / Kinki Regional Bureau of Health and Welfare Narcotics Control Department, "Carrying Medicines When Traveling Abroad")
Nights, Holidays, and Emergencies
Most hospitals are closed at night and on holidays. In those cases, choose based on how serious the situation is.
| Situation | What to do |
|---|---|
| Unconscious, trouble breathing, serious injury | Call 119 for an ambulance |
| Not sure whether to call an ambulance | Call the Emergency Consultation Center “#7119” (only in areas where it operates) |
| Suddenly feeling unwell at night or on a holiday | Go to a local holiday and night emergency clinic (休日夜間急患センター) |
#7119 is a hotline where doctors, nurses, and paramedics advise by phone on whether to call an ambulance and which hospital you can visit. It does not cover every area in Japan, so it is a good idea to check ahead whether it is available where you live.
(Source: Fire and Disaster Management Agency, "Emergency Consultation Center Program (#7119)")
For a child’s sudden fever or a hospital visit during pregnancy, see the articles below.
Family & Life
Ambulance or Clinic? A Decision Guide for International Parents When a Child Gets Sick in Japan
When your child gets suddenly sick in Japan, this guide walks international parents through calling 119 with an English …
Read related article
Family & Life
Giving Birth in Japan: A Complete Guide on Procedures, Costs, and the 500,000 Yen Subsidy (2026)
Complete guide for international residents giving birth in Japan. Covers cost estimates, claiming the Lump-Sum Birth Gra…
Read related article
Quick Reference by Situation
Finally, here is what to do in common situations.
| Situation | What to do first |
|---|---|
| Just arrived and not yet insured | If you are an employee, ask your employer. Otherwise, handle insurance enrollment at your city or ward office |
| No substitute for an insurance card | Ask your insurer about registering a My Number Card insurance card or issuing an Eligibility Confirmation Document |
| Cold or fever | Go to a neighborhood internal medicine clinic. Many take same-day visits |
| Want to see a large hospital | Visit a clinic first and ask for a referral letter |
| Not confident in Japanese | Prepare a multilingual questionnaire. Look for JMIP-certified hospitals |
| Medical costs likely to be high | High-Cost Medical Expense Benefit. Check with your insurer about the cap application procedure |
| Sudden illness at night | Holiday and night emergency clinic; if unsure, call #7119 |
FAQ
Can I go to a hospital without insurance?
You can, but you pay the full cost (100%) yourself. Some hospitals charge even more than that. If you are not enrolled, talk to your city or ward office or your employer right away.
Is Japanese healthcare expensive compared with other countries?
What you pay at the counter is kept down by the 30% copay and the monthly cap. Because the government sets consultation and medicine prices, differences between hospitals are also small. Large hospitals, however, may add extra charges. If you are not insured, you pay the full cost yourself.
Where can I find English-speaking doctors?
JMIP-certified institution searches, municipal lists of institutions that support other languages, and embassy hospital lists are good starting points. It is easier to find options in big cities such as Tokyo and Osaka. Before your visit, confirm by phone or the official website whether they can see you in English.
Does insurance cover dentists and gynecologists?
Yes. Treatment of cavities and gum disease and consultations for gynecological conditions are covered. On the other hand, teeth whitening, orthodontics, and cosmetic treatments are often not covered and are paid out of pocket.
Are there medicines I can buy at a pharmacy without a prescription?
Yes. Over-the-counter medicines such as headache medicine, cold medicine, and stomach medicine can be bought at pharmacies and drugstores. Antibiotics and strong painkillers require a prescription.
Do I need a receipt after a doctor’s visit?
When your medical costs for the year exceed 100,000 yen (or less, if your income is low), you may get some tax back by filing a tax return. It’s safest to keep your receipts rather than throw them away.
(Source: National Tax Agency, "When You Have Paid Medical Expenses (Medical Expense Deduction)," No. 1120)
Conclusion
Scrambling to look things up after you get sick is the hardest way to do it, in Japan or anywhere else. While you’re healthy, take care of these three things.
- Check that you have your My Number Card insurance card registered, or an Eligibility Confirmation Document on hand
- Find a neighborhood internal medicine clinic on a map app and save it
- Try creating a multilingual questionnaire once
Japanese healthcare is easy to use once you understand how it works. With the preparation done, you can stay calm when you feel unwell.
Your insurance card substitute is the My Number Card insurance card or the Eligibility Confirmation Document. You pay 30% at the counter, and there is a cap even if medical costs get high. Going to a large hospital without a referral letter costs extra, so start with a neighborhood clinic.
For health problems when the seasons change, see this article as well.
Living in Japan
What is Gogatsubyo (Japan’s May Sickness)? A Foreigner’s Complete Guide to Causes, Symptoms & Solutions (2026)
Feeling drained, sleepless, or unmotivated after Golden Week? Gogatsubyo (May Sickness) hits foreign residents in Japan …
Read related article
For the full picture of procedures right after you arrive, see this guide.
Living in Japan
What to Do After Arriving in Japan as a Student (2026)
Just landed in Japan as a student? Here's what to do after arriving in Japan, in order: Residence Card, SIM, city office…
Read related article
