Japan's Healthcare System for Foreign Residents and Visitors
How public health insurance works, what you pay, what is not covered, how referrals and large hospitals work, and how to get language support, whether you live in Japan or are visiting.
Quick answer
Residents are enrolled through an employer or their city's National Health Insurance and usually pay 30% of approved costs (ages 6 to 69; other ages pay 10%, 20% or 30% by age and income). Tourists are not covered and pay the full cost, so travel insurance is essential. Unpaid medical bills can lead to entry restrictions on future visits.
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How Japan's public health insurance works
Japan has an extensive network of clinics, hospitals, pharmacies and specialists. People enrolled in public health insurance pay monthly premiums and a share of the approved cost when they receive covered treatment. MHLW states that people aged 6 to 69 pay 30%; others pay 10%, 20% or 30% depending on age and income.
You are enrolled
You must be properly enrolled and able to confirm your current eligibility.
The treatment is covered
The service must be recognised as insured treatment under Japan's fee schedule.
The provider is in the system
The clinic, hospital, dentist or pharmacy must bill it under public insurance.
Extras are separate
Non-covered services and optional charges are payable even when the treatment itself is insured.
Being insured does not mean everything is covered. Many clinics offer both insured and self-funded services, sometimes in the same visit.
Main types of health insurance in Japan
Employees' health insurance
Employees of organisations in Japan's social-insurance system are enrolled through their employer, who shares the premium. Eligible family members may join as dependants.
National Health Insurance
Residents not covered through an employer, such as many self-employed people, students and people between jobs, generally enrol through their city or ward office.
Premiums, dependant rules and procedures differ between schemes. Confirm your own position with your employer, city office or insurer.
Foreign residents, tourists and eligibility
Foreign residents
Nationality does not prevent you from joining. Residents who meet the residence and employment requirements are generally required to enrol. A residence card alone does not prove your insurance is active; job changes, moves and visa changes can all affect it.
Tourists and short-term visitors
Ordinary tourists are not enrolled in Japan's public health insurance. You pay the provider directly and claim from your travel insurer. JNTO notes that visitors with unpaid medical bills may be refused entry on future trips.
Before you travel, check your policy covers: outpatient care, emergencies, hospital admission, surgery, prescriptions, dental emergencies, medical evacuation, pre-existing conditions, interpreters and translated documents.
What insured residents show at reception
The old health insurance cards have expired. Residents now confirm eligibility with either a My Number Card registered for health insurance (マイナ保険証, Myna Hokensho) or an Eligibility Certificate (資格確認書, Shikaku Kakuninsho). See What to bring to a doctor in Japan.
What is commonly covered?
Public health insurance covers medically necessary treatment recognised under Japan's fee schedule. Depending on your condition, that typically includes:
| Area | Common examples | Qualification |
|---|---|---|
| Consultations | Clinic visits, specialist consultations and follow-up | Must be billed as insured treatment. |
| Tests | Blood tests, X-rays, CT, MRI and other indicated investigations | Must be ordered for an insured medical reason. |
| Treatment | Procedures, surgery, rehabilitation and hospital care | The specific treatment and reason decide coverage. |
| Medicines | Approved prescription medicines dispensed through the insured system | Non-listed medicines may cost extra. |
| Dental care | Examinations, fillings, extractions and standard treatment | Premium materials, implants and orthodontics are often private. |
What is commonly not covered?
Cosmetic treatment
Procedures mainly for appearance are self-funded.
Private rooms
Private or upgraded hospital room charges are separate from insured treatment.
Medical certificates
Certificates for work, school, immigration or insurance usually carry a fee.
Routine health checks
General check-ups are funded by employers, municipalities or yourself rather than treatment insurance.
Some vaccinations
Routine programmes are subsidised; optional and travel vaccinations are usually self-funded.
Elective dental work
Whitening, premium materials, most implants and most orthodontics sit outside standard cover.
Normal pregnancy and uncomplicated childbirth are not treated as illness, so they are not billed as insured treatment. Insured patients can usually receive a lump-sum childbirth allowance instead, and complications are handled under the ordinary insurance rules.
The High-Cost Medical Expense Benefit
Hospital stays, surgery or ongoing treatment can still add up. Japan's High-Cost Medical Expense Benefit (高額療養費, kōgaku ryōyōhi) caps what an insured patient pays for covered treatment in a calendar month. The ceiling depends on age and income.
If you use a My Number Card or arrange the benefit in advance, you usually pay only up to the ceiling at the cashier. Otherwise you pay first and claim the excess back from your insurer.
Not included in the cap: private-room charges, hospital meal charges, personal items, and anything outside public insurance.
Do you need a referral to see a specialist?
Not always. You can usually book a clinic or specialist clinic directly. Large hospitals are different: since 1 October 2022, specified large hospitals must charge an extra ¥7,000 or more for a first visit without a referral letter (紹介状), and ¥3,000 or more for follow-ups, on top of the normal bill. Emergencies are handled differently.
Before going to a large hospital, check:
- Whether you need a referralAnd whether the department accepts direct bookings.
- Whether the no-referral fee applies
- Whether they accept international or uninsured patients
- Which records to send ahead
- Whether an interpreter must be booked in advance
Language support and medical documents
Language gaps affect symptom descriptions, history, consent, treatment discussions and medicine instructions. Translation apps help with simple phrases but are not reliable for clinical detail, consent or medication risks.
MedicTranslate provides medical document translation and medical interpreters for international patients. See also How to find an English-speaking doctor or clinic in Japan.
Choosing a clinic
Looking for English-friendly care? You can choose a clinic from our list. MedicTranslate can arrange the booking. Each clinician makes their own medical decisions, and fees are shown before you book.
Browse all foreign-friendly clinics.
Bringing your regular medication to Japan
Japan's health insurance and its medicine import rules are separate systems. A medicine prescribed or insured in another country may still be prohibited, controlled, limited by quantity or need an Import Confirmation Certificate in Japan.
Travelling with regular medication? A written assessment checks each active ingredient, strength and quantity against current published guidance.
Get my medication assessed (from US$59)See the prohibited and restricted medication guide and medication import support.
Preparation checklists
Foreign residents
- My Number Card or Eligibility Certificate
- Residence card
- Referral letter, for large hospitals
- Medication and allergy information
- Relevant medical records
- Municipal subsidy certificate, where applicable
- Payment method
Tourists and short-term visitors
- Passport
- Travel-insurance policy and assistance number
- Medication list and allergies
- Relevant medical history
- A way to pay the full bill
Keep receipts, itemised invoices, prescriptions, certificates and reports. Your insurer may need specific documents, or translations, before it reimburses a claim.
Need help preparing for healthcare in Japan?
MedicTranslate translates medical records into Japanese, arranges interpreters for selected appointments and translates receipts and reports for overseas insurance claims. Clinical services remain with the provider.
- In-person or remote medical interpreters
- Concise Japanese translations of the records that matter
- Receipts and reports translated for insurance claims
Quotes depend on document length, language pair and appointment details. Subject to the applicable terms.
Frequently asked questions
Can tourists join Japan's National Health Insurance?
No. Ordinary tourists and short-term visitors are not eligible. Eligibility depends on residence and insurance requirements, so visitors should have travel insurance.
How much do insured patients pay in Japan?
People aged 6 to 69 pay 30% of approved costs. Others pay 10%, 20% or 30% depending on age and income. Non-covered charges are paid separately.
What happens if a tourist cannot pay a medical bill in Japan?
Unpaid bills can cause problems later: JNTO notes that visitors with unpaid medical expenses may be restricted or refused entry to Japan in future. Travel insurance with medical cover avoids this.
Can I use overseas travel or private health insurance in Japan?
It depends on the insurer and provider. Many patients pay first and claim later. Confirm the process and the documents your insurer needs.
What do I use instead of the old health insurance card?
A My Number Card registered for health insurance, or an Eligibility Certificate. The old cards have expired.
Does public insurance cover a private hospital room?
The treatment can be covered, but a private-room charge is a separate patient expense and is not included in the High-Cost Medical Expense cap.
Do I always need a referral?
No. Clinics usually accept direct appointments. Large hospitals charge an extra ¥7,000 or more for a first visit without a referral letter, and some departments require one.
Can MedicTranslate diagnose my condition or recommend treatment?
No. Diagnosis, prescriptions and treatment decisions come from licensed healthcare professionals. MedicTranslate provides translation, interpreting and appointment coordination.
This article provides general information reviewed on 28 September 2026. It is not medical, legal or insurance advice. Eligibility, coverage, contributions and benefits depend on your insurance status, age, income, treatment and provider, so confirm current requirements with your insurer, employer, city office or provider. MedicTranslate provides translation, interpreting and coordination and does not give medical advice. Call 119 for a serious or life-threatening emergency in Japan.
- MHLW: My Number Card as your health insurance certificate (English, July 2025)
- Japan Health Insurance Association: guide to health insurance benefits (English)
- MHLW: High-Cost Medical Expense Benefit (English)
- MHLW: extra charge for first visits without a referral (English)
- MHLW: FY2022 fee revision, large-hospital no-referral fee (Japanese)
- JNTO: travel insurance in Japan