At a Glance: Japanese Healthcare
| System Name | Universal Health Insurance (Kai Hoken) |
|---|---|
| Coverage | Mandatory for all residents (inc. foreigners > 3 months) |
| Patient Cost | 30% Co-payment (for most adults) |
| Insurance Covers | 70% of Approved Medical Procedures |
| Access | "Free Access" (Choose any clinic/hospital) |
| Emergency Number | 119 (Ambulance/Fire), 110 (Police) |
Japan boasts one of the longest life expectancies in the world, largely due to its efficient and egalitarian healthcare system. Under the Kai Hoken (Universal Health Insurance) system, everyone living in Japan is required by law to have health insurance coverage.
The system is fundamentally different from the US or UK. It is a social insurance system where you pay monthly premiums (based on income) and pay a percentage of the bill (co-payment) when you visit the doctor. In return, you can walk into almost any clinic or hospital in the country without a referral.
The Two Main Systems: SHI vs NHI
Depending on your employment status, you will fall into one of two main categories. Understanding this distinction is crucial for enrollment and billing.
1. Employees' Health Insurance (SHI)
Shakai Hoken
- Who: Full-time employees of companies.
- Premiums: Split 50/50 between employer and employee. Automatically deducted from salary.
- Card: Issued by the company/union.
- Dependent: Spouse/Kids covered at no extra cost.
2. National Health Insurance (NHI)
Kokumin Kenko Hoken
- Who: Self-employed, freelancers, students, unemployed, and part-timers.
- Premiums: Based on previous year's income. You pay bills at the Convenience Store (Konbini) or bank.
- Card: Issued by local City Hall (Ward Office).
- Dependent: You pay extra for every family member.
The 30% Co-Payment Rule
When you go to a clinic in Japan, you do not pay the full price. You show your insurance card (Hokensho), and you pay only a fraction of the cost. The government sets uniform prices for all medical procedures.
| Age Group | You Pay (Co-payment) |
|---|---|
| Under 6 Years (Preschool) | 20% (Often 0% due to local subsidies) |
| Age 6 to 69 (School/Adults) | 30% |
| Age 70 to 74 | 20% (30% for high earners) |
| Age 75+ | 10% (30% for high earners) |
Tip: Most municipalities offer a "Pink Card" or Medical Subsidy Certificate for children (Maru-Nu / Maru-Sho), making healthcare virtually free for kids up to age 15 or 18.
High-Cost Medical Expense Benefit
What happens if you need expensive surgery costing 1,000,000 Yen? Do you have to pay 30% (300,000 Yen)? No.
Japan has a safety net called Kogaku Ryoyohi Seido (High-Cost Medical Expense Benefit). This caps your monthly medical payment based on your income.
- Average Income Earner Cap: Approx. 80,000 - 90,000 Yen per month.
- How to use: Apply for a "Limit Application Certificate" (Gendogaku Tekiyo Ninteisho) beforehand, or pay upfront and get reimbursed later (takes ~3 months).
"Free Access" System: No GP Referral Needed
Japan does not have a strict GP (General Practitioner) gatekeeper system.
- Clinics (Shinryojo): You can walk into any neighborhood clinic (ENT, Dermatology, Internal Medicine) without an appointment usually.
- Hospitals (Byouin): You can go directly to a large hospital, BUT if you do so without a referral letter (Shokaijo) from a clinic, you may be charged an extra "Sentei Ryoyo" fee (approx 5,000 - 7,000 Yen).
Find a Hospital (English Speaking)
While healthcare quality is high, the language barrier can be a challenge. Major cities like Tokyo and Osaka have many English-speaking doctors.
Search Medical Institutions
Use the official Japan National Tourism Organization (JNTO) guide to find hospitals that accept foreigners and speak your language.
Official Hospital Search →In Tokyo? Check the Himawari service.