Healthcare in Japan is both accessible and compulsory for expats who have a resident’s visa or a work permit. In addition to the two public schemes – one for salaried workers and one covering the remaining population – expats also have the option of obtaining private health insurance in Japan. It's mandatory for expats with a visa exceeding three months (90 days) to be registered on one of the two public insurance schemes. 

Public healthcare in Japan

Public healthcare in Japan falls under either the Employees' Health Insurance Plan or the National Health Insurance scheme.

Under the Employees' Health Insurance programme, it's compulsory for a company that employs more than five workers to provide its employees and their families with medical insurance and healthcare in the event of injury, sickness, death or childbirth. This plan covers the worker for up to 80 percent of their healthcare expenses and covers their family for up to 70 percent.

The other insurance programme is the National Health Insurance scheme. This plan is also compulsory and covers Japanese residents other than salaried people and workers. People under the National Health Insurance are covered for up to 70 percent of their healthcare expenses, 80 to 90 percent for people aged 74 or more (depending upon resources), and 80 percent for children under the age of three.

Expats will need to register at their local municipal office or local city hall in order to start receiving healthcare in Japan under the National Health Insurance. A national social security card will then be issued and delivered. This document is needed when using public hospital facilities for anything from consultation to surgery.

It may be worthwhile for expats to take out additional private health insurance to cover any remaining costs not covered by the public schemes.

Private healthcare in Japan

The medical system in Japan is one of the best in the world, and expats should not be concerned about the standard of practice. However, in many cases private international medical insurance is still recommended. This will greatly depend on one's employer, as different employment categories have different rules regarding healthcare. If an expat has private insurance they will be required to pay their bills upfront and will be reimbursed by their insurance scheme at a later point.

Many doctors might be nervous about treating a non-Japanese patient, particularly if the patient can't speak Japanese. There are medical services in Tokyo which will direct expats to their nearest English-speaking doctor/dentist. In other cities, it may be necessary to take a Japanese friend or colleague along to act as interpreter and to reassure the doctor.

Medicines and pharmacies in Japan

Pharmacies can readily be found on all major streets or in shopping malls in Japanese cities. Pharmacies tend to be well-stocked and are open from 9am to 5pm. The prices of most medicines in Japan are subsidised by Japanese health insurance, making the price significantly cheaper.

Pharmacists are generally very knowledgeable. However, not all pharmacists speak good English so expats may struggle if they have lots of questions. It's useful for expats to buy a little book and have the pharmacist keep a record of their prescriptions. It's also handy to let the doctor and pharmacist know the medications which have been prescribed in the past.

Expats moving to Japan should note that there is a clear difference between pharmacies and drugstores in Japan. Drugstores only sell certain medicines and a variety of healthcare goods. The medicines and products available at drugstores in Japan are not covered by Japanese health insurance. In contrast, pharmacies in Japan only deal with medicines and sell no other merchandise. 

Health hazards in Japan

There are no major health hazards in Japan. However, expats are advised to ensure that their routine vaccinations are up-to-date.

Air pollution is arguably the region's biggest issue. This is particularly bad during the winter months. Those with respiratory issues or asthma may find their symptoms become heightened when they move to Japan. 

Emergency services in Japan

In the event of a medical emergency in Japan, expats can call an ambulance on 119.

Outside Tokyo, it's unlikely that the operator answering an emergency call will have a good command of English and therefore expats will benefit from learning a few basic Japanese phrases to use in an emergency.

The response times of the Japanese ambulance services are fairly good, especially in urban locations. Again, expats should bear in mind that while medical staff are well-trained in Japan, they may not speak English fluently.

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