Japan Healthcare System Guide

Dial: 119 (ambulance/fire) or 110 (police)

Typical response time: 5-10 minutes in cities (national average 8.9 minutes). Ambulance service is FREE for everyone including tourists. However, finding a hospital willing to accept the patient ("たらい回し/tarai-mawashi" — being bounced between hospitals) can add 30-60+ minutes in some cases.

Costs: Ambulance: FREE. ER treatment: ¥10,000-50,000+ ($70-350+) without insurance. Hospital admission: ¥30,000-100,000+/day ($200-700+). An additional ¥5,000-8,000 surcharge applies for visiting large hospitals without a referral letter (紹介状/shōkaijō).

Call 119 for ambulance (FREE — no charge regardless of nationality). Say "kyūkyūsha onegaishimasu" (救急車お願いします — "ambulance please"). The #7119 health consultation hotline (available in Tokyo, Osaka, and other cities) provides 24/7 advice on whether you need an ambulance — some operators speak English. For English assistance, call AMDA International Medical Information Center: 03-6233-9266.

No "GP" system — patients visit specialised clinics directly (内科/naika for general medicine, 小児科/shōnika for pediatrics, etc.). Walk-in without referral. International clinics in Tokyo (St. Luke's, Tokyo Midtown Medical) and Osaka offer English-speaking doctors but at premium prices.

Typical wait: Usually under 30 minutes at regular clinics. International clinics: same-day to next-day appointments. Large hospitals without referral: 1-3+ hour waits.

Typical cost: ¥3,000-10,000 ($20-70) at regular clinics. International clinics: ¥10,000-30,000+ ($70-200+) per consultation.

Clinics are extremely abundant in cities — virtually every neighbourhood has multiple. Most close on Sundays, national holidays, and often Wednesday or Thursday afternoons. Saturday mornings usually available. Evening clinics (夜間診療) available in larger cities. Rural areas: clinics scarce, but quality is generally good.

Recommended: Routine vaccines (MMR, DTP, Polio, Flu), COVID-19, Hepatitis A, Hepatitis B, Japanese Encephalitis (rural areas/long stays — especially rice-paddy regions), Measles (MMR booster — periodic outbreaks), Rabies (pre-exposure for extended rural stays)

No mandatory entry vaccines. Japanese Encephalitis vaccine recommended for rural stays during rainy season (Jun-Sep). Japan has periodic measles outbreaks — ensure MMR is current. Influenza peaks Jan-Mar. Japan does NOT require proof of COVID vaccination.

Insurance required for visa: no

Public coverage for visitors: no

Visa waiver for 68 countries (90 days, no extension). Visit Japan Web (VJW) pre-registration recommended for smooth immigration. Work visas require Certificate of Eligibility (在留資格認定証明書) from employer/sponsor. Residents MUST enrol in NHI within 14 days of registering address — 30% copay system.

Private GP visit: ¥3,000-10,000 ($20-70) at regular clinics. International clinics: ¥10,000-30,000+ ($70-200+). Dental: ¥5,000-15,000+.

Emergency care without insurance: ¥10,000-50,000+ ($70-350+) for ER. Hospital admission: ¥30,000-100,000+/day. Surgery: ¥500,000-2,000,000+ ($3,500-14,000+). Costs are reasonable by Western standards but add up quickly for extended stays.

Medication: Medications affordable by Western standards. Dispensed at hospital pharmacies or independent dispensing pharmacies (調剤薬局/chōzai yakkyoku) next to clinics — bring your prescription (処方箋/shohōsen). Generic medications (ジェネリック/jenerikku) increasingly available and cheaper. Pharmacy staff rarely speak English.

Hours: Mon-Sat 9am-7pm typical. Drugstore chains (マツモトキヨシ/Matsumoto Kiyoshi, ウエルシア/Welcia, ツルハ/Tsuruha, ドン・キホーテ/Don Quijote) open until 10pm-midnight — sell OTC medications, cosmetics, and snacks. Hospital dispensing pharmacies close earlier (5-6pm). 24-hour pharmacies rare except in very large cities.

Over the counter: Drugstores sell OTC medications but categories differ from Western countries. Japanese OTC classifications: 第1類 (Class 1 — pharmacist consultation required), 第2類 (Class 2), 第3類 (Class 3 — self-service). Ibuprofen (イブ/Eve brand), acetaminophen, antihistamines, and stomach medicines widely available. Packaging is in Japanese — use Google Lens to translate.

Controlled substances: CRITICAL: Japan has extremely strict drug laws. The following are ILLEGAL even with a foreign prescription: Adderall and other amphetamine-based ADHD medications, Vyvanse, Dexedrine, methamphetamine (even prescribed). Codeine over 10% concentration, some cold medicines with pseudoephedrine above limits, and all cannabis products (including CBD in some cases) are prohibited. Stimulant medications (覚醒剤/kakuseizai) carry severe penalties including imprisonment. For permitted controlled medications (e.g., methylphenidate/Concerta, some opioid painkillers), you MUST obtain a Yakkan Shōmei (薬監証明) import certificate BEFORE travel from the Regional Bureau of Health and Welfare. Maximum 1 month supply.

• There is no "GP" system — patients choose which specialist clinic to visit directly (内科/naika for general issues)
• Many common Western medications are ILLEGAL in Japan — including Adderall, Vyvanse, and some cold medicines with pseudoephedrine
• Very few doctors speak English outside international clinics in Tokyo/Osaka — translation apps are essential
• Clinics close on Sundays, national holidays, and often Wednesday/Thursday afternoons
• Payment at regular clinics is usually cash only — credit cards often not accepted (international clinics do accept cards)
• Large hospitals charge a ¥5,000-8,000 surcharge without a referral letter from a clinic
• Ambulances are FREE but finding a hospital to accept you can cause delays ("tarai-mawashi" problem)
• Pharmacy prescriptions are dispensed at separate pharmacies next to the clinic, not at the clinic itself

• Use AMDA International Medical Information Center (03-6233-9266) for English-speaking doctor referrals — multilingual service
• Check ALL medication legality with Japanese Embassy BEFORE packing — violations result in arrest and imprisonment
• Apply for Yakkan Shōmei import certificate if carrying any controlled medications — process takes 2+ weeks
• Download Google Translate with Japanese offline pack — use camera mode to read clinic signs and medicine labels
• Carry cash (¥10,000-30,000) for clinic visits — many don't accept credit cards
• For after-hours care, call #7119 (available in Tokyo, Osaka, other cities) — health consultation hotline with some English support
• Visit 内科 (naika — internal medicine) clinics for general health issues — closest equivalent to a Western GP
• Tax-free drugstores (look for "Tax Free" signs) offer OTC medication purchases for tourists without consumption tax