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Sick in Japan? Your Expat Guide to Doctors, Insurance & Emergencies (No AI BS)

I’ve been there. You wake up with a throat raw enough to scrape asphalt, your nose is running like a broken faucet, and every joint in your body screams. You’re in Japan, and suddenly, that picture-perfect vacation or exciting new life feels terrifyingly vulnerable. I remember my first serious cold here, about three years into my Japan adventure. My Japanese was… passable for ordering ramen, not for explaining my deepest bodily woes to a stoic doctor. I stood in front of a clinic sign, shivering not just from the fever, but from sheer panic, convinced I was going to accidentally sign up for organ donation instead of getting antibiotics. Let’s face it: if you can’t speak Japanese fluently, getting sick here is a nightmare. I know, because I’ve been there.

This isn’t some generic AI-generated fluff. This is the real deal, from someone who’s tripped, stumbled, and occasionally gotten things right in the Japanese medical system for over a decade. I’m your Japan Local Fixer, and I’m going to tell you exactly how to survive a winter (or any season) illness here without losing your mind or your life savings.

The Real Struggle: Why Getting Sick Here Feels Like a Boss Battle

Honestly, the Japanese healthcare system is fantastic – if you know how to navigate it in Japanese. For the rest of us, it’s like trying to find a specific noodle stall in Shinjuku Golden Gai after three beers: confusing, overwhelming, and potentially leading you down the wrong alley. The biggest hurdle, by far, is the language barrier. I once tried to explain a persistent cough using dramatic hand gestures and sounds that probably made me sound like a dying cat. The doctor just stared, then handed me a tiny, indecipherable packet of pills.

Then there’s the insurance confusion. Are you a tourist with travel insurance, or a resident with national health insurance? It makes a huge difference in how you access care and, crucially, how much you pay. I’ve seen countless posts on Reddit, like that poor Canadian traveler wondering if emergency medical insurance is “worth it” for Japan. (Spoiler: YES, it absolutely is if you’re a tourist!) And for residents, the recent shift to the “My Number” card for health insurance has thrown everyone for a loop. It’s a big deal, and if you haven’t sorted it, you’re in for some friction at the clinic.

🎯 Insider Tip: Don’t ever assume a clinic will have English staff. Always call ahead or check their website if you’re not going to a known international clinic. Save yourself the wasted trip and frustration.

Step-by-Step Solution: Your Japan Healthcare Survival Guide

Okay, deep breaths. Here’s how we’re going to tackle this.

Finding an English-Speaking Doctor (Yes, They Exist!)

My general rule of thumb: for minor illnesses, go to a small local clinic (クリニック, kurinikku). For anything serious or that requires specialized equipment, a larger hospital (病院, byōin) is your best bet. But how do you find one that won’t just stare blankly when you say “headache”?

1. Start with Resources:

   • AMDA International Medical Information Center: This is your holy grail. They have a hotline (03-6233-9266) with multilingual support and can help you find clinics based on your location and language needs.
   • Japan Healthcare Info: Another excellent resource with a searchable database of English-speaking doctors.
   • Local Embassies/Consulates: Many maintain lists of English-speaking medical facilities.

2. Specific Examples (for my fellow expats in major cities):

   • Tokyo:
     • Tokyo Medical and Surgical Clinic (TMSC): A classic. High-quality, English-speaking staff, but it’s a private clinic, so expect higher fees if uninsured or only travel insured.
     • St. Luke’s International Hospital: A large, reputable hospital with an international department. They’re well-equipped for serious issues.
     • National Center for Global Health and Medicine: Another good option for comprehensive care.
   • Osaka:
     • Osaka International Cancer Institute (formerly Osaka General Hospital): While specialized, they have good international services.
     • Osaka Red Cross Hospital: A large general hospital with some English support.
   • Kyoto:
     • Kyoto University Hospital: A major teaching hospital that can handle complex cases, with some English support available.
     • Marutamachi Hospital: Often cited for its availability of English-speaking doctors.

3. What to Bring: Always, always bring your passport, and if you’re a resident, your health insurance card/My Number card and your residence card (Zairyu Card). Having these makes registration much smoother.

🎯 Insider Tip: For general clinics, try to visit right when they open (usually 9-9:30 AM) or after lunch (2-3 PM). Avoid lunchtime rushes (12-1 PM) and just before closing, especially if you think you’ll need extra time. Some clinics only take appointments, so check!

Getting a Prescription & Where to Buy OTC Meds

Japan has a system where the doctor prescribes, and you take that prescription to a separate pharmacy (薬局, yakkyoku). This often means another wait, but it’s standard.

1. Prescription Process:

   • After your doctor’s visit, you’ll get a prescription slip (処方箋, shohōsen).
   • Take it to any pharmacy. Many clinics have a pharmacy right next door or across the street.
   • Hand over your prescription and your insurance card/My Number card.
   • The pharmacist will prepare your medication, explain how to take it (often with printed instructions), and you pay there.

2. Over-the-Counter (OTC) Medications:

   • Drugstores (ドラッグストア, doraggu sutōa): This is where you’ll find everything from basic pain relievers to cold medicines, stomach remedies, and even cosmetics.
     • Matsumoto Kiyoshi (マツモトキヨシ): The yellow-and-black giant. You can’t miss it. They have a huge selection, often with English labels for popular products.
     • Daikoku Drug (ダイコクドラッグ) & Sundrug (サンドラッグ): Also very common and well-stocked.
     • Don Quijote (ドン・キホーテ): While more of a discount department store, they have substantial medicine sections, often with tax-free shopping for tourists.
   • What to look for:
     • Cold Medicine: Pabron Gold A (パブロンゴールドA) or Lulud A Gold (ルルアゴールド) are popular, effective choices for general cold symptoms.
     • Pain Relievers: Bufferin Premium (バファリンプレミアム) and Eve Quick (イブクイック) are common for headaches and general pain.
     • Stomach Upset: Seirogan (正露丸) is a classic for diarrhea, with a very distinct smell! Ohta’s Isan (太田胃散) is good for indigestion.
   • Reading Labels: If you can’t read Japanese, use Google Translate’s camera function. Look for phrases like “風邪薬” (kazegusuri, cold medicine), “痛み止め” (itamidome, painkiller), or “胃薬” (igusuri, stomach medicine).

🎯 Insider Tip: If you rely on a specific OTC medication from your home country, take a photo of the packaging (front, back, and ingredients list). Show it to a pharmacist. They might be able to recommend a Japanese equivalent, or at least tell you if it’s available.

Insurance: Tourist vs. Resident (The My Number Card Headache)

This is where things get tricky. Know your status!

For Tourists: Get Travel Insurance. Period.

That Reddit user asking “is it worth it?” – my answer is a resounding YES. Japanese medical care is excellent, but if you’re a tourist without National Health Insurance, it’s expensive. Travel insurance acts as your safety net.

• How it works: Typically, you’ll pay upfront at the clinic/hospital, then submit the receipts to your travel insurance provider for reimbursement. Some larger international hospitals might directly bill your insurer, but don’t count on it for smaller clinics.
• Proof: Always carry proof of your travel insurance policy, including policy number and emergency contact details.
• Why it’s worth it: A simple doctor’s visit without insurance can be ¥5,000-¥15,000. An ER visit? Easily ¥30,000-¥100,000 or more, not including tests or treatment. Don’t risk it.

For Residents: National Health Insurance (国民健康保険, Kokumin Kenkō Hoken) & The My Number Card

If you live in Japan for more than three months, you’re usually required to enroll in National Health Insurance (NHI). This covers 70% of your medical expenses, meaning you only pay 30% out-of-pocket. It’s a lifesaver.

The My Number Card Change (THIS IS IMPORTANT):
As of November 30, 2025, your traditional paper/plastic Japan health insurance card is effectively phased out. Now, residents need to link their health insurance information to their My Number card (マイナンバーカード, mainambā kādo) or use the dedicated My Number Health Insurance Card reader at clinics. This isn’t just a suggestion; it’s becoming the standard.

• What you need to do:
  1. Get a My Number Card: If you don’t have one, apply at your local city hall (区役所, kuyakusho or 市役所, shiyakusho). It takes time (weeks to months), so do it ASAP. You’ll need your My Number notification card and ID.
  2. Activate Health Insurance Function: Once you have your physical My Number card, you need to link your health insurance data to it.
     • Mynaportal App: Download the Mynaportal (マイナポータル) app on your smartphone and use it with your card’s IC chip reader. You’ll need to set up a password during the card application.
     • Convenience Store Terminals: Many convenience stores (e.g., Seven-Eleven, Lawson, FamilyMart) have multi-purpose terminals where you can activate this function.
     • Post Office/City Hall: Staff can assist you.
  3. At the Clinic: When you visit, look for the special card reader (顔認証付きカードリーダー, kao ninshō tsuki kādo rīdā). Insert your My Number card, and it will verify your insurance eligibility. If you haven’t linked it, you might have to pay 100% upfront and then get reimbursed later, which is a massive headache.
  4. Certificate of Eligibility: If you haven’t gotten your My Number card yet, or if it’s lost, your municipality might issue you a “Certificate of Eligibility for Health Insurance” (健康保険資格確認書, kenkō hoken shikaku kakunin-sho) which acts as temporary proof. Contact your local city hall immediately if you’re in this situation.

🎯 Insider Tip: Even if you’ve linked your My Number card, carry your physical health insurance card (if you still have an unexpired one) or a printout of your insurance details just in case the system is down or the clinic’s reader isn’t working. It happens.

119 Guide: Emergency! When to Call an Ambulance

My biggest fear, living abroad, was always a true emergency. What if I couldn’t communicate when it mattered most? I’ve thankfully never had to call 119 for myself, but I once saw a friend collapse on the street. That feeling of absolute helplessness as passersby spoke rapid-fire Japanese was terrifying. This is why having a plan is crucial.

When to Call 119:
* Severe injuries (car accident, major fall).
* Sudden, intense chest pain (heart attack symptoms).
* Stroke symptoms (sudden weakness/numbness on one side, difficulty speaking).
* Unconsciousness or severe disorientation.
* Heavy bleeding that won’t stop.
* Difficulty breathing.
* Any situation where you believe immediate medical transport is essential to save a life or limb.

How to Call 119 (And What to Say):
Dial 119 from any phone. It’s free. The operator will likely answer with “Kaji desu ka? Kyuukyuu desu ka?” (火事ですか？救急ですか？ – “Is it fire? Is it an ambulance?”).

Here’s a sample script to get you started. Speak slowly and clearly.

Important points:
* Location: Give your exact address (or the nearest major landmark). Having your address written down is a lifesaver.
* What happened: Briefly explain the situation.
* Your Name: Tell them who you are.
* Interpreter: Japan’s emergency services are getting better at connecting callers with interpreters, but it might take a moment. Stay calm and repeat your request for English.

🎯 Insider Tip: Have your hotel’s address (for tourists) or your home address (for residents) written on a piece of paper or saved on your phone. If you can’t speak, you can point to it. Also, know the cross streets or nearest train station to give additional landmarks.

Price Breakdown: What to Expect to Pay (No Surprises)

This is the part everyone wonders about. Prices can vary widely based on the clinic, hospital, and what services you receive. These are typical ranges.

🎯 Insider Tip: For non-emergencies, always opt for a smaller clinic over a large hospital. Hospitals have a “first consultation fee” (初診料, *shoshinryō*) that is often much higher, especially if you go to a large hospital without a referral from a clinic.

Common Pitfalls & How to Avoid Them

• Going to a hospital for a runny nose: You’ll wait for hours, pay more, and probably get less personalized attention than a small clinic. Hospitals are for serious stuff.
• Not having ID/insurance proof: Always, always carry your passport/residence card and insurance details. They will ask.
• Assuming English is spoken: Unless it’s an international clinic, assume basic Japanese is required or use a translation app.
• Not understanding your prescription: Before you leave the pharmacy, if you don’t understand the instructions, ask! Use Google Translate or write it down.
• Ignoring the My Number card for residents: This isn’t optional anymore. Get it sorted, or face unnecessary costs and bureaucratic hurdles.
• Asking resident-specific healthcare questions on tourist forums: As the research data showed, this leads to frustration. Use appropriate expat forums (like r/Japanlife on Reddit) or the resources I mentioned above for resident-specific queries.

🇯🇵 Point & Speak: Essential Phrases for the Clinic

When words fail, pointing to these phrases can make a world of difference. Write them down, or save this page on your phone!

Frequently Asked Questions