What to do if you require medical assistance while visiting Japan

You’ve made it to the 2019 Rugby World Cup in Japan to cheer on your side.

You’ve cleared customs, checked in to your destination and even enjoyed a few days sightseeing and eating your way through your arrival city.

You’re now set to move a little further afield: to Kumamoto or Kamaishi in Iwate Prefecture or Oita Prefecture or Toyota City or even north to Sapporo in Hokkaido. Something a little more out of the way than the usual Tokyo-Osaka corridor where there is much more of a soft landing and plenty of English or other foreign-language support (at least more than in the non-metropolitan areas).

At this point, visitors will probably be most concerned with getting to their destinations, language barriers and what local cuisine or experiences they’d like to try at their next stop. Before leaving one of the major cities, though, it’s worth mentioning that you should ensure you have the information you need if an accident occurs or you require some medical care while visiting Japan.

Foreign residents of Japan don’t have to worry so much about this since everyone who lives in Japan is required by law to pay into the kokumin kenko hoken, or the Japanese national health insurance plan. Under this system, Japanese taxpayers (that includes foreigners) are issued an insurance card to present at any byoin (hospital), clinic or pharmacy they visit for treatment or medication and 70% of all their medical costs (or more) are covered. If you’re a foreigner living in Japan, we have published a complete series about this on our GaijinPot site, the “Guide to Understanding the Japanese Health Insurance System.”

For tourists who may be visiting for the Rugby World Cup that’s currently taking place or the Tokyo 2020 Olympics — things are not quite so simple. Up-to-date, modern medical care is readily available here, but expect some confusing bureaucracy and unexpectedly steep costs if you’re not prepared.

What follows is a simple guide on what to do should you require medical attention in Japan as a visitor. It is by no means exhaustive and should not be taken as medical advice on any type of condition or injury — I am not a doctor and I certainly don’t play one on TV — but it should serve as a basic signpost to point you in the direction of the care you need.

Be prepared

Medical costs in Japan can get prohibitively expensive without some form of insurance.

I mentioned this in a previous article, “What to Do if You Are Stopped by the Police in Japan,” and it bears repeating: Do yourself a favor and purchase travel insurance. This applies to visitors from all countries — whether or not they have health care back home.

“Medical costs in Japan can be pretty hefty,” says Marion Auclair, consular sporting liaison officer for the British Embassy in Tokyo. “And it’s not a secret that the [British] government does not fund any hospital bills — or any hotel bills. So if you don’t have any travel insurance, it can be a very expensive bill to try and pay.“

To put it another way: Should an accident happen to you here in Japan, you alone are responsible for the cost of medical treatments and stays.

“The cost of a cast for a broken leg can be around UK£3,000 (¥400,000),” says Auclair. “If you need surgery [on the leg], that can be £20,000 (¥2,668,000).”

Japanese hospitals and clinics do not accept foreign health insurance. Without travel insurance for Japan, you will be required to pay the full cost of any medical treatment and/or facility stay — and this could significantly affect not just your trip, but your life.

There are some care providers that have partnered with international insurance companies, but these are an extremely rare exception and not the rule. Contact your own insurance provider at home to see if they provide coverage in Japan (if you use Blue Cross, for example) and if they do, they will be able to provide you with a list of partner hospitals and clinics to visit.

If you forget to purchase travel insurance before you leave, you can buy it once you land in Japan. Insurance agencies like Sompo Japan Nipponkoa and Tokyo Marine Nichido, for example, offer one-to-10 day, 11-to-20 day and 21-to-30 day packages for travelers that you can purchase online after you arrive. It is well worth the minimal investment — about ¥2,900 (U.S.$27) to ¥6,900 ($64) payable via credit card — to cover you in case you require medical attention.

These companies will also provide lists of approved hospitals and clinics to visit across Japan should you need one, as well as a phone or online chat translation service in your native language.

Personal triage

If you do find that you require medical help while you’re here, you’re going to need to make some personal decisions.

For foreign residents and Japanese citizens alike, the country’s healthcare system doesn’t use general practitioners (or what you might think of as a “family doctor”) who can diagnose and recommend the proper physician to treat your condition. Instead, you’ll need to know what type of specialist you require, then decide what doctor or clinic you’d like to visit and make an appointment.

The Japanese Ministry of Health, Labour and Welfare publishes a basic list of hospitals and clinics by prefecture on its website. You may want to have a Japanese speaking friend or Google Translate handy as most of these sites are all in Japanese.

If you’re staying in Japan’s capital city, the Tokyo-to Hoken Iryo Joho (Tokyo Metropolitan Health and Medical Information Center) website — also known as Himawari — provides reliable information on services, facilities, pharmacies and. It has information in English, Chinese, Korean, Spanish and Thai regarding care facilities in the area and can be called daily (03-5285-8181) from 9 a.m. to 8 p.m.

Do not expect staff at hospitals in Japan to speak your native language. Some hospitals — like those affiliated with universities — may have a translation service available (either an on-call staff member or via a telephone or video call link up) but this is not a requirement.

An organization set up to assist foreigners who need access to Japan’s medical institutions is Japan Medical Service Accreditation for International Patients (JMIP). Its website publishes general information for visitors to Japan looking for information on hospitals and clinics with a prefectural search button on their homepage.

The AMDA International Medical Information Center, though it is more designed for residents, also has good multi-lingual information to help foreigners receive medical care in Japan via telephone and with downloadable PDF documents of typical registration and health forms translated into Chinese, English, Korean, Portuguese, Spanish and others.

Another resource you can visit online is the Japan National Tourist Organization’s (JNTO) “Guide for when you are not feeling well” for a searchable database of medical institutions by area, language and medical services or to download the list in PDF form. Languages available for search include Arabic, Chinese, English, French, German, Hindi, Indonesian, Italian, Khmer, Korean, Laotian, Malay, Mongolian, Nepali, Persian, Polish, Portuguese, Romanian, Russian, Sinhala, Spanish, Tagalog, Thai, Tibetan and Vietnamese.

Not all locations will be able to handle all of these languages, of course, so your mileage may vary. You can also call its Tourist Information Center for help in Tokyo (03-3201-3331) every day from 9 a.m. to 5 p.m. or visit one of the TIC locations at Narita or Kansai international airports or at these locations across the country.

If it’s an obvious emergency, you’ll need to visit a kyukyu byoin, or what’s known as an “emergency hospital” (which you can find in the links listed above). I know this sounds like an oxymoron, but these hospitals are open 24 hours daily and are staffed with doctors and nurses who can deal with most urgent medical care. Again — without insurance — unless it is a dire emergency, they may not be able to help.

If it’s urgent, but not a life-or-death situation, then your next option should be a regular hospital. These hospitals have typical office hours, are usually closed weekends and holidays and may not be able to attend to critical emergencies — in which case they will direct you to a facility that can. The staff here will be able to handle and treat non-emergency diagnoses and prescriptions (they will probably also have a pharmacy on hand or in close proximity).

Medical clinics are readily available across the country, but to be honest, probably aren’t the locations a visitor would likely need to go — as they are mainly set up for residents.

If you simply need medication, you’ll want to visit a kusuriya or yakkyoku (pharmacy or chemist) such as Tomod’s (Japanese) or Matsumoto Kiyoshi (Japanese) for any over-the-counter (OTC) remedies like pain relief, allergy medication, bandages and dressings, ointments and personal hygiene goods. It goes without saying that Japanese pharmacies do not accept or fill foreign prescriptions.

If you’re in an accident

If you are injured in an accident (hit by a car, for example) or require urgent medical assistance, it’s time to call an ambulance that can transport you to the proper facility.

To call an ambulance, you need to dial 119 or ask someone with a phone to dial it for you.

If you need help with that, you can copy and paste the Japanese text below for “Kyukyusha o yonde kudasai,” or “Please call an ambulance.” Or you can simply save the image to your mobile device.

"Please call an ambulance" in Japanese. Save to your phone or computer just in case you may need it. Image: Japan Today

Emergency calls made using Japanese pay phones do not require any coins deposited. These distinctly green banks of phones can be found situated outside (and inside) train station exits, convenience stores, police boxes and other common areas (though their once ubiquitous numbers are rapidly dwindling now in the age of mobile cellular devices). To use for emergencies, just lift the receiver and press the numbers 110 or 119.

The paramedics who arrive will assess the physical situation and, if warranted, they will load you into the vehicle and begin transport. Along the way they will do their best to find out your name, where you’re from, if you have insurance and any other pertinent information from you or a person designated to be with you. You will be taken to a hospital best able to deal with your situation. Note that this may not be the closest hospital. The ambulance ride itself is free, but a nominal charge for it might be added to whatever services the hospital you are delivered to will eventually bill you.

For all of the situations and reasons listed above, you really should carry around a personal medical information crib sheet when traveling in Japan. While you are bound to encounter language barriers in the event you need some help, most trained medical professionals should be able to understand basic conditions and medications. Keep it with your wallet or passport. Since you are required by law to have your passport on your person at all times as a visitor to Japan, it seems like a smart place to keep it handy.

The JNTO has a form in basic English and Japanese that you can fill out and show to any medical professional. The downloadable form on the website is called “Personal information concerning medical care to write down.”

Expect the unexpected

Nurse's station at a Japanese hospital.

One of the best ways to avoid problems before they occur is to not put yourself in harm’s way in the first place. In that regard, it’s a good idea to register for travel alerts from your government. Usually sent via email, Facebook, Twitter or other messaging services, these notifications cover everything from extreme weather to political incidents to natural disasters. The travel advisory pages on your government’s website should have a sign up option. If not, it will at least have a repository of up-to-date information on what’s happening in Japan on its page dedicated to travel advice. Stay tuned to these.

As the British Embassy’s Auclair puts it: “When we had the Hokkaido earthquake last year, that’s where we put all the information on where the shelters would be [and] where they would speak English, for example. And then some we would push out to our SNS, Facebook and Twitter. Email alerts would go straight to people who have registered, and they would have everything in their inbox. So, we encourage people to sign up for that travel advice.”

At this point, I know I’m repeating myself like a skipping CD player, but the best option to ensure you’re not taken by surprise — or for a financial ride you can’t afford — if you need medical care in Japan is to make sure you have some form of travel insurance. Certainly, it’s important for the financial implications, but it’s also notable for the support that comes with the policy — from putting you in touch with hospitals near you to no-cash-needed treatments to translation services while being attended to. It should definitely be your first consideration on the medical front to providing peace of mind and coverage should you find yourself in trouble.

Without insurance, you will still be able to receive the care you need in Japan, but it will be notably expensive, confusing and full of red tape. Why take the risk? You want to enjoy your visit to Japan and hopefully experience your side hoisting the Webb Ellis Cup — not worry about how you’re going to pay for all those bills after a particularly raucous celebration.