***This article has been updated on December 2019***

Being sick in a foreign country is one of the most unpleasant universal experiences for expats. Besides feeling ill, it can be tough to get up the wherewithal to visit a doctor and explain your illness in a language you don’t quite have down pat, not to mention the medical costs.

We here in Japan are more fortunate than some countries around the world in that we have what’s called the NHI: The National Health Insurance Scheme. Unlike the famous NHS, you do still have to pay for medical services in Japan– but it’s far less than places like the US. Enrolling in the NHI is mandatory for all residents of Japan. 

Photo of a doctor Visit

Photo from Unsplash by Marcelo Leal

General Costs for the Insured

Of course, everything depends on what sort of treatment you are looking for; however, the first visit to a clinic will always be the most expensive. Though you still will only pay up to 30% of the full cost. Therefore, the most common first consultation fee at your local Japanese clinic will generally be between 3 to ¥5,000, with follow-up visits costing from 600-¥1000.  English-speaking clinics with mainly foreign clientele are often higher and can range up to ¥10,000 for the first time, even with your NHI card.

Note that you will pay initial consultation fees every time you visit a new doctor, so if you’re in Japan for the long haul, try to shop around a bit for a doctor that you’ll be happy with, so you aren’t paying the initial fees over and over again. Almost all English-speaking clinics have a website, so checking whether or not they take NHI before you even get to the doctor can save you time and money. 

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Cost of a Doctor Visit

Photo from Photo AC by きなこもちさん

General Costs for the UNinsured

Without NHI, your costs can skyrocket, and you can expect between ¥10,000 to ¥50,000 in upfront costs. It is important to reiterate that technically, enrolling in the NHI is mandatory for all residents in Japan, except for special diplomatic visas. If you’re only here for a short time on the company’s dime, ask your HR or local liaison about what your options are– they may be paying for your insurance. Travel insurance may also be a great option, as Japan generally ranks low on the risk factor and it can be far more.

Some clinics and hospitals may charge the same first-time fee regardless of if you have health insurance or not. For example, St. Luke’s Hospital advertises on their website that the fee is 5,400 yen without clarifying if this with or without insurance, so one can assume that it is a flat fee either way.

Most clinics will only be able to tell you the total charges after you see a doctor and are diagnosed. Just be sure to ask for the cost of any tests before agreeing to even have blood taken as there will be an additional charge for anything besides just talking with your doctor. Generally, they can tell you over the phone what the consultation fees will be.

The following is what Tokyo Midtown Medical Clinic charges (based on price list available in their clinic).

Of course, nothing is set in stone, and though it may seem confusing, it’s best to keep a few rules of thumb in mind when it comes to healthcare in Japan:

  1. Foreigner-friendly (English-speaking) clinics and hospitals are going to cost more than a local one. If you can find a Japanese speaking friend to go with you, the local clinics are very good and can save you money, especially if you’re not enrolled in the NHI. Often, doctors do speak a little English as well, so if you have some basic Japanese ability and google translate, you can get along decently.
  2. If you do have NHI, then your costs will be no more than 30% of the total cost for a consultation, pharmaceuticals, tests, etc.
  3. Every clinic and hospital will have a first-time consultation fee, so it pays to visit the same clinic. If you need a different clinic, then it’s best to get a reference letter from the physician you already saw, as referrals waive the first-visit fees.
  4. Many expats report feeling afraid or intimidated to go to the doctor– but you don’t have to be! Tokyo is the biggest city in one of the healthiest countries in the world, and if you don’t like a doctor or hospital, there are plenty more to choose from! 

Remember– your health is your top priority, and just a little research can go a long way!

Odaji ni! (Take care of yourself!)

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