🗂️ Topic: Money, Tax & Insurance (8 guides, in situation order)

Seeing a Doctor in Japan: From Choosing a Clinic to Getting Medicine

Seeing a doctor in Japan works differently from most countries: clinics and hospitals are strictly divided, walking into a big hospital without a referral costs you extra, and many clinics close over lunch. This guide walks the whole chain, from deciding to go to picking up your medicine.

📋 At a glance: where to go for what

* Rules vary a lot between hospitals and regions. What your specific hospital says is what counts.

🩺 From deciding to go, to holding your medicine: 7 steps

1. Decide: clinic or hospital?

   This step decides how much you pay. Japan runs a split system: clinics handle everyday illness, hospitals handle serious and complex cases. If you go straight to a hospital and they judge you should have seen a clinic first, they charge a referral-free surcharge (選定療養費) — roughly ¥5,000–¥7,700 depending on the hospital. Insurance does not cover it, and it must be paid in cash.

   The test is simple: you can walk in and explain what hurts → clinic. High fever lasting days, severe pain, injury, confusion → hospital or emergency.

   No referral = extra cost
2. Find a clinic that accepts foreign patients

   Not every clinic takes foreign patients. Three signals to look for:

   • Signage or website saying 「外国人の診療可」 (accepts foreign patients)
   • JMIP certification (a national accreditation for treating international patients) — common at larger hospitals
   • Website listing language support (English, Chinese, Korean, etc.)

   The Ministry of Health, Labour and Welfare and each prefecture publish directories of medical institutions that accept foreign patients. Searching 「外国人 医療機関 検索」 plus your area usually finds them. If you come up empty, ask the international desk at your ward office or your local international association — they keep local lists.

3. Book an appointment

   Most Japanese clinics run by appointment, particularly for first visits. Walking in unannounced can mean being turned away or waiting hours.

   On the phone, cover three things: 「初診です」 (this is my first visit), your main symptom, and your preferred time. If your Japanese is shaky, write it down and read it out, or use a translation app's voice mode. Some clinics accept online booking.

4. Pack the right things before you leave
   • Insurance card (National Health Insurance or employer insurance) — without it you pay full price
   • Residence Card — some clinics ask at registration
   • Cash — plenty of clinics don't take cards. This is the single most common thing people get caught by
   • A note of your current medications and allergies — you'll need it for the intake form
   • Referral letter (if you have one, for a hospital visit)
   Cash required
5. Register and fill in the intake form (問診票)

   Hand your insurance card to the 受付 (reception), then fill in the 問診票 — a form about your current symptoms and medical history. Typical fields:

   • Chief complaint (what's wrong, since when)
   • Past medical history (hypertension, diabetes, etc.)
   • Medications you currently take
   • Allergies — especially drug allergies
   • Smoking / drinking; for women, whether pregnancy is possible

   If your Japanese isn't up to it, ask them to speak slowly or write kanji for you — Chinese speakers can often follow written medical terms. You can also pre-translate your symptoms in an app and show reception.

6. Consultation → pay at the 会計 window

   See the doctor, explain your symptoms. Afterwards, wait until your number is called for the 会計 (payment window).

   With your insurance card, you pay 30% of the medical cost (different rates apply to preschool children and ages 70–74). The first bill item is the 初診料 — the first-visit fee, higher than a return visit — followed by tests and treatment.

   If the bill is large, ask the hospital 「限度額適用認定証は使えますか」 (can you accept the ceiling-amount certificate?). With that certificate you pay only the monthly ceiling on the spot instead of fronting the full amount and claiming a refund later.

7. Take the prescription to a pharmacy (a separate bill)

   Japanese hospitals don't sell medicine. The doctor gives you a 処方箋 (prescription) that you take to a 薬局 (pharmacy) — often next door but effectively a separate business. Medicine is billed separately, insurance card again, 30% again.

   Prescriptions have an expiry (usually 4 days including the issue date). Miss it and you have to see the doctor again. The pharmacy will start you a お薬手帳 (medicine notebook) — carry it to every appointment so any doctor can see what you're taking.

   Valid 4 days

⏰ When are Japanese clinics actually open?

• Standard hours: typically 9:00–12:00 and 15:00–18:00, with a closed lunch break. Turning up at midday is a wasted trip.
• Closed days: Sundays and public holidays almost always closed; Saturdays usually morning only; many clinics also close one fixed weekday (often Wednesday or Thursday). Check the specific clinic's hours before going.
• Arrive early: get there at least 30 minutes before reception closes — many clinics stop registering patients at 11:30.

🚑 Nights, weekends and holidays

• Ambulance: dial 119. Free. Don't hesitate — there's no charge for calling one in Japan, though it should be reserved for genuine emergencies.
• Night emergency rooms (救急外来) exist only at larger hospitals. Non-urgent cases get turned away, and you'll be charged an out-of-hours surcharge.
• Holiday duty doctors (当番医): regional medical associations run a rota of clinics open on holidays. The schedule is on the association's website or your ward office site.

💴 Costs: what to watch beyond the 30%

• 初診料 (first-visit fee): charged the first time you visit a given institution, higher than a return visit. Return within a short window and you only pay the cheaper 再診料.
• Your 30% share: the standard rate with an insurance card. Different rates for preschool children and ages 70–74.
• High-cost medical care benefit (高額療養費): if a single month's out-of-pocket cost exceeds a ceiling (tiered by income), the excess is refundable — but you have to apply yourself. The hospital won't do it for you.
• 限度額適用認定証 (ceiling-amount certificate): apply in advance through your insurer (ward office for NHI). Showing it means paying only the ceiling at the counter instead of fronting the full amount. Strongly recommended before inpatient care or major tests.
• Medical expense deduction (医療費控除): if your annual out-of-pocket medical spend exceeds a threshold, you can claim it on your tax return. Keep every receipt.

📝 Closing checklist

• Get an お薬手帳 (medicine notebook) and carry it every time
• Keep all receipts (領収書) — you need them for the tax deduction
• If the bill is large, confirm whether the 限度額適用認定証 was applied
• If not, apply to your insurer for the high-cost medical care refund
• Book your follow-up appointment on the spot — Japanese clinics require appointments for return visits too

❓ FAQ

Official references: MHLW — Health Insurance ↗ ｜High-Cost Medical Care Benefit ↗

Next steps

National Health Insurance & Pension

Paying only 30% depends on having an insurance card. If you haven't enrolled yet, start here for eligibility, premiums and reductions.

Read the guide →

Ward Office Guide

The ceiling-amount certificate and replacement insurance cards are handled at the ward office — here's the workflow

Read the guide →