Healthcare in Japan

Healthcare in Japan is both accessible and compulsory for expats who have a resident's visa or a work permit. Expats will likely fall under one of two public schemes – one for salaried workers and one for the remaining population. In addition, expats can also obtain private health insurance in Japan. It's mandatory for expats with a visa exceeding three months (90 days) to be registered on a public insurance scheme.

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Health insurance in Japan

Most expats will fall under one of two major healthcare schemes in Japan – Employees' Health Insurance (Shakai Kenko Hoken) or National Health Insurance (Kokumin Kenko Hoken). In these two schemes, healthcare expenses are covered by up to 70 percent. There is also the Advanced Elderly Medical Service System (Choju Iryo Seido) for those over the age of 75, which funds up to 90 percent of medical expenses.

Under the Employees' Health Insurance programme, it's compulsory for companies to provide their employees and their families with medical insurance and healthcare in the event of injury, sickness, death or childbirth. The National Health Insurance scheme covers those other than salaried people and workers, like those who are self-employed or unemployed.

Expats will need to register at their local municipal office or city hall to start receiving healthcare in Japan. A Health Insurance Certificate will then be issued and delivered. This document is needed when using public hospital facilities for anything from consultation to surgery.

It may be worthwhile for expats to take out additional private health insurance to take care of any remaining costs not covered by the public schemes.

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Public healthcare in Japan

Japan's public healthcare system is renowned for its high quality and is accessible to all residents, including expats. It is an integral part of the nation's commitment to ensuring a solid standard of practice in healthcare. Many doctors in the public healthcare system have studied overseas, bringing a wealth of international knowledge and experience to their practice.

That said, not all doctors in the public system might be proficient in English. In urban areas like Tokyo, medical services often have provisions to direct expats to English-speaking doctors. In other cities, it might be helpful to bring a Japanese-speaking friend or colleague for translation if needed.

It's also important to note that doctors in Japan typically see many patients each day, which may lead to shorter individual consultation times than what expats from Western countries might be used to. Additionally, Japanese doctors traditionally adopt a more paternalistic approach, making decisions on the patient's behalf. This can be an uncomfortable adjustment for Western expats, who may opt for private healthcare, at least as they settle into life in Japan.

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Private healthcare in Japan

Private healthcare in Japan is another option for expats, offering benefits like shorter waiting times, a wider choice of doctors, and additional amenities. That said, these benefits come at a higher cost.

The language proficiency of doctors in the private sector can also vary, but English-speaking doctors are generally more common, particularly in private hospitals catering to the international community. The patient-doctor dynamic may also be more familiar to Western expats, with an increasing emphasis on shared decision-making.

When choosing a healthcare provider, whether public or private, expats need to consider factors such as cultural understanding and language proficiency for clear and effective communication.

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Vaccinations for Japan

While Japan doesn't require any specific vaccinations for entry, the following are generally recommended for travel to Japan, especially for long-term stays:

• Measles, Mumps, Rubella (MMR)
• Diphtheria-Tetanus-Pertussis
• Varicella (Chickenpox)
• Polio
• Influenza
• Hepatitis A and B
• Japanese Encephalitis (if planning to stay in rural areas for an extended period)

Before travelling, expats should consult with their healthcare provider to discuss necessary vaccinations based on their specific health conditions and itinerary.

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Medicines and pharmacies in Japan

Pharmacies can readily be found on all major streets or in shopping malls in Japanese cities. They tend to be well-stocked and are open from 9am to 6pm. Pharmacists are usually highly knowledgeable. However, not all pharmacists speak good English, so expats may struggle if they have lots of questions. Most medicines in Japan are subsidised by Japanese health insurance, making the price significantly lower.

Expats moving to Japan should note that there is a clear difference between pharmacies and drugstores. Drugstores only sell certain over-the-counter medicines and a variety of healthcare goods. Drugstores also stay open much longer than pharmacies, with most drugstores closing at 8pm.

The medicines and products available at drugstores in Japan are not covered by Japanese health insurance. In contrast, pharmacies in Japan only deal with prescription medicines and sell no other merchandise.

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Health hazards in Japan

While Japan has no major endemic diseases to worry about, expats should be aware that the country is in a region known for frequent natural disasters such as earthquakes and tsunamis. These can indirectly impact health and safety, particularly in the immediate aftermath, through disruptions in infrastructure, access to healthcare and other essential services.

It is recommended that expats familiarise themselves with emergency preparedness measures for such events, including securing an emergency kit and understanding evacuation protocols. Air pollution is arguably the region's most significant endemic health issue. This is particularly bad during the winter months. Those with respiratory issues or asthma may feel their symptoms heightened when moving to Japan.

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Emergency services in Japan

In the event of a medical emergency in Japan, expats can call an ambulance on 119.

Outside Tokyo, the operator answering an emergency call may not have a good command of English. Therefore, expats will benefit from learning a few basic Japanese phrases to use in an emergency. The response times of the Japanese ambulance services are fairly good, especially in urban locations.