Seeing a Doctor in Japan: Clinics, Hospitals and Emergencies

Last updated: July 2026

First, the big picture. Japanese healthcare has two levels: the clinic (診療所 / shinryojo – a small doctor's office) and the hospital (病院 / byoin). The basic rule that surprises many foreigners: you do not start at the big hospital.

Clinic or hospital – which one do I go to?

Start at a clinic. It handles colds, fevers, minor injuries and allergies. If you need surgery, admission or big tests, the clinic writes you a referral letter to a hospital.

Why not go straight to a big hospital? Because without a referral letter (紹介状 / shokaijo), large hospitals charge an extra fee of 7,000 yen or more on top of your bill. Pick the right department instead: naika (内科, general medicine) for fever and stomach problems, jibika (耳鼻科) for ear, nose and throat, ganka (眼科) for eyes.

Which department do I go to?

You settle on a clinic and then stall again right here. Japanese medical departments are finely split, and the kanji on the sign gives you nothing to work with.

When in doubt, internal medicine. It covers the body generally and will refer you onward if a specialist is needed. Turning up at the wrong department is not a problem. Describe the symptom at reception and they will tell you on the spot: that one is dermatology.

How much does a hospital visit cost?

With an insurance card you pay 30% of the treatment cost. On top of that, your first visit to any clinic carries a first-visit fee.

That fee is 2,910 yen, so about 870 yen at 30%. Tests and medicine go on top, which makes a realistic counter payment for a cold at a local clinic somewhere between 1,500 and 3,000 yen.

The expensive mistake is walking into a large hospital directly. Without a referral letter, a large hospital charges an extra 7,000 yen or more for a first visit, and 3,000 yen or more for a repeat visit. This applies to advanced treatment hospitals and to hospitals of 200 beds or more that hold regional support or referral-focused status. The amounts have been set at this level since October 2022.

What makes it hurt: insurance does not touch this charge. There is no 30%. You pay all of it, commonly 7,700 to 13,200 yen depending on the hospital, before anyone examines you.

Thinking a bigger hospital is the safer choice is exactly what walks you into it. Start at a local clinic. Get a referral letter if you need one, and that 7,000 yen never appears.

What happens during the visit? The 5 steps

Reception, intake form, examination, payment, pharmacy – in that order. Bring your insurance card, your residence card, and cash or a card.

How do I explain my symptoms in Japanese?

Say three things: since when, where, and how it feels. These exact phrases work:

Nervous about speaking? Show your symptoms on a translation app – doctors are used to it. Large hospitals sometimes have medical interpreters and multilingual intake forms.

What do I need to bring?

So that reception is not where you get stuck, bring these.

• Your health insurance card (My Number health card, or a qualification confirmation document) – without it you pay the full amount that day
• Your residence card for identification
• Money, and cash is the safe answer. Plenty of clinics still do not take cards
• If you take any medication, your medicine notebook or the boxes themselves
• A referral letter if you have one (without it a large hospital adds 7,000 yen or more)

Forgetting your insurance card does not stop you being seen. You pay 100% at the counter that day, then take the receipt to your city office or health insurance desk and claim the 70% back. Do not throw the receipt away.

What if you cannot pay the bill?

Money runs short and bodies break down on the same days. There is an order to work through.

Say so at the counter. Tell them you cannot pay the full amount today and many hospitals will arrange instalments or a later date. Leaving quietly is the worst version of this.

For hospital stays or surgery, use the high-cost medical expense system. Your monthly out-of-pocket cost is capped, and if you obtain a “limit application certificate” in advance, the counter simply stops charging at that cap. It is covered further down this article.

There is also a scheme few people know about: the free or low-cost medical care service. Established under the Social Welfare Act, it lets people in financial hardship receive treatment free or at reduced cost.

The important part: it does not depend on your nationality, or on whether you hold a residence status at all. A March 2005 notice from the Ministry of Health, Labour and Welfare states that treating someone without residence status does not put the institution in breach of immigration law, and that the institution is under no obligation to report it.

Not every hospital runs it, though. Participating institutions are limited. To find one, ask your prefecture’s hospital affairs section, or an organisation that supports foreign residents. Public consultation desks are listed on our links page.

Can I get an interpreter if nobody speaks my language?

This gets misunderstood, so start with how it actually works. Medical interpreting is not something a patient books. Hospitals and prefectures hold contracts with interpreting services, and the hospital dials in an interpreter when one is needed.

Which means you cannot summon one on the day. The answer is choosing a hospital that already has interpretation, before you need it.

There is a place to look. The Japan National Tourism Organization runs a page that lets you search medical institutions by the languages they handle – over 20 languages, filtered by department and prefecture, including hospitals that take emergencies around the clock.

Open it once while you are well and note down what exists in your area. Searching after the fever starts means doing the hardest task at the hardest moment.

If you still need to manage on the day, three things are realistic.

• Ask at reception whether anyone speaks English. More often than people expect, somebody does
• Show a translation app. Showing them the symptom table above works just as well
• Bring someone who speaks Japanese. School staff or a colleague at work will often come along if asked

Emergency: when do I call 119, and when #7119?

If it is life-threatening – unconscious, heavy bleeding, cannot breathe – call 119 now. The ambulance is free. If you are not sure whether you need one, call #7119 and a nurse helps you decide.

The ambulance in Japan is free. Do not hesitate because you fear the cost – hesitating is the dangerous part. On the phone, say Kyukyu desu (救急です – this is an emergency), then your address, then the symptoms. Slow, simple Japanese is fine.

What about the cost? Insurance covers 70 percent

With National Health Insurance, a 10,000 yen bill becomes 3,000 yen, and there is a system that caps very large bills from surgery or admission. Joining is required if you stay over 3 months (as of July 2026) – how to join, what it costs and how the cap works are all in the National Health Insurance guide. Paying your premiums also matters for your paperwork and visa renewal.

Official source: Ministry of Health, Labour and Welfare

Frequently asked questions

I forgot my insurance card. Do I pay the full price?

That day, yes – you pay 100 percent. Bring your card to the same clinic later and they refund the 70 percent difference. Keep the receipt.

Can I go straight to a big hospital?

You can, but without a referral letter a large hospital adds an extra 7,000 yen or more for a first visit, and insurance does not cover it. Start at a clinic and get a referral letter if you need one.

Does calling an ambulance cost money?

No. The ambulance is free in Japan. In a life-threatening emergency, call 119 without hesitating. If you are unsure, call #7119 first (#8000 for children).

Does insurance work at the dentist?

Yes. Dental treatment is covered and you pay 30 percent. Cosmetic treatment such as whitening is not covered.

Can I see a doctor if I do not speak Japanese?

Yes. Simple Japanese or a translation app is enough at most clinics. Large hospitals may have medical interpreters and multilingual forms. Bringing a friend also helps.

Summary

• Start at a clinic – move to a hospital with a referral letter
• The visit: reception, intake form, doctor, pay 30 percent, pharmacy
• Tell the doctor since when, where, how it feels
• Life-threatening: 119, free. Unsure: #7119
• Insurance details: NHI guide

Related guides

• Medicine in Japan: what you cannot bring, and the new buying rules
• National Health Insurance: how to join and what it costs
• Residence registration (juminhyo)
• Skill 1: Protect – visa, contracts and health