Thankfully, the central Tokyo area has quite a few English-speaking medical institutions that cater to non-Japanese-speaking residents and offer medical assistance, ensuring their stay in Japan without worrying about healthcare. However, falling sick or getting injured unexpectedly can be a distressing situation. Therefore, it is advisable to have a basic understanding of the Japanese medical system, such as how to visit a doctor and the fees involved, as it can help you deal with the situation calmly and provide peace of mind.
Where do I go for medical assistance in Tokyo?
The medical institutions available in Tokyo are clinics, small and medium-sized hospitals, and large general hospitals. If you don’t feel well or get hurt yourself, visit a nearby clinic or small/medium hospital for a doctor’s help. Large hospitals are primarily for patients in emergency and those with severe illness who have a referral letter.
The difference between a clinic and a small/medium hospital is its facility size. A medical facility with twenty inpatient beds or more is defined as a hospital. Some small/medium hospitals have specialized areas, such as proctology, where patients come all the way for the expectation of better treatment.
What is the medical fee?
For insured care, the fee is determined by the co-payment rate.
Insured care is medical care that caters to those covered by public medical insurance programs. Instead of paying insurance premiums, insured persons only need to pay their share of the medical expenses to receive medical care. In Japan, all citizens are required to enroll in a public medical insurance program, and international students and residents living in Japan are also eligible for the system, depending on the length of their stay and other conditions.
The co-payment rates for medical expenses vary based on age and income. For individuals up to 69 years old, the co-payment rate is 30%. Children who are not enrolled in compulsory education and those aged between 70 and 74 have a co-payment rate of 20%, 10% for those aged 75 and over. However, for individuals aged over 70 years old, the rate can be 30%, depending on their income. (as of 2023)
The medical consultation fee is flat, but the cost of medical care varies.
In the insured medical system, the consultation fee charged at clinics and hospitals is uniformly set. However, the total medical cost can vary from institution to institution due to prescribed medications, the treatment received, hospital bed charges, and others. It is important to note that some large hospitals charge special fees for consultations without a referral letter, whether for initial or follow-up visits.
The initial consultation fee is charged for the first visit.
Any medical institution, clinic, or hospital charges an initial consultation fee. The rate of initial fees is 2,820 JPY, which is 850 JPY if covered by insurance with a 30% co-payment. The initial consultation fee is basically to pay only for the first visit, but it will be charged again if you revisit the clinic/hospital after a long time.
A fee is required to obtain a letter of referral.
After a medical consultation, if your doctor determines that you require intensive treatment at another larger hospital, they will provide you with a referral letter to receive further consultation there. The service fee for preparing a referral letter or Patient Referral Document is 2500 JPY (750 JPY for a 30% co-payment.) Do not open the enclosed referral letter. It may need to be reissued for a fee if it is opened.
How can I find a clinic or hospital?
If you do not speak Japanese and are concerned about the language barrier, consider finding an English-friendly institution. Recently, finding English-speaking hospitals is much easier on the internet. There are many medical institutions in central Tokyo, especially in Minato City, Shibuya City, Chiyoda City, and Chuo City. For an intensive search on the internet, you can use Tokyo Metropolitan Medical Institution Information Service “Himawari,” which allows you to search by setting several search terms. That automatic translation service enables searches in English, Korean, Chinese, and Japanese.
Tokyo Medical Information Service HIMAWARI
https://www.himawari.metro.tokyo.jp/qq13/qqport/tomintop/
For mobile phones (Japanese / English)
https://www.himawari.metro.tokyo.jp/i/qq13immelt.asp
Remote consultation by AMDA
AMDA International Medical Information Center, a non-profit organization, provides medical consultation by phone in multiple languages. To find available languages, days, and hours of operation, see the AMDA’s website.
AMDA International Medical Information Center
https://www.amdamedicalcenter.com/
How to see a doctor in Japan
If you need to see a doctor at a clinic or small/medium hospital in Japan, here are some instructions to follow. Although there may be some variations depending on the size and system of each medical institution, the general consultation process typically follows a similar pattern.
Going to see a doctor for the first time
1. Find a clinic or small/medium hospital nearby.
2. At the reception, tell that you are a first-time visitor and show your health insurance* card or Individual number card (My Number Card) combined with your health insurance card.
*Starting in 2024 Autumn, the current health insurance cards will no longer be issued and will be unified with My Number Cards.
- You will be asked to fill out a medical questionnaire about your health conditions, e.g., allergic tendencies.
- You will be asked to wait in a waiting room.
3. Wait in the waiting room.
- They may instruct you to take a blood sample or urine test before waiting.
4. Enter a consulting room when instructed.
- At the hospital with several consulting rooms, they will indicate which room to enter with the room number.
5. A doctor conducts a medical consultation.
6. After the diagnosis, go to the reception desk.
- If you are prescribed medicine, receive a prescription.
- Pay (copay) the medical fee. Small clinics outside the downtown area may only accept cash payments.
- Receive a patient registration card*
*What ’s a patient registration card?
A patient registration card, or Shinsatsu-ken (診察券,) is a card to use when revisiting your doctor. The registration card simplifies identity and medical record verification and shortens re-examination waiting times.
7. Go to a pharmacy to get medicine.
- Purchase medicine by showing your prescription.
- Receive a medicine record*
*What is a medication record book?
The medication record book called ”Okusuri-techo” is a notebook where you can record your medication history, allergic tendencies, etc. It serves as a record book to reduce the risk of drug duplication and inappropriate combinations. Pharmacies offer two types of medication record books: a paper notebook and an app called Okusuri Plus; both are provided for free. Once you have your medication record book, be sure to bring it with you whenever you go to any medical institution, including eye and dental clinics. Bringing your medication record book can reduce the administration cost by 120 JPY (40 JPY for a 30% co-payment).
Revisiting your doctor
1. Go to see your doctor.
2. At the reception, show and hand your patient registration card, appointment slip (if you have one) and health insurance card.
- Don’t forget to bring your medication record book.
3. Wait in the waiting room.
- They may instruct you to take a blood sample or urine test before waiting.
4. Enter a consulting room when instructed.
- At the hospital with several consulting rooms, they will indicate which room to enter with the room number.
5. Your doctor conducts a medical consultation.
- If the doctor is unable to treat your disease, you will be referred to another hospital. In that case, you will need to request a referral letter (with a fee).
6. After the diagnosis, go to the reception desk.
- If you are prescribed medicine, receive a prescription.
- Pay (copay) the medical fee. Small clinics outside the downtown area may only accept cash payments.
7. Go to get medicine at a pharmacy.
- Hand your prescription to get medicine and make the payment (co-payment)
Emergencies
In case of emergency, call an ambulance. The number is 119.
Remember, calling an ambulance is only for emergencies in a serious situation, such as severe symptoms or bleeding injuries. If you are unsure whether to call an ambulance or what to do, call 7119 first to ask for advice. Reading the information on the Tokyo Fire Department’s website below is advisable.
#7119 Emergency Telephone Consultation Center in the Tokyo Fire Department (TFD )
https://www.tfd.metro.tokyo.lg.jp/ts/ems_e/page03.html
Tokyo EMS Guide
https://www.tfd.metro.tokyo.lg.jp/hp-kyuuimuka/en_guide/08bl/
Related Information
Large English-speaking hospitals in central Tokyo
St. Luke’s International Hospital (Chuo City)
聖路加病院
https://hospital.luke.ac.jp/eng/
IUHW Mita Hospital (Minato City)
国際医療福祉大学三田病院
https://mita.iuhw.ac.jp/english/
Japanese Red Cross Medical Center (Shibuya City)
日本赤十字社医療センター
https://www.med.jrc.or.jp/en/tabid/393/Default.aspx
Mitsui Memorial Hospital (Chiyoda City)
三井記念病院（千代田区）
https://www.mitsuihosp.or.jp/english/
Tokyo Chiropractic（Minato City）
東京カイロプラクティック(港区）
https://tokyochiro.com/english/