Japan Health Insurance for Expats

Citizens and expats living in Japan are required to enroll in public health insurance, but many choose to supplement with private insurance policies. International health insurance can cover expats during their time in Japan as well as their other global adventures.

This guide will provide expatriates and their families with information on how to gain access to Japanese healthcare and the key health insurance plans available. Read on to learn more, or obtain a no-obligation, free quote below.

Recommended International Health Insurance Plans for Expatriates Living in Japan

The Healthcare System in Japan

Japan’s public healthcare system is renowned for its quality and has had universal healthcare since 1961. Foreigners and workers from abroad are included in this public system. Healthcare coverage is provided to those eligible through Japan’s Statutory Health Insurance System (SHIS).

Private healthcare, however, offers shorter wait times and more freedom for expats to choose their doctors, who, more often than not, speak English. Additionally, private hospitals are more likely to have specialist treatment at the ready, whenever required.

Private Hospitals in Japan

Private hospitals in Japan are known for their high-quality medical care, cutting-edge technology, and a focus on patient-centered treatment, which cater to both local and international patients. They excel in specialized fields such as oncology, cardiac care, and emergency medicine.

Here’s a list of some of Japan's top private hospitals, known for their advanced medical services, cutting-edge technology, and commitment to patient care:

• St. Luke’s International Hospital, Tokyo: A historic hospital in central Tokyo, renowned for comprehensive care across specialties, including advanced neurology and oncology. It's especially popular with international patients for its multilingual support and modern facilities.
• Keio University Hospital, Tokyo: Affiliated with Keio University, this hospital integrates advanced medical research with patient care, making it a leading center for cancer treatment, organ transplants, and complex surgeries.
• Kameda Medical Center, Chiba: Known for its exceptional robotic surgery and precision medicine, Kameda offers patient-centered care with a focus on specialized fields like oncology and cardiac care.
• Tokyo Midtown Medical Center: Combining luxurious amenities with top-tier medical services, this hospital focuses on wellness and preventive care, catering to international and local patients seeking executive health checks and other premium services.
• Kobe City Medical Center General Hospital, Kobe: A leader in trauma and disaster response, this hospital is highly regarded for its expertise in emergency care as well as rehabilitative services.

Public Hospitals in Japan

Despite the length of queues and wait times in Japanese public hospitals, it can be said that they offer some of the highest quality standards of care for locals and expatriates alike. If you are in a location without access to a private hospital, public hospitals are also a viable choice.

Listed below are some of the best public hospitals in Japan:

• University of Tokyo Hospital: Known for its comprehensive services and pioneering research in fields like neurology and cardiovascular care, this hospital is often regarded as one of the top public medical facilities in Japan.
• Kyoto University Hospital: Renowned for its neurology department and extensive stroke and neurological care services, it is also a leader in innovative treatment and rehabilitation​.
• Osaka University Hospital: This facility provides top-tier NICU services and is known for its specialized departments, making it a vital resource in Japan’s healthcare system​.
• Nagoya University Hospital: A key medical training center that provides extensive care across several medical fields, it is especially praised for safe and accessible healthcare practices​.
• National Center for Global Health and Medicine (NCGM): Located in Tokyo, this center emphasizes treatment and research for both Japanese and international patients, with specialties in infectious diseases and kidney care​.

Health Insurance Options for Expats in Japan

For expatriates in Japan, public and private health insurance plans are both accessible. The only difference is that private healthcare eliminates the need to wait for treatments, making specialist treatment available at any moment upon landing in Japan. Thus, private health insurance is recommended.

Public Health Insurance in Japan

Japan’s public health insurance system, SHIS, is made of three different types of insurance: Social Health and Employee Health Insurance, National Health Insurance (NHI), and Health Insurance for the Advanced Elderly.

Social Health Insurance, also known as Employee Health Insurance, is provided for expats by their employers while working in Japan. This form of public health insurance is paid for by contributions from employers and a small portion from employees.

The key details regarding eligibility are listed below:

• Eligibility for Young Adults: NHI insurance plans cover individuals who are self-employed, unemployed, work less than 30 hours a week, or are students.
• Eligibility for Advanced Elderly Health Insurance: Requires all Japanese residents 75 and older to enroll. Individuals enrolled in this insurance will pay a premium that is deducted from their pensions.

Qualifying for Public Health Insurance for Expats in Japan

Expats can qualify for public health insurance through their employers or by residing in Japan for 3 months or longer. In fact, it is mandatory for expats with a visa exceeding three months (90 days) to be registered with a public insurance scheme.

Expats are advised to register at their local municipal office or local city hall to start receiving healthcare in Japan under these programs. Once applications have been approved, a national social security card will then be issued and delivered.

The Social Security and Tax Number card is needed when using public hospital facilities for anything ranging from medical check-ups to operations.

Retirees Seeking International Healthcare in Japan

Expats retiring in Japan should choose an international health insurance plan that offers comprehensive and flexible coverage for their unique needs. This may include coverage for cancer screenings, chronic condition support, and preventative health benefits.

Retiree expats living in Japan for longer than 90 days can apply for government-subsidized Health Insurance for the Advanced Elderly. This will only cover expats during their stay in Japan and within the country's borders, whereas international health insurance will protect expats across the globe.

Coverage and Cost of Public Health Insurance in Japan

SHIS Insurance plans offer comprehensive benefits and coverage for 70 percent of the cost associated with hospital visits, tests, medical appointments, prescriptions, and other medical costs. The remaining 30 percent is paid by the patients.

Depending on their financial circumstances, patients can pay less—either 20 percent or even 10 percent. It’s also important to note that Employee Health Insurance includes coverage for family members, whereas NHI does not.

Public health insurance typically covers:

• Hospitalization
• Primary and Speciality care
• Hospice care
• Certain approved prescriptions
• Physical therapy
• Dental care

Note: Public health insurance does not cover orthodontics or corrective lenses for children over 9.

Private Health Insurance in Japan

Private insurance is available through local insurance companies or international insurance brokers. International insurance companies are an attractive choice for expats due to their global benefits and coverage.

In short, travel insurance covers costs in case of accidents or sickness, as well as lost baggage or rescheduling fees, and international health insurance offers a more comprehensive solution for healthcare.

Listed below are some of the advantages of securing private health insurance:

• Comprehensive Coverage: Private insurance often covers services not included in Japan's national health insurance (NHI), such as alternative treatments, advanced dental care, and higher-end hospital accommodations.
• Access to English-Speaking Healthcare Providers: Some private health plans cater to expats by including networks with English-speaking doctors and hospitals, which can make navigating healthcare easier for non-Japanese speakers.
• Higher Reimbursement Rates: While NHI typically covers 70% of healthcare costs, private insurance can reimburse a larger portion or even cover 100% of eligible expenses, reducing out-of-pocket costs.
• Flexibility with Healthcare Providers: Private plans may allow policyholders more choice of hospitals and clinics, even those not covered by NHI, offering access to specialized and private hospitals with potentially shorter wait times.
• Overseas Coverage: Private insurance policies often include coverage for medical needs outside of Japan, which can be essential for expats who travel frequently or want coverage during visits home.
• Faster Access to Care: Some private plans may offer reduced wait times for appointments and procedures, helping policyholders access care more promptly than with public insurance alone.
• Customized Benefits: Expats can tailor private insurance plans to meet specific needs, such as maternity coverage, mental health support, or wellness benefits, which might be limited under NHI.

Best Private Insurance Providers for Expats in Japan

The best international health insurance companies for expats in Japan include Cigna, Geoblue, and more. We will offer a brief overview below of each provider and the key points and benefits of their plans and coverage.

Cigna

Cigna Global provides flexible insurance plans to expats in Japan with 24/7 access to a customer care team. Their plans are both customizable and comprehensive. Cigna has Silver, Gold, and Platinum plans with different levels of coverage and limits.

All three of these plans share several common key coverage benefits:

GeoBlue

GeoBlue offers an Xplorer health insurance plan that comes in essential or premier. These plans were created for expats traveling from the United States for business, leisure, or study trips. Expats can choose plans that include the United States in their coverage or not.

Some shared features across all levels of plans are:

April International

April International has over 30 years of experience in the international health insurance market. They provide both comprehensive and flexible plans to expats while in Japan. They provide varying levels of coverage, fully customizable policies, and a wide direct billing network.

Some of the shared coverage across their plans are:

NOW Health

NOW Health International offers expats in Japan comprehensive health insurance solutions, as well as plans for international students. They have several different tiers of plans: WorldCare Advance, WorldCare Excel, and WorldCare Apex. These plans differ in annual limits and coverage options.

These are the key benefits shared across all three benefits:

AXA

AXA global health insurance is a wonderful choice for expats in Japan with its range of differing coverage and customizable additional benefits. They offer short-term and long-term plans, with comprehensive coverage for any medical needs.

Some examples of shared coverage by all AXA insurance plans include:

IMG Global

IMG provides international health insurance plans for expats in Japan. They offer comprehensive policies and superior services to their members, like crisis support and preventative care. Their global medical plans come in bronze, silver, gold, and platinum categories.

Some of the shared features across their varied plans are:

Additional Benefits and Coverage for Expats in Japan

Most insurance providers allow additional coverage options to extend expats’ benefits during their time in Japan. This could cover things like dental, optical, maternity, and more.

• Dental: Dental check-ups, cleanings, and major dental procedures can be covered by additional benefits.
• Maternity and family coverage: Expats looking to expand their family can customize international health insurance plans to cover prenatal care, childbirth, and postpartum care. There are also additional benefits to cover the newborn.
• Preventive care: Some plans will offer regular health checkups, screenings, vaccinations, and wellness programs. These resources will help expats keep themselves healthy in their adventures abroad.

Pre-existing Conditions Coverage for Expats in Japan

Expats with pre-existing conditions may have fewer options when buying international insurance in Japan, but there are still solutions available. You can choose a plan with a pre-existing condition exclusion, a moratorium, or coverage with loading.

Here is a general overview of what each term means:

• Exclusion: The insurer will not pay or reimburse the policyholder for medical bills related to the condition if they choose to buy a plan from them.
• Moratorium: The insurance company offers health insurance but observes the pre-existing condition for a specific time known as the waiting period. This period is usually 24 months, and the insurance company reviews its decision.
• Coverage with loading: Insurance companies may offer coverage for pre-existing conditions, but only with higher premiums. Not all pre-existing conditions are eligible for this kind of coverage, and not all companies offer this option.

Factors to Consider When Choosing Health Insurance in Japan

When choosing a health insurance policy, expats in Japan are urged to consider the scope of their insurance coverage, their pre-existing conditions, the necessity for National Health Insurance and international coverage, and whether or not their insurers provide claim support.

The factors listed below will ensure that your coverage meets both personal and financial needs:

• Comprehensive Coverage: Check if the policy covers essential services like inpatient, outpatient, and emergency care. Dental and vision are often not included in Japan's public health insurance, so a private plan offering these services can be beneficial.
• Pre-existing Conditions: Coverage for pre-existing conditions varies among insurers. Some plans impose waiting periods, while others adjust premiums based on medical history. Understanding how your chosen insurer handles pre-existing conditions is crucial for avoiding unexpected costs.
• Supplemental Coverage for National Health Insurance (NHI): Japan’s National Health Insurance typically covers 70% of healthcare costs, leaving residents responsible for the remaining 30%. Private insurance can help cover this gap and may include additional services.
• International Coverage: For expats who travel frequently or maintain connections in other countries, choosing a plan with international coverage ensures continuous care abroad. Such plans often include benefits like emergency evacuation and repatriation.
• Claim Process and Language Support: A streamlined claims process with support in English can be especially helpful for expats. Some insurers offer direct billing with Japanese hospitals, which minimizes upfront payments, while others require reimbursement later​.

Bringing Prescriptions into Japan

Expats who have a prescription medication that has no available equivalent drug in Japan will need a Yunyu Kakunin-sho Certificate to legally import a year’s supply. If bringing the medication with them, expats can apply for this certificate before leaving and declare it to customs officials.

Here are the key points to keep in mind when bringing prescription drugs into Japan:

• Determine the Need for a Yunyu Kakunin-sho Certificate: If you require a prescription medication that has no equivalent available in Japan, you will need to apply for a Yunyu Kakunin-sho (import certificate) to legally bring in a supply for up to one year.
• Application Process: Apply for the Yunyu Kakunin-sho before leaving your home country. This involves submitting the necessary documentation to the Japanese authorities, which may include a prescription from your doctor and details about the medication.
• Customs Declaration: Upon arrival in Japan, you must declare your medications to customs officials. Ensure you have the Yunyu Kakunin-sho certificate ready for inspection.
• Understand Quantity Limits: For personal use, you can bring a one-month supply of prescription drugs without needing a Yunyu Kakunin-sho. However, if you exceed this limit, the certificate is mandatory.
• Check for Prohibited Substances: Be aware that certain medications, particularly narcotics and psychotropics, are strictly regulated. Importing these substances requires special permission, and you must have a copy of your prescription or related documents.
• Consult Official Resources: For the most accurate and up-to-date information, consult the Ministry of Health, Labour and Welfare's guidelines or their dedicated online application portal for import confirmation.

Travel Safety Tips for Expats in Japan

Expats are recommended to be up to date with vaccines before they travel to Japan. The correct vaccines will offer protection from measles, hepatitis A and B, rabies, and Japanese encephalitis.

Here are some important travel and safety tips to consider:

• Stay Up-to-Date with Vaccinations: Ensure that you are vaccinated against common diseases such as measles, hepatitis A and B, rabies, and Japanese encephalitis. These vaccines can protect you from serious health risks while in Japan.
• Japanese Encephalitis Awareness: Japanese encephalitis is transmitted by mosquitoes, particularly in rural areas. Vaccination is recommended, especially if you plan to spend time outdoors or in agricultural regions.
• Food and Water Safety: Be cautious with food and water. While Japan has high food safety standards, it's wise to avoid tap water in rural areas and be cautious with street food. Stick to reputable restaurants and ensure food is well-cooked.
• Prevent Bug Bites: Use insect repellent containing DEET or picaridin to protect against mosquito bites, especially during the warmer months when mosquito activity is high.
• Emergency Preparedness: Familiarize yourself with local emergency numbers (e.g., 110 for police, 119 for fire and ambulance). Keep a list of local hospitals and clinics handy in case of medical emergencies.
• Natural Disaster Awareness: Japan is prone to earthquakes and typhoons. Stay informed about safety protocols and evacuation routes. Consider carrying a small emergency kit with essentials like water, snacks, and a flashlight.
• Transportation Safety: Use public transportation, which is generally safe and efficient. If driving, familiarize yourself with local traffic laws and ensure you have the necessary permits.
• Cultural Sensitivity: Respect local customs and etiquette. Understanding cultural norms can enhance your experience and help you avoid misunderstandings.
• Stay Connected: Keep in touch with family and friends back home. Consider using apps that allow for simple communication and sharing your travel itinerary with someone you trust.
• Health Insurance: Ensure you have comprehensive health insurance that covers you while in Japan. Check if your policy includes coverage for medical evacuation if necessary.

Frequently Asked Questions

Is public health insurance available in Japan for foreigners?

Public health insurance is available through Social Health or Employee Insurance and National Health Insurance. Expats working for employers in Japan will be enrolled in an Employee Insurance plan, and unemployed or self-employed expats will be required to apply for NHI insurance.

Is healthcare free in Japan?

Healthcare isn’t free in Japan but available at a lower, subsidized rate for Japanese residents. Typically, the government will pay 70% of medical costs. Depending on income, age, and location of residence, some residents may pay lower rates than others.

What should I do if I need medical care but don’t have health insurance in Japan?

If you find yourself in need of medical care without health insurance in Japan, you will be responsible for covering the full cost of your medical expenses. It is advisable to seek out a health insurance plan as soon as possible, as medical costs can be quite high.

Conclusion

Expats have the choice to rely on only public health insurance in Japan or purchase an additional private health insurance policy. International health insurance is a smart choice for expats who plan to travel more extensively and want supplemented coverage during their time in Japan.

Pacific Prime can assist you in selecting and comparing various plans. With over 20 years of experience connecting expatriates with health insurance tailored for living abroad, Pacific Prime’s brokers understand the specific healthcare needs in Japan.

Contact us today for more information, or use our online quotation system to compare quotes!