Medical Insurance in Japan: Your Complete Guide for Tourists, Relocators, and Digital Nomads

Planning a trip to Japan or considering a longer stay? Understanding medical insurance is absolutely crucial for anyone visiting or moving to the Land of the Rising Sun. Whether you're backpacking through Tokyo for two weeks, relocating for a new job, or working remotely as a digital nomad, having the right medical coverage can save you from financial disaster and ensure you get the best care possible.

Japan boasts one of the world's most advanced healthcare systems, ranking 5th globally according to healthcare quality indices. However, this excellence comes at a price, especially for those without proper insurance coverage. Let's dive into everything you need to know about navigating Japan's medical insurance landscape.

Understanding Japan's Healthcare System

Japan operates a universal healthcare system that has been in place since 1961, covering 98.3% of the population through various insurance schemes. The system is built on a simple principle: everyone pays into the system, and everyone receives coverage when they need it. For residents, this means paying only 30% of medical costs out of pocket, with the government covering the remaining 70%.

The Japanese government, through the Ministry of Health, Labour and Welfare (MHLW), oversees the entire system and sets standardized fees for medical procedures across all hospitals and clinics. This means whether you visit a clinic in bustling Tokyo or a rural hospital in Hokkaido, you'll pay the same rates for the same treatments.

However, this system primarily serves long-term residents. Short-term visitors face a very different reality - they must pay full medical costs upfront, which can be astronomical.

Want a visual overview of how Japan's healthcare works?
Check out this quick explainer:

This video breaks down how Japan’s public health insurance works and whether you actually need supplementary coverage. It’s a clear, no-nonsense overview that helps you understand when the basic system is enough—and when it might fall short. A great watch if you're relocating or staying longer than just a tourist visit.

For Tourists: Protecting Yourself During Short Visits

As a tourist in Japan, you're walking a financial tightrope without proper travel insurance. Japan doesn't require proof of travel insurance for entry, but the potential costs of medical care should make it an absolute priority.

The Reality of Medical Costs for Uninsured Tourists

Let's look at some real numbers that highlight why insurance is essential. Japan Health Info recommends that uninsured travelers bring ¥20,000-50,000 ($135-340) just for a basic medical consultation. But these costs can skyrocket quickly:

Comparison of medical costs in Japan showing the dramatic difference between insured and uninsured patients

A simple emergency room visit can cost ¥10,000-15,000 ($68-102), while more serious procedures become extremely expensive. Consider this real example: a collision with a bicycle resulting in traumatic pneumothorax and fractured ribs, requiring surgery, a 19-day hospital stay, and medical evacuation back to the US, cost hundreds of thousands of dollars.

How much could it cost without insurance?
This video breaks it down with real examples:

Essential Travel Insurance Features

When choosing travel insurance for Japan, look for these critical features:

• Medical coverage of at least ¥10 million (approximately $68,000)
• Emergency medical evacuation coverage
• 24/7 multilingual support services
• Cashless payment arrangements with Japanese hospitals
• COVID-19 coverage for treatment and quarantine costs

Top Travel Insurance Providers for Japan

Based on comprehensive research, here are the best options for tourists:

• World Nomads: Excellent for adventure travelers with comprehensive coverage including skiing, snowboarding, and hiking activities. Their policies start around $2.87 per day and include emergency evacuation coverage.
• SafetyWing: The most budget-friendly option at approximately $1.83 per day for travelers under 40. Their essential plan covers medical expenses, emergency evacuation, and travel delays.
• Tokio Marine Omotenashi Policy: A Japan-specific option that can be purchased online even after arriving in Japan. At ¥760 per day, it offers up to ¥10 million in medical coverage with cashless payment services.

For travelers who want more traditional travel medical coverage with strong emergency benefits, especially if they have ongoing health needs, plans like Atlas Travel Health Insurance can be a good fit. They are designed for international trips, offer high medical limits, and can help protect you from the kind of large, unexpected hospital bills that are common for uninsured visitors in Japan.

Government-Recommended Insurance Options

The Japan Tourism Agency operates a dedicated website for safe travel and provides information about purchasing travel insurance after arrival in Japan. You can access their medical institution search tool at their official emergency guidance website, which helps locate tourist-friendly hospitals with English-speaking staff.

For Relocators: Navigating Long-Term Health Coverage

Moving to Japan for work, study, or family reasons? Congratulations - you'll have access to one of the world's best healthcare systems! However, enrollment in health insurance is mandatory, not optional.

Mandatory Public Health Insurance

All residents staying longer than three months must enroll in either National Health Insurance (NHI) or Employee Health Insurance (SHI) within 14 days of arrival. This isn't a suggestion - it's a legal requirement backed by Japanese law.

National Health Insurance (NHI): Designed for students, self-employed individuals, and unemployed residents. Premiums are calculated based on your previous year's income and typically cost around ¥15,000 ($102) monthly for average earners.

Employee Health Insurance (SHI): Provided by employers for full-time workers. Companies must enroll employees within five days of employment, with premiums split between employer and employee (approximately 5% of your salary).

How the Public System Works

Once enrolled, you'll receive a health insurance card that provides access to over 90% of Japanese hospitals and clinics. The system covers:

• Doctor visits and specialist consultations
• Hospital stays and surgeries
• Prescription medications
• Dental care (basic procedures)
• Mental health services
• Preventive care and health checkups

The government has implemented monthly out-of-pocket maximums to protect residents from catastrophic medical expenses. For working-age adults, this cap is approximately ¥80,100 ($544) per month, regardless of how expensive your treatment becomes.

Supplementing with Private Insurance

Many expats choose to supplement their public coverage with private international health insurance. These plans typically cost ¥25,000-65,000 ($170-441) monthly but provide additional benefits like:

• English-speaking doctors and international hospitals
• Coverage for procedures not included in public insurance
• Shorter waiting times for non-emergency treatments
• Global coverage that travels with you
  
  

Overview of the four main types of health insurance available in Japan for different groups of people

For Digital Nomads: Special Visa Requirements and Coverage

Japan launched its digital nomad visa program in 2024, opening new opportunities for remote workers. However, the requirements are strict and the insurance obligations significant.

Digital Nomad Visa Requirements

To qualify for Japan's digital nomad visa, you must meet these stringent criteria:

• Annual income: Minimum ¥10 million ($68,377)
• Health insurance: ¥10 million medical coverage minimum
• Visa duration: 6 months maximum with no renewal option
• Work restriction: Must work for non-Japanese companies only
• Eligible countries: Limited to 49 countries including the US, EU nations, Australia, and Canada
  
  

Specialized Insurance for Digital Nomads

Digital nomads need insurance that travels with them and provides comprehensive global coverage. The most popular options include:

• Genki Native International: Specifically designed for nomads and long-term travelers. Offers worldwide coverage (with limited coverage in the US and Canada) starting at around €50 per month.
• SafetyWing Nomad Insurance: Popular among the digital nomad community with coverage in 175+ countries. Their plans start at approximately $42 per month and can be purchased and managed entirely online.
• IMG GlobeHopper: Flexible medical-focused coverage with high medical limits and emergency evacuation. Particularly good for nomads who need customizable coverage levels.

These plans typically include telemedicine consultations, mental health support, and coverage for the lifestyle risks that nomads face while traveling.

If you plan to base yourself in Japan while continuing to travel in and out of the country, look for products specifically branded as travel health insurance for digital nomads. Solutions such as Nomad Insurance are built around this lifestyle: they follow you across borders, help you meet Japan’s digital nomad visa requirements, and still provide coverage when you are temporarily outside Japan.

Real-Life Scenarios: When Insurance Saves the Day

Let's examine some real situations that demonstrate why proper insurance coverage is essential:

Scenario 1: The Skiing Accident

Sarah, a tourist from Canada, was skiing in Hakuba when she collided with another skier, resulting in a broken leg requiring surgery. Without travel insurance, her total bill would have exceeded ¥500,000 ($3,400) for the surgery alone, plus ¥20,000 ($136) per day for hospital stay. With her World Nomads policy, she paid nothing out of pocket and received assistance arranging her medical evacuation back to Canada.

Scenario 2: The Food Poisoning Crisis

Marcus, a digital nomad working in Tokyo, developed severe food poisoning requiring emergency room treatment and a three-day hospital stay. The total cost reached ¥180,000 ($1,224). His Genki Native insurance covered the entire expense and provided 24/7 multilingual support to help him navigate the Japanese healthcare system.

Scenario 3: The Appendicitis Emergency

Jennifer, an English teacher on Employee Health Insurance, required emergency appendectomy surgery. In the US, this procedure typically costs over $33,00071. In Japan, the total cost was ¥600,000 ($4,080), but with her SHI coverage, she only paid ¥180,000 ($1,224) - a 70% savings71.

Government Resources and Official Information

The Japanese government provides extensive resources for foreigners seeking healthcare information. Here are the essential official sources:

Ministry of Health, Labour and Welfare (MHLW): The primary government agency overseeing Japan's healthcare system. Their English website (mhlw.go.jp/english) provides comprehensive information about insurance enrollment, benefits, and procedures.

Japan Tourism Agency: Maintains an emergency website (jnto.go.jp/emergency) with medical institution search tools, emergency contacts, and safety information specifically for tourists.

Ministry of Foreign Affairs: Provides official information about visa requirements, including digital nomad visa applications and insurance requirements.

Emergency Contact Information

Keep these essential numbers readily available:

• Emergency services: 119 (ambulance and fire)
• Police: 110
• Tourist assistance hotline: 050-3816-2787
• Medical institution search: Available through JNTO website

The government has also implemented new measures to address unpaid medical bills by foreign visitors, including sharing information between hospitals and immigration authorities. Since 2021, foreigners with unpaid medical expenses may face entry restrictions, making proper insurance coverage even more critical.

Making the Right Choice for Your Situation

Choosing the right medical insurance for Japan depends entirely on your specific circumstances, length of stay, and risk tolerance. Here's a quick decision framework:

• For trips under 90 days: Travel medical insurance is essential. Budget around ¥2,500-3,500 ($17-24) per day for comprehensive coverage.
• For moves longer than 3 months: Public insurance enrollment is mandatory. Budget ¥15,000-17,500 ($102-119) monthly, plus consider supplemental private coverage.
• For digital nomads: Ensure your insurance meets visa requirements with ¥10 million coverage minimum. Expect to pay ¥5,000-15,000 ($34-102) monthly for specialized nomad-friendly policies.

Remember, the cost of insurance is always a fraction of potential medical expenses. Japan's healthcare system is world-class, but accessing it without proper coverage can be financially devastating. Don't let a medical emergency turn your Japanese adventure into a financial nightmare - invest in appropriate coverage before you travel.

The peace of mind that comes with knowing you're properly protected allows you to fully enjoy everything Japan has to offer, from the bustling streets of Tokyo to the serene temples of Kyoto. Make the smart choice and secure your health insurance before you step off the plane.

Useful Links - Medical Insurance and Healthcare in Japan

Official Government Resources

Ministry of Health, Labour and Welfare (MHLW)

• Main English Website: https://www.mhlw.go.jp/english/
• Description: Primary government agency overseeing Japan's healthcare system. Provides comprehensive information about insurance enrollment, benefits, and procedures.

Japan National Tourism Organization (JNTO)

• Emergency Medical Information: https://www.jnto.go.jp/emergency/eng/mi_guide.html
• Travel Insurance Information: https://www.japan.travel/en/plan/travel-insurance-in-japan/
• Medical Institution Search: https://www.jnto.go.jp/emergency/eng/mi_guide.html
• Description: Official tourism agency with dedicated emergency support and medical facility search tools for tourists.

Ministry of Foreign Affairs

• Visa Information: https://www.mofa.go.jp/j_info/visit/visa/index.html
• Digital Nomad Visa Details: Contact nearest Japanese consulate or embassy
• Description: Official information about visa requirements, including digital nomad visa applications and insurance requirements.

Emergency Contact Information

Emergency Services

• Ambulance/Fire Emergency: 119
• Police Emergency: 110
• Japan Visitor Hotline: 050-3816-2787 (24/7 multilingual support in English, Chinese, Korean)
• International Access: +81-50-3816-2787

Tourist Medical Support

• JNTO Tourist Assistance: 050-3816-2787
• Ministry of Health COVID-19 Call Center: 0120-565-653
• Police Lost & Found: 0570-550-142
• Police General Information: (03) 3503-8484

 

Frequently Asked Questions (FAQ) - Medical Insurance in Japan

General Questions

Q: Is medical insurance mandatory in Japan?

A: Yes, it depends on your status. All residents staying longer than 3 months must enroll in either National Health Insurance (NHI) or Employee Health Insurance (SHI) within 14 days of arrival. Tourists are not required to have insurance to enter Japan, but it's strongly recommended as medical costs can be extremely expensive without coverage.

 

Q: What happens if I don't have insurance and need medical care in Japan?

A: Without insurance, you must pay the full cost of medical treatment upfront. A simple emergency room visit can cost ¥10,000-15,000 ($68-102), while serious procedures can cost hundreds of thousands of dollars. Since 2021, foreigners with unpaid medical expenses may face entry restrictions on future visits to Japan.

 

Q: Can I buy travel insurance after arriving in Japan?

A: Yes, you can purchase travel insurance even after arriving in Japan. The Japan Tourism Agency operates a dedicated website where you can buy insurance online. However, it's always better to purchase insurance before traveling to ensure immediate coverage.

For Tourists

Q: How much should I budget for travel insurance to Japan?

A: For comprehensive coverage, budget around ¥2,500-3,500 ($17-24) per day. Basic plans start from approximately $1.50-2.87 per day depending on your age and coverage level. Essential coverage should include at least ¥10 million ($68,000) in medical coverage.

 

Q: What should my travel insurance cover for Japan?

A: Essential features include:

• Medical coverage of at least ¥10 million ($68,000)

• Emergency medical evacuation coverage

• 24/7 multilingual support services

• Cashless payment arrangements with Japanese hospitals

• COVID-19 coverage for treatment and quarantine costs

 

Q: Which travel insurance providers are best for Japan?

A: Top recommended providers include:

• World Nomads: Excellent for adventure travelers, comprehensive coverage including skiing and snowboarding

• SafetyWing: Most budget-friendly at approximately $1.83 per day for travelers under 40

• Tokio Marine Omotenashi Policy: Japan-specific option that can be purchased online even after arriving

 

Q: Are adventure sports covered by travel insurance in Japan?

A: It depends on your policy. World Nomads automatically covers 200+ adventure sports including skiing, snowboarding, and hiking. Other providers may require specific adventure sports waivers. Always check your policy details before engaging in activities.

For Relocators (Long-term Residents)

Q: When do I need to enroll in Japanese health insurance?

A: You must enroll within 14 days of arrival if you're staying longer than 3 months. This is a legal requirement, not optional. Companies must enroll employees in Employee Health Insurance within 5 days of employment.

 

Q: What's the difference between National Health Insurance (NHI) and Employee Health Insurance (SHI)?

A:

• NHI: For students, self-employed, and unemployed residents. Premiums based on previous year's income, typically around ¥15,000 ($102) monthly

• SHI: For full-time employees. Provided by employers with premiums split between employer and employee (approximately 5% of salary)

 

Q: How much will I pay out-of-pocket with Japanese health insurance?

A: With Japanese public health insurance, you pay only 30% of medical costs. The government has monthly out-of-pocket maximums: approximately ¥80,100 ($544) per month for working-age adults, regardless of treatment cost.

 

Q: Should I get private insurance in addition to public insurance?

A: Many expats supplement public coverage with private international health insurance (¥25,000-65,000/$170-441 monthly) for benefits like English-speaking doctors, shorter waiting times, and global coverage.

Q: What documents do I need to apply for health insurance?

A: You need:

• Passport with Japanese visa or residence card

• Details of your Japanese address

• Social security number (マイナンバー) or tax ID

• Proof of income (determines insurance payments)

For Digital Nomads

Q: What are the requirements for Japan's digital nomad visa?

A: Requirements include:

• Annual income of minimum ¥10 million ($68,377)
• Health insurance with ¥10 million medical coverage minimum
• Work for non-Japanese companies only
• Citizenship from one of 49 eligible countries
• Visa valid for 6 months maximum with no renewal option

 

Q: What type of insurance do digital nomads need for Japan?

A: Digital nomads need specialized insurance that travels globally and meets the ¥10 million minimum coverage requirement. Popular options include:

• Genki Native International: Worldwide coverage starting at €50/month
• SafetyWing Nomad Insurance: Coverage in 175+ countries starting at $42/month
• IMG GlobeHopper: Flexible medical-focused coverage with high limits

 

Q: Can digital nomads access Japan's public healthcare system?

A: No, digital nomad visa holders are not considered residents and cannot enroll in Japan's public health insurance system. They must rely entirely on their private international insurance.

 

Q: Can I bring my family on a digital nomad visa to Japan?

A: Yes, legally married spouses and children can accompany you. Your health insurance must cover your spouse and children, and you need to submit documents proving relationships (marriage certificate, birth certificates).

Emergency Situations

Q: What are the emergency numbers in Japan?

A:

• Emergency services (ambulance/fire): 119
• Police: 110
• Japan Visitor Hotline: 050-3816-2787 (24/7 multilingual support)

 

Q: Do I need to pay for ambulance services in Japan?

A: Ambulance services in Japan are free for everyone, including tourists. However, you'll still need to pay for hospital treatment if you don't have insurance.

 

Q: How do I find English-speaking doctors in Japan?

A: Use the medical institution search tool on the JNTO emergency website (jnto.go.jp/emergency) to locate hospitals and clinics with English-speaking staff. You can filter by language services and location.

 

Q: What should I do if I lose my health insurance card?

A: Contact your insurance provider immediately to report the loss and request a replacement. You can still receive treatment, but you may need to pay upfront and seek reimbursement later.

Cost and Claims

Q: How do I make a claim on my travel insurance?

A: Report incidents to your insurer as soon as possible. For theft, report to local police within 24 hours and get a police report. Keep all records, photos, and contact details. Ask for English invoices from medical providers for easier reimbursement.

 

Q: What medical costs can I expect in Japan without insurance?

A:

• Basic medical consultation: ¥20,000-50,000 ($135-340)
• Emergency room visit: ¥10,000-15,000 ($68-102)
• Appendectomy surgery: ¥600,000 ($4,080)
• Complex procedures can cost hundreds of thousands of dollars

 

Q: Are prescription medications covered by insurance?

A: Yes, both public and private insurance typically cover prescription medications. With public insurance, you pay 30% of the medication cost. Some over-the-counter medications can be purchased at pharmacies and drugstores.

 

Q: Does Japanese health insurance cover dental care?

A: Yes, Japanese public health insurance covers basic dental procedures including check-ups, fillings, extractions, and basic treatments. However, cosmetic procedures and some advanced treatments may not be covered.