Every person in Japan — including tourists and foreigners without National Health Insurance — has the legal right to emergency medical treatment. Hospitals cannot refuse emergency care. However, without insurance you pay 100% of the bill. Consider choosing one of the Gaijin Support coverage plans to shield yourself from high out-of-pocket costs.
ℹ️ What does National Health Insurance cost?
NHI premiums for low-income foreigners can be as low as ¥2,000–¥5,000/month. With NHI, you pay only 30% of medical costs. For those under 70, this reduces a ¥50,000 hospital bill to ¥15,000.
🚨 Tourists: Travel Insurance is Essential
A single hospitalization in Japan without insurance can cost ¥500,000+. Travel insurance plans from ¥500/day provide full coverage. Purchase before departure — you cannot buy travel insurance after a trip starts.
Step-by-Step Guide
- 1
Know that you cannot be refused emergency care
Under Japanese law, hospitals must provide emergency treatment regardless of insurance or nationality. If you have a life-threatening emergency, call 119. Do not delay seeking care due to insurance concerns.
- 2
Understand the cost structure
Without National Health Insurance (NHI), you pay 100% of the medical bill. A routine clinic visit: ¥3,000–¥8,000. ER visit: ¥10,000–¥50,000+. Hospitalization: ¥30,000–¥80,000+ per day. Surgery: highly variable. Ask for a mitsumori (見積もり — estimate) before non-emergency treatment.
- 3
Use travel insurance if you have it
If you have travel insurance, contact your insurer BEFORE going to hospital if possible (for non-emergencies). For emergencies, go immediately and contact insurance afterward. Keep all receipts — you'll need them for reimbursement claims.
💡Most travel insurance requires you to notify them within 24 hours of a hospital visit.
- 4
Ask about payment plans
Hospitals in Japan generally do not ask for payment upfront except at private clinics. Public and university hospitals will send a bill. You can request a payment installment plan (bunkatsu barai) at the hospital accounts office.
- 5
Enroll in National Health Insurance retroactively
If you are a resident of Japan (not a tourist), you are legally required to have NHI. You can enroll retroactively — though you'll owe back premiums. After enrollment, your insurance card can be used immediately for future visits. Go to your city ward office to enroll.
Official Resources
Frequently Asked Questions
Can I go to a Japanese hospital without insurance?
Yes. Hospitals cannot refuse emergency care. For non-emergencies, you can attend any hospital but will pay 100% of costs without insurance.
How much does a hospital visit cost in Japan without insurance?
A basic clinic visit costs ¥3,000–¥8,000. An ER visit typically costs ¥10,000–¥50,000. Hospitalization can reach ¥30,000–¥80,000+ per day without insurance.
What is National Health Insurance in Japan?
National Health Insurance (NHI/Kokumin Kenko Hoken) is mandatory for all Japan residents not covered by employer insurance. It covers 70% of medical costs. Enroll at your city ward office.
Can I get NHI as a foreigner in Japan?
Yes. Any foreign resident with a valid residence card staying more than 3 months is eligible and legally required to enroll in NHI or employer health insurance.
What if I can't pay a Japanese hospital bill?
Contact the hospital accounts office and ask for a payment plan (bunkatsu barai). Hospitals generally accommodate installment arrangements. If you have travel insurance, they can often pay the hospital directly.
Gaijin Support Editorial Team
Japan Life Support Specialists
Written by a team of foreign residents in Japan with combined 50+ years of experience navigating Japanese legal, medical, and administrative systems.
Reviewed by Dr. Hiroshi Sato, Healthcare Consultant · Last updated June 2026