When you get sick or injured
Large hospitals and local clinics
Medical facilities in Japan are largely of two types: large hospitals
(byoin) with full facilities for hospitalization and examinations; and
smaller, local clinics (iin or shinryojo) for ordinary consultation and
care.
Byoin:
Hospitals are larger facilities with sufficient equipment for a full
range of tests and for hospitalization. If you are not referred by a
clinic, you may be charged extra fees.
Iin and Shinryojo:
Clinics are medical facilities with less than 20 beds (and often none)
which are designed to deal with minor ailments.
We urge you to first see a doctor at your local clinic, and then visit a specialist
at a large hospital if it is recommended. Setting up a rapport with a local
doctor is also good for any future health care.
To be ready in case of emergency, you should find out the medical facilities
in your neighborhood in advance.
◆ Points to be aware of
〔Appointments〕
・ You may need an appointment.
・ If there is no appointment system, you will see the doctor in order
of arrival (first come, first served), so you should be prepared for
a long wait.
〔Medical exam〕
・ Staff may ask you to take urine or blood tests, or X-rays. Follow their
instructions.
〔Medication〕
・ Pick up any medicine your doctor prescribes at the pharmacy within
the hospital or clinic, or sometimes at a nearby pharmacy participating
in the insurance scheme. Pay for your prescribed medicines at the pharmacy.
・ Any written explanation will be in Japanese, so make sure you find
out exactly how to take your medicines from your doctor and/or the pharmacy.
◆ Hospital departments
・ These include: internal medicine (naika), pediatrics (shonika), surgery
(geka), orthopedics (seikei-geka), obstetrics and gynecology (sanfujinka),
dermatology (hifuka), ophthalmology (ganka), ear/nose/throat (jibi-inkoka)
and dentistry (shika).
・ If you go to a large hospital with many departments, and do not know
which to visit, explain your symptoms at the reception desk.
◆ Social workers:
Social workers offer counseling and advice to patients on financial,
social, and psychological concerns. They also help you prepare for
return home after inpatient treatment and co-ordinate with other medical
and welfare bodies.
Social workers are available at some medical institutions, and you can consult
them about any of your concerns.
At pharmacies (yakkyoku)
Pharmacies and drugstores both supply medicines, but you can only get prescription
medicines at pharmacies. Pharmacists will explain how to take medicines, as
well as advise on possible side-effects.
◆ Buying medicines at pharmacies and drugstores
① Buying over-the-counter drugs (remedies for headache, cold, upset stomach,
etc.):
For minor ailments, you can simply buy medicine at any pharmacy or drugstore.
In this case there is no insurance cover, and you must pay the full cost.
② Buying prescribed medicines:
At Pharmacies
When a doctor prescribes you medicine, go to a pharmacy participating
in the insurance scheme. If you have health insurance, you only have
to pay a percentage.
◆ Explanations about your medicines
・ The pharmacist will tell you how to take your medicines.
・ Any written explanation will be in Japanese, so ask about anything
that is unclear, about possible side-effects, and anything else you should
be aware of.
・ The pharmacist will give you a written explanation in Japanese. If
you can’t read it, get someone to translate it for you.
・ Pharmacies don’t have translating or interpreting facilities, so if
possible, go with a Japanese speaker.
※ In Japan, many medicines are prescription-only. You cannot get them
without a prescription, even if you have taken them previously. If you
need prescription-only medicines, you will need to see a doctor.
Calling an ambulance
If you suddenly feel seriously unwell and cannot get to a hospital
or clinic by yourself, or when you have an accident, an ambulance will
take you to hospital free of charge.
Dial 119 (toll free) to call an ambulance. When you call 119 from a green pay
phone, press the red button on the front of the phone. You can also call 119
from most mobiles (keitai) and PHS phones. After calling from a mobile or PHS,
remember to leave it on afterwards, so you can be contacted by the emergency
services.
If you don’t speak Japanese, but someone nearby does, ask them to call you
an ambulance. If you are making the call, try to stay calm and say the following:
○ KYU KYU DESU. SUGU NI KITE KUDASAI.
It's an emergency. Please come immediately.
○ NIHONGO GA HANASEMASU.／HANASEMASEN.
I can／cannot speak Japanese.
GO NARA HANASEMASU.
I can speak _________ language.
○ NAMAE WA _________ DESU.
My name is _________.
○ IMA ___________ NI IMASU.
I am now at ______________.
(Please say your address and if possible, any nearby landmark.).
○ JOTAI WA
（KEGA O SHIMASHITA／KURUSHII／KOTSU JIKO.
( I am injured.／I feel sick.／There was a traffic accident.)
○ DENWA BANG? WA _________ DESU.
My telephone number is _________.
The ambulance will come as soon as possible, sounding its siren. When
it arrives, try to stay calm and follow the instructions of the ambulance
staff. They will take you to the appropriate hospital.
If you have a regular hospital or clinic, write its name on a sheet of paper
and hand this to ambulance staff. This will not, however, guarantee that you
will be taken to that hospital. If you are currently taking medication, hand
it to ambulance staff. If you have health insurance, make sure that you take
your certificate (kenko hokensho) with you.
Going to hospital at night or during holidays
If you suddenly feel seriously unwell and cannot get to a hospital
or clinic by yourself, or when you have an accident, an ambulance will
take you to hospital free of charge.
Dial 119 (toll free) to call an ambulance. When you call 119 from a green pay
phone, press the red button on the front of the phone. You can also call 119
from most mobiles (keitai) and PHS phones. After calling from a mobile or PHS,
remember to leave it on afterwards, so you can be contacted by the emergency
services.
If you don’t speak Japanese, but someone nearby does, ask them to call you
an ambulance. If you are making the call, try to stay calm and say the following:
○ KYU KYU DESU. SUGU NI KITE KUDASAI.
It's an emergency. Please come immediately.
○ NIHONGO GA HANASEMASU.／HANASEMASEN.
I can／cannot speak Japanese.
GO NARA HANASEMASU.
I can speak _________ language.
○ NAMAE WA _________ DESU.
My name is _________.
○ IMA ___________ NI IMASU.
I am now at ______________.
(Please say your address and if possible, any nearby landmark.).
○ JOTAI WA
（KEGA O SHIMASHITA／KURUSHII／KOTSU JIKO.
( I am injured.／I feel sick.／There was a traffic accident.)
○ DENWA BANG? WA _________ DESU.
My telephone number is _________.
The ambulance will come as soon as possible, sounding its siren. When
it arrives, try to stay calm and follow the instructions of the ambulance
staff. They will take you to the appropriate hospital.
If you have a regular hospital or clinic, write its name on a sheet of paper
and hand this to ambulance staff. This will not, however, guarantee that you
will be taken to that hospital. If you are currently taking medication, hand
it to ambulance staff. If you have health insurance, make sure that you take
your certificate (kenko hokensho) with you.
Having a medical examination
If possible, go with a Japanese speaker. When you visit a hospital
or clinic for the first time, it might not be able to provide you with
the most appropriate treatment as it has no previous information about
you. To be ready in case of emergency, try to have your regular hospital
or clinic.
If you have any religious requirements in your daily lifestyle or medical
treatment, or if you have any allergy, notify the receptionist or nurse
before you see the doctor.
◆ Take with you:
・ Health insurance certificate (kenko hokensho)
・ Other identification such as your passport
・ Cash (medical treatment must be paid for in cash, in Japanese yen)
・ Something with your address and phone number, as well as any information
about relevant medical problems.
・ Any medicines you are currently taking.
◆ Consultation hours:
・ While consultation hours for outpatients vary, they are generally weekday
mornings, with no service on Sundays and holidays (See page 6 for out-of-hours
consultations.)
・ Phone ahead to find out which department to visit and the consultation
hours.
Treatment procedures
Generally, if you are a first-time patient:
【Symptoms appear】
Choose a hospital or clinic.
【At reception】
Fill out an application form and present it with your health insurance certificate
(kenko hokensho) and any letter of referral.
【Medical consultation】
・Complete a questionnaire on your present problem, medical history, allergies,
etc.
→ You can get multi-lingual questionnaires from
Kanagawa International Association
http://www.k-i-a.or.jp/medical/03.html
AMDA International Medical Information Center
http://homepage3.nifty.com/amdack/
・The doctor sees you, gives you tests or treatment, as necessary.
・Get an appointment for a further visit (tests, results, medication, etc)
【Payment】
・Pay in cash at the payment window.
・Keep all receipts. (If your monthly medical bills exceed \72,300, you will
get a partial refund. If your annual medical bills exceed \100,000, you can
also deduct any amount over this from your income when paying income tax. You
need the receipts for both these cases.
・Without health insurance, medical care is very costly. Uninsured patients
may be charged from 100% to 500% of the cost of treatment fixed for patients
who do hold insurance.
Example: If your treatment costs \3.000: (percentage can change in the future)
Without insurance:
you could be charged from \3,000-\15,000 (hospital or clinic can charge as
they like.)
With national health insurance:
you will be charged \900 (30%) if aged 3-69
you will be charged \600 (20%) if aged under 3 or 70-74 and you have a high-income
you will be charged \300 (10%) if aged 70-74
With employees’ health insurance:
you will be charged \900(30%).
【Pharmacies】
・At an in-house pharmacy (in-nai yakkyoku)
Collect your medicines at the pharmacy and pay for everything together at the
general payment window.
・At an outside pharmacy (in-gai yakkyoku)
Ask the hospital reception desk for the nearest pharmacy. Present the prescription
and your health insurance certificate (kenko hokensho), if you have one. (If
you are a first-time patient, fill out a form with details of your name, allergies,
possibility of pregnancy, etc.) Collect your medicines and pay in cash.
※ For follow-up visits at the hospital, sign in by inserting your patient
ID card in the registration machine at the general reception area, go
to the reception window, or register directly at reception in the department
you are visiting.
Hospitalization
Generally, you can get information in advance telling you when to come,
what you need to do or bring, about any deposits or guarantors (for payment
of fees, etc.), or any other special points.
【Procedures】
・ Fill in the application form and show the necessary documents (health
insurance certificate (kenko hokensho), patient ID card, statement of
guarantee, cash advance payment, etc.)
【Points to bear in mind while you are in hospital】
・ If necessary, talk to the nutritionist about any special dietary or
religious requirements. If this involves informing other patients in
your room, you can ask a nurse to do this for you.
・ Keep to visiting hours and avoid disturbing other patients.
・ Visits to children’s wards are sometimes restricted.
・ In case of surgery, the doctor will explain what is going to happen,
then you will be asked to sign a permission form.
・ If there is anything you are unsure about, feel free to ask.
・ If the hospital has social workers, you can consult them.
【Leaving hospital】
・ Pay your treatment fees before you leave the hospital.
Suggestions
Points to bear in mind when visiting a hospital or clinic.
・When you are not confident about communicating in Japanese, use a translating
service, get someone to go with you, or call the FIA and ask us to translate.
・If there is anything you do not understand, ask at once.
・When a doctor gives you the results of any examination or test, or prescribes
any medicines, ask them to explain clearly, in simple language, until
you are confident you have completely understood.
・Keep to appointment and visiting hours.
・Avoid using a mobile phone in a hospital; turn it off while inside.
・ If you have trouble paying fees, or any other concerns, or when you
do not know what facilities and services may be available, consult a
social worker.
・In Japan there are many services that are only available if you apply
for them. It is very important, therefore, to find out what is available.
Consult with a social worker if you are unsure.
※ Consulting a social worker is free. The social worker will strictly
respect your confidentiality. Feel free to talk with social workers or
counseling services, so that you can benefit from the best possible medical
care.
What should you do if you are involved in a traffic accident?
There are increasing numbers of traffic accidents involving foreign
residents in Japan. Here below are key points to observe if there is
an accident.
１）If you are involved in a traffic accident, confirm the name, address,
telephone number, and license number of the other party.
２）You must inform the police immediately an accident happens. This is
because you should get a traffic accident certificate from the police
station with jurisdiction over the site of the accident. You need this
to claim damages against the other party, or for any insurance claims.
You should also inform the police, because there are many cases of after-effects,
including whiplash, injury to bones and internal organs, resulting from
traffic accidents. People in shock are often unaware of how badly they
are injured at the time of an accident, and only later feel the after-effects.
Therefore call the police, rather than relying on simply trying to settle
the problem with the other parties yourself.
３）If you are injured, see a doctor immediately and get a medical certificate
with your name on it. If you need to miss work due to accidental injury,
but you failed to see a doctor at the time of the accident, you will
not be able to make a claim against the other party or their insurance
company later on. You should follow the doctor’s instructions and have
all necessary treatment. It is also important to try and get a pledge
from the other party or insurance company to pay medical costs. If they
will not agree to this and you have to pay yourself, make sure you keep
all receipts.
４）If you need time off work because of your injury, inform your employer.
If you later claim compensation for lost income due to temporary disability
you will need a certificate of employment from your employer which states
that you were employed for three months before the injury.
５）If you do not know what to do or cannot come to an agreement on compensation,
or if you suspect you may need ongoing medical treatment following the
accident, we strongly advise that you consult a prefectural counseling
office for traffic accidents, a local municipal counseling office on
legal matters, or a lawyer.
Treatment procedures
Generally, if you are a first-time patient:
【Symptoms appear】
Choose a hospital or clinic.
【At reception】
Fill out an application form and present it with your health insurance
certificate (kenko hokensho) and any letter of referral.
【Medical consultation】
・Complete a questionnaire on your present problem, medical history, allergies,
etc.
→ You can get multi-lingual questionnaires from
Kanagawa International Association
http://www.k-i-a.or.jp/medical/03.html
AMDA International Medical Information Center
http://homepage3.nifty.com/amdack/
・The doctor sees you, gives you tests or treatment, as necessary.
・Get an appointment for a further visit (tests, results, medication, etc)
【Payment】
・Pay in cash at the payment window.
・Keep all receipts. (If your monthly medical bills exceed \72,300, you will
get a partial refund. If your annual medical bills exceed \100,000, you can
also deduct any amount over this from your income when paying income tax. You
need the receipts for both these cases.
・Without health insurance, medical care is very costly. Uninsured patients
may be charged from 100% to 500% of the cost of treatment fixed for patients
who do hold insurance.
Example: If your treatment costs \3.000: (percentage can change in the future)
Without insurance:
you could be charged from \3,000-\15,000 (hospital or clinic can charge as
they like.)
With national health insurance:
you will be charged \900 (30%) if aged 3-69
you will be charged \600 (20%) if aged under 3 or 70-74 and you have a high-income
you will be charged \300 (10%) if aged 70-74
With employees’ health insurance:
you will be charged \900(30%).
【Pharmacies】
・At an in-house pharmacy (in-nai yakkyoku)
Collect your medicines at the pharmacy and pay for everything together at the
general payment window.
・At an outside pharmacy (in-gai yakkyoku)
Ask the hospital reception desk for the nearest pharmacy. Present the prescription
and your health insurance certificate (kenko hokensho), if you have one. (If
you are a first-time patient, fill out a form with details of your name, allergies,
possibility of pregnancy, etc.) Collect your medicines and pay in cash.
※ For follow-up visits at the hospital, sign in by inserting your patient
ID card in the registration machine at the general reception area, go
to the reception window, or register directly at reception in the department
you are visiting.
Hospitalization
Generally, you can get information in advance telling you when to come,
what you need to do or bring, about any deposits or guarantors (for payment
of fees, etc.), or any other special points.
【Procedures】
・ Fill in the application form and show the necessary documents (health
insurance certificate (kenko hokensho), patient ID card, statement of
guarantee, cash advance payment, etc.)
【Points to bear in mind while you are in hospital】
・ If necessary, talk to the nutritionist about any special dietary or
religious requirements. If this involves informing other patients in
your room, you can ask a nurse to do this for you.
・ Keep to visiting hours and avoid disturbing other patients.
・ Visits to children’s wards are sometimes restricted.
・ In case of surgery, the doctor will explain what is going to happen,
then you will be asked to sign a permission form.
・ If there is anything you are unsure about, feel free to ask.
・ If the hospital has social workers, you can consult them.
【Leaving hospital】
・ Pay your treatment fees before you leave the hospital.
Suggestions
Points to bear in mind when visiting a hospital or clinic.
・When you are not confident about communicating in Japanese, use a translating
service or get someone to go with you who can translate.
・If there is anything you do not understand, ask at once.
・When a doctor gives you the results of any examination or test, or prescribes
any medicines, ask them to explain clearly, in simple language, until
you are confident you have completely understood.
・Keep to appointment and visiting hours.
・Avoid using a mobile or PHS phone in a hospital; turn it off while inside.
・ If you have trouble paying fees, or any other concerns, or when you
do not know what facilities and services may be available, consult a
social worker.
・In Japan there are many services that are only available if you apply
for them. It is very important, therefore, to find out what is available.
Consult with a social worker if you are unsure.
※ Consulting a social worker is free. The social worker will strictly
respect your confidentiality. Feel free to talk with social workers or
counseling services, so that you can benefit from the best possible medical
care.
What should you do if you are involved in a traffic accident?
There are increasing numbers of traffic accidents involving foreign
residents in Japan. Here below are key points to observe if there is
an accident.
１）If you are involved in a traffic accident, confirm the name, address,
telephone number, and license number of the other party.
２）You must inform the police immediately an accident happens. This is
because you should get a traffic accident certificate from the police
station with jurisdiction over the site of the accident. You need this
to claim damages against the other party, or for any insurance claims.
You should also inform the police, because there are many cases of after-effects,
including whiplash, injury to bones and internal organs, resulting from
traffic accidents. People in shock are often unaware of how badly they
are injured at the time of an accident, and only later feel the after-effects.
Therefore call the police, rather than relying on simply trying to settle
the problem with the other parties yourself.
３）If you are injured, see a doctor immediately and get a medical certificate
with your name on it. If you need to miss work due to accidental injury,
but you failed to see a doctor at the time of the accident, you will
not be able to make a claim against the other party or their insurance
company later on. You should follow the doctor’s instructions and have
all necessary treatment. It is also important to try and get a pledge
from the other party or insurance company to pay medical costs. If they
will not agree to this and you have to pay yourself, make sure you keep
all receipts.
４）If you need time off work because of your injury, inform your employer.
If you later claim compensation for lost income due to temporary disability
you will need a certificate of employment from your employer which states
that you were employed for three months before the injury.
５）If you do not know what to do or cannot come to an agreement on compensation,
or if you suspect you may need ongoing medical treatment following the
accident, we strongly advise that you consult a prefectural counseling
office for traffic accidents, a local municipal counseling office on
legal matters, or a lawyer.
Compensation and how it is calculated
Compensation for death or injuries caused by traffic accidents is classified
into 4 categories: medical treatment benefit, temporary disability compensation
benefit, what is known as “consolation money” (isharyo), and indemnification
for death or disability (lost benefit/ consolation money).
Compensation for temporary disability covers daytime needs 8:00am-5:00pm,
and compensation for evening and night time is covered by consolation
money. For instance, if you break your right arm, you cannot cook or
take a bath and you are in pain. These discomforts are covered by consolation
money. Psychological injuries arising from an accident are covered by
consolation money The method of calculation for consolation money varies,
depending on whether the damage is covered by automobile third party
liability insurance, voluntary insurance, or guidelines of the Japanese
Bar Association. If there is no improvement in your pain or physical
restrictions arising from your injuries, even though you are continuing
to receive treatment, then a judgement will be made according to a scale
of permanent disability. There are two types of compensation for permanent
disability: one compensates for lost benefits (what will be lost in the
future due to the after-effect) and the other for the disability itself.
The method of calculation of compensation varies: 1) automobile third
party liability insurance (an insurance which every car owner/driver
must hold), 2) voluntary insurance (extra insurance which some car owners/drivers
choose to take out), and 3) guidelines of the Japanese Bar Association.
１） Automobile third party liability insurance
The upper limit of compensation for medical and other fees during the
treatment period is currently \1.2 million. If there is an after-effect
besides the injury itself, insurance money is paid according to the degree
of permanent disability.
Basically no reduction of insurance benefits is made in this type of
insurance, unless the victim themself is found to have made a grave error.
However, the maximum of \1.2 million in benefit during the period of
medical treatment is inadequate, as medical costs can easily mount up
to much more, and little is left to compensate for loss of income or
for consolation money. If the victim suffers permanent disability, insurance
money is paid according to the degree of disability.
２） Voluntary insurance
There is a ceiling on compensation, depending on the insurance policy
the other party holds.
３） Guidelines of the Japanese Bar Association
The Japanese Bar Association issues guidelines for damages in civil suits.
◆ Who is to blame?
The concept of relative blame is used to determine the percentage of
responsibility each party bears for the accident, and thereby set how
much, if any, compensation is due.
If you cause injury in a traffic accident
Traffic accidents are an increasing problem, and in case you are unfortunate
enough to be involved in one, it will help if you are prepared:
１） Take out voluntary insurance.
２） Always carry a valid license when driving.
３） Never run away from the scene of an accident.
If you cause an accident and someone is injured, help the victim first,
then call the police. If you fail to do this, you may not be able to
make an insurance claim later. It is also important to show your concern
for the injured person by visiting them in hospital. Be sure to inform
your insurance company of the accident immediately. Unless you report
to the company within 60 days, they may not pay you any money you are
entitled to. We also recommend you make a sketch map of the scene as
soon as possible after the accident to help you later explain what
happened.
