Good news: care in Tokyo is easy to get, fast and cheap by US standards. The catch is learning where to go first, because walking straight into a big hospital costs you extra.

The short version

• For everyday problems, go to a neighborhood clinic (kurinikku or iin). Big hospitals are for referrals and emergencies.
• Large hospitals charge an extra fee if you show up without a referral letter. Two Tokyo hospitals we checked charge JPY 7,700 and JPY 8,800 (about USD 49 to 56) [1][2].
• Himawari, Tokyo's medical information line at 03-5285-8181, helps you find clinics with English-speaking staff, every day from 9 a.m. to 8 p.m. [3]
• Call 119 for an ambulance (free, interpreters available). Call #7119 if you're not sure you need one; that line is in Japanese only [4][5].
• Prescriptions are usually filled at a separate pharmacy, and US prescriptions aren't honored in Japan [6].

This guide covers using the system. For premiums, the 30% co-pay and who joins which plan, see our guide to National Health Insurance in Japan.

USD conversions use the Federal Reserve H.10 rate of October 30, 2026 (USD 1 = JPY 157.47) [7].

Clinics vs hospitals: start small

Back home you might pick an in-network primary care doctor, wait three weeks for an appointment and go to urgent care in between. Tokyo works differently.

Most Tokyo neighborhoods have dozens of small private clinics, often on the upper floors of buildings near train stations. Each has a specialty on the sign: internal medicine (naika), pediatrics (shonika), ENT (jibika), dermatology (hifuka), orthopedics (seikei geka), eye care (ganka). You choose the specialty yourself. There's no gatekeeper, and many clinics take walk-ins during posted hours.

Big hospitals work as the next step up. Japan's health ministry set up a system so that primary care happens at clinics and advanced, specialist care at hospitals with 200 or more beds [2]. To push patients toward clinics, those hospitals charge an extra "selective treatment" fee to first-time patients who come without a referral letter (shokaijo) [1][2].

What the no-referral fee looks like

That fee comes on top of the regular bill, and insurance doesn't cover it. A visit to a local clinic first, which can write you a referral if needed, is the no-brainer.

Finding English-speaking care

Plenty of Tokyo doctors read English medical terms. Fewer are comfortable running a whole appointment in English, and front-desk staff usually speak only Japanese. Here's how to find the right place.

Himawari

The Tokyo Metropolitan Government runs the Tokyo Medical Institution Information Service, known as Himawari [3].

• Phone: 03-5285-8181
• Languages: English, Chinese, Korean, Thai and Spanish
• Hours: every day, 9 a.m. to 8 p.m., 365 days a year
• Cost: the service is free; you pay only for the call [3]

Tell them your symptoms, your neighborhood and that you want English, and they'll suggest clinics nearby, including ones open at night or on weekends [5]. For searching online, Tokyo points people to the national Medical Information Net (NABII), which lists clinics and the languages they offer [3].

Other ways to find a doctor

• Ask your employer or school. HR teams and international student offices usually keep a short list.
• Your ward office. Many wards publish English guides with medical contacts.
• Hospitals with international departments. St. Luke's in Tsukiji and other large hospitals have English pages for first-time patients [1]. Get a referral first unless it's urgent.
• Word of mouth. Americans trade names of English-friendly pediatricians and dentists constantly. Ask in our community group for Americans in Japan.

What to bring to any appointment

1. Your health insurance card (or your My Number card if it's linked for insurance)
2. Your residence card
3. Cash, since some small clinics don't take cards
4. A list of your medications with generic names
5. Your referral letter, if you're going to a large hospital

On your first visit, you'll fill out a questionnaire (monshinhyo). Ask if they have an English version; many clinics do.

Emergencies: 119 and #7119

119 for an ambulance

In Japan, 119 is for fire and ambulance (110 is police). The call and the ambulance ride are free [5].

• When you call, the dispatcher asks, "Is it a fire or an ambulance?" Say ambulance (kyukyu-sha).
• Explain the illness or injury, give the address (or a building or landmark), and your name and phone number [5].
• Interpreting is available in English, Chinese, Korean, Portuguese and Spanish through a three-way call with a translation center [4].
• Tokyo also offers "Live 119," a video service that lets dispatchers see the patient and walk you through first aid [4].
• When you hear the siren, go outside and wave the crew down [5].

Ambulances in Japan are white with red stripes, not the boxy red-and-white rigs you know from back home.

#7119 when you're not sure

7119 is Tokyo's emergency telephone consultation center. Nurses and other medical staff help you decide whether you need an ambulance and, if you don't, tell you which hospital can see you. It runs around the clock, every day, but in Japanese only [5]. If your Japanese isn't up to it, have a Japanese-speaking friend call, or call Himawari during its hours.

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Pharmacies and prescriptions

Japan mostly separates prescribing from dispensing. Your clinic hands you a prescription slip, and you fill it at a dispensing pharmacy (look for 調剤 or "chozai"), usually right next door. Drugstores like the big chains on every Tokyo shopping street sell over-the-counter medicine, cosmetics and snacks; some also have a pharmacy counter.

Things that surprise Americans:

• Smaller packs and lower doses. Japanese over-the-counter medicines often come in lower strengths than US versions. Read the box or ask the pharmacist.
• Your US prescription won't work here. The State Department notes that US prescriptions aren't honored in Japan [6]. You'll need a Japanese doctor to prescribe your regular medications.
• Some common US drugs are banned. Adderall is strictly prohibited in Japan [6]. Japan's health ministry says importing stimulants, including lisdexamfetamine (the active ingredient in Vyvanse), is prohibited except in rare cases with permission obtained before you arrive [8].
• Medicine passbook (okusuri techo). Pharmacies record what you've been given in a small booklet or app. Bring it each time.

Bringing medicine when you move

Japan's health ministry lets you bring up to a one-month supply of prescription drugs for personal use without extra paperwork. More than that needs an Import Confirmation (Yunyu Kakunin-sho), which you must apply for and receive before you leave home [8]. Narcotics need separate permission from the Japanese government [8].

The State Department also recommends carrying medicine in its original packaging with your doctor's prescription [6]. If you take something controlled, sort this out with your doctor months before your move.

Dentists, checkups and the rest

• Dentists are everywhere in Tokyo and most routine work is covered by public insurance. Cleanings may be spread over several short visits.
• Annual checkups (kenko shindan) are often arranged by employers. If you're self-employed, your ward offers screenings, and many are free or cheap.
• Pediatrics visits are heavily subsidized for children in Tokyo, with ward-level programs that cover much of the cost. Ask your ward office how to get the medical subsidy card for your kids.
• Mental health care in English is limited and in high demand. Start looking before you need it.

Sources

1. St. Luke's International Hospital: First-time patients
2. JR Tokyo General Hospital: Outpatient information
3. Tokyo Metropolitan Government: Himawari medical institution information service (Japanese)
4. Tokyo Fire Department: Information for foreign residents
5. Tokyo Intercultural Portal Site: In case of a sudden illness, incident or accident
6. US Department of State: Japan international travel information
7. Federal Reserve: H.10 foreign exchange rates
8. Ministry of Health, Labour and Welfare: Bringing medicines for personal use into Japan

Keep reading

• National Health Insurance in Japan
• Your residence card and My Number in Tokyo
• Earthquake and disaster preparedness in Tokyo
• Medicare when you live abroad