Nagoya

1. Overview of Japan’s Healthcare System

Japan has a highly efficient and accessible healthcare system, with universal health coverage provided through the National Health Insurance (NHI) or Employees’ Health Insurance (EHI). Healthcare in Japan is not free, but the government subsidizes a significant portion of the costs, making it affordable for residents. Visitors and immigrants should be aware of the following key points:

• Residents (including immigrants staying for more than 3 months) are required to enroll in the NHI or EHI.
• Visitors (short-term stays under 3 months) are not eligible for NHI and must rely on travel insurance or pay out-of-pocket.

---

2. Costs Associated with Healthcare in Nagoya

A. For Residents (with NHI or EHI)

• Insurance Premiums:
  • NHI premiums are calculated based on your income and household size. On average, expect to pay ¥15,000–¥30,000 per month for an individual.
  • EHI premiums are deducted directly from your salary (typically 10% of your income, shared between you and your employer).
• Out-of-Pocket Costs:
  • Patients pay 30% of the total medical bill (the government covers the remaining 70%).
  • For children under 6 years old and seniors over 70, the co-payment is reduced to 20% or 10%.
  • Example costs:
    • General consultation: ¥1,500–¥3,000 (after insurance).
    • Specialist consultation: ¥2,000–¥5,000.
    • Prescription medication: ¥500–¥2,000 per prescription.
    • Hospitalization: ¥10,000–¥20,000 per day, including meals and basic care.

B. For Visitors (without NHI or EHI)

• Visitors must pay the full cost of medical services upfront. Costs can be significantly higher:
  • General consultation: ¥5,000–¥10,000.
  • Specialist consultation: ¥10,000–¥20,000.
  • Emergency care: ¥20,000–¥50,000 or more, depending on the severity.
  • Hospitalization: ¥50,000–¥100,000 per day.
• It is highly recommended to purchase comprehensive travel insurance before arriving in Japan to cover these expenses.

---

3. Procedures for Accessing Medical Services

A. Finding a Medical Facility

1. Hospitals and Clinics:

   • Nagoya has a mix of large hospitals, specialized clinics, and general practitioners.
   • For non-emergency care, visit a clinic (クリニック) first. Clinics are smaller, less crowded, and more affordable than hospitals.
   • For emergencies or specialized care, go to a hospital (病院, byouin).

2. Language Considerations:

   • Many medical staff in Nagoya speak limited English. Look for facilities with multilingual support or bring a Japanese-speaking friend.
   • Alternatively, use translation apps like Google Translate or Pocketalk.

3. Recommended Facilities in Nagoya:

   • Nagoya University Hospital: A large teaching hospital with English-speaking staff and specialists.
   • Nagoya City East Medical Center: Known for its emergency care and multilingual support.
   • Meijo Hospital: Offers a wide range of services and has interpreters available.
   • Nagoya Central Hospital: Convenient for general consultations and minor treatments.

B. Booking an Appointment

• Non-Emergency:
  • Call the clinic or hospital in advance to book an appointment. Some facilities allow online reservations.
  • Walk-ins are accepted at many clinics, but you may face long wait times.
• Emergency:
  • Dial 119 for an ambulance (free of charge). Be prepared to explain your situation in Japanese or use a translation app.

C. At the Medical Facility

1. Documents to Bring:
   • Residents: Bring your health insurance card (保険証, hokenshou) and residence card (在留カード, zairyu card).
   • Visitors: Bring your passport and travel insurance details.
2. Reception Process:
   • Fill out a registration form (available in English at some facilities).
   • Present your documents and wait for your turn.
3. Payment:
   • Pay at the cashier after your consultation. Most facilities accept cash, and some accept credit cards.
   • Keep your receipt for insurance reimbursement if applicable.

---

4. Cultural Considerations

• Punctuality: Arrive on time for your appointment. Being late is considered disrespectful.
• Politeness: Bowing and using polite language are customary when interacting with medical staff.
• Shoes: Some clinics may require you to remove your shoes at the entrance. Slippers are usually provided.
• Privacy: Japanese medical facilities prioritize patient privacy. Expect to discuss your symptoms discreetly.
• Medication: Pharmacies (薬局, yakkyoku) are often located near clinics. You’ll need to present your prescription to purchase medication.

---

5. Emergency and After-Hours Care

• Emergency Numbers:
  • Ambulance/Fire: 119.
  • Police: 110.
• After-Hours Clinics:
  • Nagoya has several night clinics (夜間診療所, yakan shinryoujo) for non-life-threatening emergencies. These clinics operate in the evenings and on weekends.
  • Example: Nagoya City Night Emergency Clinic (near Sakae).
• 24-Hour Pharmacies:
  • Some pharmacies in Nagoya operate 24/7. Look for Matsumoto Kiyoshi or Sugi Pharmacy branches.

---

6. Health Insurance Enrollment for Immigrants

If you are moving to Nagoya for work, study, or long-term residence, you must enroll in the NHI or EHI within 14 days of registering your address at the local city office. Here’s how:

1. Visit the Ward Office (区役所, kuyakusho):
   • Example: Nagoya City Hall or your local ward office (e.g., Naka Ward Office).
2. Documents Required:
   • Residence card (在留カード, zairyu card).
   • Passport.
   • Proof of address (e.g., rental contract).
   • Employment details (if applicable).
3. Procedure:
   • Fill out the application form for NHI.
   • Receive your health insurance card within a few weeks.
4. Cost:
   • Premiums are billed monthly. You can pay at convenience stores, banks, or via automatic withdrawal.

---

7. Additional Tips

• Health Checkups: Nagoya offers free or low-cost annual health checkups for NHI/EHI members. Check with your ward office for details.
• Vaccinations: Routine vaccinations for children are covered under NHI. Adults may need to pay for certain vaccines (e.g., flu shots cost around ¥3,000–¥5,000).
• Mental Health Services: Mental health is less openly discussed in Japan, but services are available. Look for English-speaking counselors at Nagoya International Center or private clinics.

---

8. Key Resources

• Nagoya International Center (NIC):
  • Offers multilingual support, including healthcare guidance.
  • Website: www.nic-nagoya.or.jp
  • Phone: 052-581-0100.
• Aichi Medical Interpretation System:
  • Provides interpreters for medical appointments.
  • Website: www.amd.or.jp.

---

By following this guide, you’ll be well-prepared to navigate the healthcare system in Nagoya, whether you’re a visitor or a long-term resident. Let me know if you need further assistance!