After my first couple of hours in a Japanese hospital, I started to feel like I was in prison—a prison where everyone was friendly and polite and always said “please” when they gave you an order, but a prison nonetheless.
There were many rules, but after a couple of weeks, I got used to them and the environment and even started enjoying my stay. In the end, I was in the hospital for 18 days.
Most hospitals have private rooms with a shower, but you’ll need to pay.
This seemed far too long and even slightly unnecessary, but Japanese hospitals tend to err on the side of caution and keep people in until they are absolutely sure they are OK. You can ask to leave earlier if you really want to.
In this article, I’ll explain what being in a Japanese hospital is like and a few things you should know before being admitted as an inpatient.
Health Insurance
Under normal circumstances, adults are liable for 30% of the cost of medical treatment if they’re covered under national health insurance. However, there is a monthly cap applied to significant medical expenses based on your income. If your medical expenses go over the monthly cap, you don’t have to pay any more than that.
Your expense cap can be checked on the Ministry of Health, Labour & Welfare website (page 4—Japanese).
It’s a good idea to carry your health insurance card around with you.
This is called the kogaku ryoyohi seido, or High-Cost Medical Expense Benefit, and it is a key element to prevent financial hardship from medical bills. For example, my treatment cost over ¥2.5 million, but thanks to the benefit, I was only charged ¥85,000. This amount includes medical expenses and a stay in a normal (communal) ward. It does not include food, the cost of a double or private room, or additional fees.
Keep in mind that you need to apply for this benefit yourself—ideally before checking into the hospital. If you do so, your hospital bill will be limited to the amount under the monthly cap. You can apply for this through your local city hall (if you are on basic national health insurance) or through your employer (if you are on employee insurance).
Hospital Rules and Environment
Hospitals can be pretty strict. After all, they are institutions that are trying to balance the interests of all patients and staff. Every hospital will be different, but my hospital’s schedule looks like this:
- 6 a.m.: Nurses do morning rounds
- 7 a.m.: Breakfast
- Noon: Lunch
- 6 p.m.: Dinner
- 9 p.m.: Lights out
I haven’t gone to sleep at 9 p.m. since middle school!
Hospitals may also have a restaurant or convenience store.
Rooms are never completely dark due to emergency lighting, and nurses come around every couple of hours during the night to check on patients. Combined with the slightly too short bed and the hard mattress, I didn’t really sleep properly the whole time I was in the hospital. You might want to bring earplugs and a sleep mask with you.
Patients in standard six- or four-patient rooms or twin rooms were allowed to shower three times a week, either Monday, Wednesday, and Friday or Tuesday, Thursday, and Saturday. This was a shock, as I usually shower at least twice a day, morning and night. Most hospitals have private rooms with showers, but you’ll need to pay more, and those rooms are not covered by national health insurance.
Each patient had a small TV, a fridge and some drawers to store belongings.
Hospital food
Photo: Ben TanakaThe food ended up being better than I expected. Basically, it was white rice every meal, with fish, tofu or meat, soup, some vegetables and milk for breakfast. Before being admitted, I was asked about food allergies and preferences, and a nutritionist came to have a chat on the third day to see if everything was OK.
I’m a fairly fussy eater but found myself eating about 90% of what I was served. My meal plan was unrestricted (people with certain conditions have different meal plans) and set at 2,000 calories per day. This seemed about right as I was hungry before meals but not overly so, and I didn’t lose as much weight as I was hoping to!
My food was ¥700 a day and not covered by insurance. Some hospitals have better food for a fee, but sadly, mine did not. Hospitals may also have a restaurant or convenience store. You can see more pictures of the food here.
Planning your stay
Usually, for operations and serious medical treatment, the hospital will ask a family member to be present for explanations and to give permission for the treatment.
For surgery, they will be asked to be present for the entire operation just in case something happens and they need to make a decision. If a family member is unavailable, a friend or colleague can do this instead.
You should also have a briefing session with the hospital before admission to go over procedures and other basic information. I’d recommend bringing a list of questions with you, as they won’t volunteer all the necessary information. See the checklist section below for some ideas.
Unplanned Stays
If you find yourself in the hospital due to sudden illness or a traffic accident, you will have to depend on the kindness of family or friends to get you any necessities. So for this reason—it’s probably a good idea to carry your health insurance card around with you.
My daughter ended up hospitalized due to appendicitis a few years ago. Fortunately, we could take care of everything for her, but it might also be worth leaving a spare key with a trusted friend if you don’t have family or roommates.
Most hospitals will also provide necessities like pajamas, cutlery, towels and slippers for a fee. I ended up doing this for my stay. It was ¥400 a day for basically everything (except underwear), and it made things very easy. This fee is not covered by insurance.
Checklist
This is a (probably incomplete) list of things I wish I had thought of before going into hospital:
- Small kettle (there was hot water available, but not boiling)
- Coffee or tea
- Cups, forks, spoons or chopsticks
- Underwear and slippers
- Your medicine or supplements. The hospital will vet them to ensure they won’t react to your inpatient treatment but will not issue new meds based on external prescriptions. I got six weeks of allergy meds from my regular doctor, just in case.
- A laptop (Ask about internet access beforehand if you can. Be prepared to spend a lot of money on data if you plan on using your phone for the internet.)
- Decent headphones
- Pillow, lightweight sheets, a sleep mask and earplugs
- Check to see if the hospital has a convenience store or restaurants (They make a big difference.)
Japanese Language
I speak passable Japanese, so chatting with some of the nurses was quite fun. It made my stay much more tolerable. Making friends with one of the cleaners was a highlight. If you don’t speak Japanese, you may struggle a bit more, but the staff will appreciate any effort you make to be cheerful and friendly.
How about you? If you have spent time in hospital recently, how was your stay? Was your hospital more comfortable than mine?
This site is protected by reCAPTCHA - Privacy Policy - Terms of Service
Pretty accurate article. I would add that you should bring an extension cord too because outlets are rarely close to your bed. Just make sure they don’t get tangled with the medical equipment cords. Also, if you can afford it, I found that it is worthwhile to splurge the extra few thousand per day for a private room.
Very nice article! I had moved to Tokyo 2 years ago and I was always questioning how to do in an emergency case! Right now I am using only routine appointments, checking general condition. I would say that it is too superficial, comparing to what I had in Brazil (Private health plan, of course!!) and I sometimes question how to get more detailed exams, as I am getting old…
I moved from Canada to Japan permanently just over a year ago. IN Canada, the health care system is practically non existent. It is virtually impossible to get a family doctor, and next to impossible to sign up with either a nurse practioner or a pass for the limited number of health clinics that exist. You are more or less dependent on going to the emergency of a hospital and it is not uncommon to make three days of visits even to fulfil important medications. In four years, I suffered from extreme pain 24 hours a day. My body was riddled with advanced arthritis almost in every joint. I could not walk. I could not sleep. I had virtually no access to trained surgeons just fleeting visits and promises they would eventually get to me. I kid you not. In Japan, in a mere three weeks, I received all of the MRIs, xrays, ultrasound tests and a host of other necessary diagnostic screening tests that eluded the caretakers in Canada. I was able to book with three different prominent surgeons in Asahikawa, Hokkaido during this period and promised major operations within a months time. I was immediately given the option to sign up for rehabilitation services in a. major hospital which I have used for more than a year now. I rented a reclining top of the line hospital bed for a low monthly fee. I was interviewed by social services on an ongoing basis to chart my situation. The care, no, the love and genuine concern I received was over the hill in comparison to my native Canada. It was so surreal. This one service itself, health care, is why I decided to live the rest of my life in Japan. Like most things, the society here is orderly and works. Anyone who thinks otherwise should high tail it, in my humble opinion.
Very helpful article! Thank you!
Years ago, my PSA was gradually rising. My doctor (surgeon)
recommended a biopsy. (Note: I am just fine and take meds for
three months and none for three months.) The first step was to
clear the way for the instrument. A young nurse proceeded to
apply a small enema, but had difficulty. Some friends jokingly
call me an a-hole, so there should not have been any problem.
After administration, the head nurse came to inspect my poop
and said it was enough, which made me proud. Then into the
surgical ward and anesthesia. My doctor came with an entourage
of several interns and nurses for training. To test if the med was
working, I was asked where I came from. After some thought,
I replied, “Juni kai.” (ninth floor), clearly not what he expected.
A nurse tittered and my doctor took of his mask and laughed, as
did everyone else. The anesthesiologist, said, “More meds.” I slept.
A short time later, I was mostly out but could vaguely see the
entourage. Somehow, my private parts had fallen out of my
pajamas. My doctor turned to the youngest and prettiest nurse
and ordered her to put them back gently. Which she did. Now, I
should note that I am very happily married to a fantastic lady.
But that charming experience has left an indelible memory
and favorable view of hospitals. It was a bit of harsh training for
the young nurse, but I am sure no situation bothers her now.
HI BEN:
I want to stay in Tokyo 3 months at a time, during Spring, Fall, and maybe Winter months. I have just a Passport.
If I contract COVID, would I have to stay at only those hospitals that participate with BLUE CROSS, BLUE SHIELD in order to receive reimbursement for any bills accrued?
My Federal government Health Insurance is affiliated with the BLUE CROSS, and provides partial payments.
I realize I’d have to pay any difference in cash upon check-out, and I have a Tokyo friend (Registered Nurse) who would help me with any billing.
Thank you for your advice!
H. Miyamoto