Japan ER Guide: Medical Emergencies for Expats
The other day, my American friend suddenly became unwell and crouched down, saying it might be a heart attack. I was completely caught off guard and found myself momentarily at a loss. It made me realize how important it is to be prepared for medical emergencies in Japan—especially if you're a foreigner.
So here I am, writing a practical guide to help you handle medical emergencies in Japan. I’ve also included several reliable English-language resources to make navigating these situations easier.
In This Blog:
Emergency Contacts
Ambulance Services (#119)
Walk-In to ER
If It’s Not Urgent, But You’re Sick - Yellow (Semi-Urgent)
Frequently Asked Questions
Emergency Care Challenges for Expats – And How to Prepare
What is “Special Functioning Hospitals”?
Pharmacies in Japan
Wrap-Up
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1. Emergency Contacts
Medical and Fire Emergency: Dial 119
Police Emergency: Dial 110
Language Support: Many fire departments provide multilingual support. When a 119 call is made, they connect to a telephone interpreting service. If you speak a foreign language, don’t hesitate to call 119 in case of ambulance, fire or rescue needs.
2. Ambulance Services (119)
When to Call an Ambulance:
Japan offers a free app called "Q-suke" (Nationwide Emergency Medical Guide App) that helps you decide whether an ambulance is needed. It's in Japanese only, so use a translation app or ask someone nearby for help.
By selecting the relevant symptoms and conditions on the screen, the app will display recommended actions based on the level of urgency, such as:
o Red (Emergency): Call an ambulance immediately
o Yellow (Semi-Urgent): Visit a medical facility as soon as possible
o Green (Less Urgent): It’s not an emergency, but seek medical attention
o Blue (Not Urgent): Continue to monitor the situation carefully
Example Symptoms Requiring Ambulance Transport (Available in 16 languages)
Source: Official Guidance by the Ministry of Internal Affairs and Communications
Adults:
o Difficulty moving or numbness on one side of the face
o Facial droop, slurred speech
o Sudden severe headache, dizziness, or vision problems
o Severe chest or back pain, shortness of breath
o Sudden numbness in limbs
o Continuous severe abdominal pain
o Loss of consciousness, seizures, heavy bleeding, severe burns
o Traffic accidents, drowning, high falls
Children (3 months to 15 years):
o Blue lips, visibly ill appearance
o Violent coughing or wheezing
o Headaches with seizures or loss of consciousness
o Severe vomiting, diarrhea, or abdominal pain
o General unresponsiveness, seizures, burns, or choking
Tip: Ambulance services are free in Japan, but don’t misuse them—some patients truly need urgent care.
In some areas like Matsusaka City, ambulance use without hospitalization may cost ¥7,700 to discourage non-urgent calls.
Tip: If you are covered by Japanese health insurance, the cost of treatment after transport will be charged as usual under your insurance plan.
What to Tell the Operator
o When you dial 119, you’ll be asked whether the emergency is for Fire or Ambulance → Say “Ambulance”.
o Describe what happened and how it occurred.
o Provide the patient’s age (if known) and current condition.
o Give your exact location (address and nearby landmarks). Use Google Maps if needed.
o State your name and phone number—they may need to contact you again.
You can say: "Kyuu-kyuu-sha onegai shimasu. Eigo no tsuuyaku onegai dekimasu ka?"
(Please send an ambulance. Can I speak with an English interpreter?)
Tips:
o Stay calm and speak slowly
o Use translation apps if needed
o Ask someone nearby to flag down the ambulance
o Bring your health insurance card in your wallet
3. Walk-In to ER
You may sometimes drive the patient directly to the emergency room. However, note that triage systems are often in place, where patients are categorized by urgency—not everyone is seen immediately.
Some patients may complain about the wait without realizing this system is common.
Be sure to bring:
o Health insurance card or My Number card
o Cash or credit card
o Current medications
4. If It’s Not Urgent, But You’re Sick- Yellow (Semi-Urgent)
#7119 Medical Consultation Hotline (Free, excluding phone charges)
Available in Tokyo and some other regions, you can call #7119 for 24/7 advice. They assess your symptoms and tell you whether an ambulance is necessary. Some operators speak English or offer interpreter support. To use #7119, press the “sharp” (#) button first, then dial 7119.
#8000 Pediatric Emergency Hotline (Free, excluding phone charges)
If your child suddenly becomes ill at night or on a holiday and you’re unsure what to do, call #8000. This nationwide pediatric hotline connects you to nurses or pediatricians who advise whether you should go to the hospital or wait. To use #8000, press the “sharp” (#) button first, then dial 8000.
How to Find Medical Facilities with English-Speaking Staff
Recommended free English-friendly sites:
o Japan National Tourism Organization (JNTO) Medical Guide
o AMDA Medical Information Center (NPO)
o Tokyo Medical Information Site for Foreign Tourists and Residents
o Tokyo English Lifeline (TELL)- free, anonymous mental health support in English.
Tip: Even if you're not sick, identify your local primary doctor in advance.
5. Frequently Asked Questions
Q: Will I be denied care if I don’t speak Japanese?
A: No, you won’t be denied care. However, language barriers are one of the biggest challenges. In emergency situations, translation tools and apps may not be as effective as direct verbal communication.
If you have a high-risk condition, I highly recommend preparing a brief summary of your medical and medication history in Japanese in advance.
Q: Can I go to any hospital in an emergency?
A: Yes, but not all hospitals accept walk-ins or have English-speaking staff. If it’s serious, call 119—the ambulance team will assess the situation and take a patient to an appropriate facility based on condition.
Q: Do I need my health insurance card?
A: Yes. Without it, you may be required to pay the full amount or place a deposit upfront.
In fact, along with language barriers, unpaid bills are one of the major concerns for hospitals treating foreign patients.
Presenting a valid Japanese health insurance card gives medical providers the assurance to proceed with treatment smoothly.
Q: I had emergency surgery—now my visa is about to expire. What should I do?
A: Obtain a medical certificate/Doctor’s note from your doctor as early as possible and contact immigration authorities. If you are a student, be sure to inform your school administration as well.
Medical certificates usually involve a fee.
6. Emergency Care Challenges for Expats – And How to Prepare
When a medical emergency strikes, clear communication and cultural awareness can make all the difference. Based on real experiences I’ve had or heard from other HR colleagues, here are some challenges expats face—and what you can do to prepare.
Real story:
An expat developed severe stomach pain at work, so I took him to the ER by ambulance. Later, a nurse told me he had become frustrated because the testing methods and sequence didn’t match what he was used to in his home country. As a result, the doctor had to spend extra time explaining the process.
Example:
After being rushed to the ER, some expats have requested prescription refills without undergoing a medical evaluation. However, under Japan’s Medical Practitioners Act (Article 20), doctors are not allowed to prescribe medication without examining the patient—even in an emergency setting.
Example:
During an emergency imaging procedure, a family member suddenly entered the X-ray room, insisting that “a relative should always accompany the patient,” which caused disruption. In Japan, for safety reasons, family members are not permitted to enter exam rooms without permission—especially during procedures like X-rays.
How to Be Ready for an Emergency
It’s critical to prepare in advance, so that if an emergency does happen, you can focus on getting care—not navigating confusion.
Don’t let your guard down just because you’re young. In 2018, the average age of foreign patients who visited Keio University Hospital’s emergency department was 33 years old.
Here are a few essentials to have ready:
a. Always carry your health insurance card (or My Number card).
b. Visit a local doctor before an emergency happens. Go to a clinic, hospital, or even an annual checkup to see how the system works. Some hospitals also offer educational sessions—these can be great opportunities to familiarize yourself with the environment. The more you experience in advance, the better prepared you’ll be when something urgent arises.
c. Prepare an Emergency Card with the following key information in both English and Japanese:
Your full name and address (in Japanese)
Emergency contacts (family, embassy, employer)
Chronic conditions or allergies
Medication history (consider using a Medication Notebook / お薬手帳)
Religious or cultural care preferences
Key medical terms translated into Japanese
Our Story
When my husband moved to Japan after undergoing quadruple bypass surgery in the U.S., the first thing we did was to find a local doctor at a clinic. Fortunately, the doctor was able to arrange for all his medications here in Japan.
One day, my husband’s blood pressure spiked, and since I was at work, he went to the ER by himself - well, it’s only a five-minute walk.
To our surprise, he was told to visit a local clinic instead. The hospital/ER—classified as a Special Functioning Hospital —determined his case wasn’t urgent.
I was disappointed when I heard what had happened. The next day, we went to our local doctor, got a referral letter. That same day, we went back to the Special Functioning hospital and the cardiologist prescribed the necessary medication.
I didn’t fully understand the system—after living abroad for many years, I had forgotten how different Japan’s medical process could be. In fact, when we first visited the Special Functioning Hospital shortly after my husband moved to Japan, a doctor told us to go to a local clinic. My bad.
Up next: What is Special Functioning Hospitals ?
7. What is “Special Functioning Hospitals” ?
In Japan, some of the large hospitals (e.g., university hospitals) are classified as Tokutei Kinou Byouin (特定機能病院) or Special Functioning Hospitals, which are top-tier acute care hospital.
They focus on:
o Provide advanced medical care
o Develop/evaluate advanced medical technologies
o Conduct advanced medical care training
They do not usually accept walk-in patients for mild symptoms like colds or mild fever.
What to Do to Receive Medical Care at Special Functioning Hospitals
o Start by visiting a primary doctor at a local clinic/mid-size hospital
o If further treatment or testing is needed, the doctor will issue a referral letter, which you can take to a Special Functioning Hospitals.
Visiting Without a Referral
o You may be turned away, or
o You’ll be charged a "Selected Medical Treatment Fee" (選定療養費) of ¥7,000–¥11,000 for a first-time visit—not covered by insurance
Exceptions to the Selected Medical Treatment Fee
o You arrive by ambulance in an emergency.
o You already have a referral letter from a clinic or another hospital.
o The hospital determines, based on their assessment, that emergency care is required even without a referral.
Always check with the hospital beforehand if you’re unsure.
8. Pharmacies and Drugstores in Japan
After seeing a doctor at a clinic or hospital, you will take your prescription to a nearby pharmacy (調剤薬局 / chouzai yakkyoku) to receive your medication.
Pharmacies - What Is a “Chouzai Yakkyoku”?
A chouzai yakkyoku is a dispensing pharmacy where licensed pharmacists prepare and provide medications based on your doctor’s prescription. While they also sell over-the-counter (OTC) medicines, prescription-only drugs can only be dispensed at these pharmacies.
Pharmacists will check your medication history using your Medication Notebook (お薬手帳 – You can obtain it at pharmacies. E-Medication Notebook is also available.) to ensure there are no drug interactions or duplicate prescriptions. Most clinics and hospitals have a pharmacy located nearby for convenience.
Over-The-Counter Medicines (市販薬 / 一般用医薬品)
Medications that you can purchase without a prescription are called over-the-counter (OTC) drugs or general-use medicines. These are available at pharmacies and drugstores (薬店), which often carry everything from cold medicine to vitamins and daily essentials.
Brand Name vs. Generic Medications
Japan encourages the use of generic medications to reduce healthcare costs. Starting in October 2024, if a generic drug is available but you choose to have the brand-name (original) drug prescribed and dispensed instead, your out-of-pocket cost will increase.
Pharmacy Hours
Most pharmacies are open during regular business hours. For late-night or weekend needs, search on Google Maps using:
o “24時間 薬局” – 24-hour pharmacy
o “休日営業 薬局” – pharmacy open on holidays
9. Wrap-Up
Medical emergencies are stressful—especially in a foreign country. But being prepared can ease anxiety and even save lives.
Listen to your body. My husband always carries nitroglycerin with him, just in case—and now he also keeps an “emergency card” on hand at all times.
To learn more about health insurance, check this blog.
Lastly, the Ministry of Health, Labour and Welfare (MHLW) has published a multilingual medical phrasebookfor use in healthcare settings.
It’s available in English, Spanish, Portuguese, and Chinese, and is extremely helpful for both patients and medical staff. I have learned it too.
Stay safe, and take care!