Japan's education and healtcare

Child Care

Many expatriates with kids look for housing that is relatively close to the nearest school, kindergarten, or nursery. While there are lots of day care options and schools in Japan, the language barrier may be a problem.

Japanese parents with pre-school kids can have their children looked after by a baby-sitting agency. A local child care center (hoikuen) or a nanny service taking care of infants and toddlers at home (affectionately called hoiku mama) is another valid option.

However, public child care facilities tend to be Japanese-only. Therefore, expat parents often fall back on private day care services, bilingual nannies recommended by other expats, and the many independent kindergartens and pre-schools in the Tokyo-Yokohama region. The latter have several language options, especially for English-speaking children.

Education

The language barrier is also the main reason why most expat children do not attend a Japanese school. Legally speaking, non-Japanese students have the right to receive extra Japanese lessons at any public school in Japan.

Since the lack of Japanese skills may still lead to difficulties and isolation, though, most expats prefer sending their kids to a private international school. These also have the distinct advantage that they may include pre-schools, day care services or after-school facilities for younger kids under the same roof. Unfortunately, they are often rather expensive.

International Schools

In the Greater Tokyo Area, there are international schools catering to the US American, British, Canadian, Chinese, French, German, Indian, and Korean communities. Some of them also offer the International Baccalaureate. Please refer to our article on living in Tokyo for more information.

The international schools in the Kansai Region (Kyōto – Kōbe – Ôsaka) are mostly English-language institutions. In the Nagoya-Aichi area, there are also some international schools with English as their main language of instruction.

Public Healthcare

The quality standards of medical care in Japan are very high. Moreover, the country has a public healthcare plan for all Japanese nationals, as well as foreigners staying in Japan for more than a year. They can enroll in the National Health Insurance System, or in a healthcare association plan via their employer. Their insurance contributions are deducted directly from their salary, or they must remember to pay the NHI tax on a regular basis.

The self-employed and the unemployed have to enroll in the National Health Insurance plan at the local government office. Their NHI tax varies depending on income (or lack thereof).

Private Health Insurance

Unfortunately, the government-run health insurance option does not apply to foreign residents living in Japan for fewer than 12 months. It also never covers all medical expenses. You usually have to pay for 30% of your healthcare costs from your own pocket.

If you have private medical insurance, you may have to pay on the spot and file a reimbursement claim with your insurance company later. Some healthcare providers, however, do have direct billing services with some hospitals.

Various medical treatments are not included at all, e.g. plenty of pre-natal care, deliveries and pregnancy terminations, voluntary vaccinations, orthodontics, health check-up exams, etc. Therefore, many expats take out an additional medical insurance from a private provider during their expat assignment.

Medical Care for Expats

While medical standards are indeed high, the language barrier is again a considerable problem. When going to see a doctor or visiting a clinic for primary care or a hospital for more serious illnesses, you should therefore not only bring your health insurance card, but also ask an interpreter to accompany you.

If you would like to avoid that hassle, ask your nearest embassy or consulate (or the PTA members at your kid’s international school) for recommendations of bilingual medical staff.

In the Greater Tokyo Area, you can also call the Tokyo Metropolitan Health and Medical Information Center for general information on medical services and referrals (03-5285-8181) from 9am to 8pm. Under the number 03-5285-8185, the center offers an emergency translation service for medical purposes, too.

Nonetheless, it is a good idea to always carry some Japanese-language emergency information on your medical history with you.

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