Living in Japan?
Education and Healthcare in Japan
Childcare Options for Expats
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 preschool kids can have their children looked after by a babysitting agency. A local childcare center (hoikuen) or a nanny service taking care of infants and toddlers at home (affectionately called hoiku mama) is another valid option.
However, public childcare 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 preschools in the Tokyo-Yokohama region. The latter have several language options, especially for English-speaking children.
Sending Your Kids to a Japanese School
The language barrier is also the main reason why most expat children do not attend a Japanese school. Since the lack of Japanese skills may lead to difficulties and isolation most expats prefer sending their kids to a private international school. These also have the distinct advantage that they may include preschools, day care services or after-school facilities for younger kids under the same roof. Unfortunately, they are often rather expensive.
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.
Here are some links to selected international schools in Japan:
- Canadian Academy (Kōbe)
- KIU Academy (Kyōto)
- Nagoya International School
- Ōsaka & Senri International Schools
- The American School in Japan (Tokyo)
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 for resident non-citizens and long-term visitors. Individuals have to enroll in one of three coverage options, depending on their type of employment and age.
Coverage is provided by the Social Health Insurance (large companies), or the National Health Insurance, which includes the Japanese Health Insurance Association (for those employed by small- or medium-sized companies) and the municipal-run Citizens Health Insurance (for the unemployed or self-employed). Your insurance contributions are deducted directly from your salary, or you must remember to pay the NHI tax on a regular basis.
The NHI is also available for non-Japanese residents staying in Japan for a minimum period of three months (no visitor visa or short-term visa holders).
With regards to clinics and hospital costs both SHI and NHI patients are required to pay 30% of the total cost. However, that percentage is reduced to 20% for children under three receiving treatment.
Private Health Insurance
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 with the SHI or NHI at all, for example plenty of prenatal 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.
What to Do if You Get Sick
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 or check out the information on “Guide for When You’re Feeling Ill” provided by the Japan National Tourism Organization
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 (+81 (0)3 52858181) from 09:00 to 20:00. Under the number +81 (0)3 52858185, 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 or your medical history with you.
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