Payment in Japan: how medical bills work (clinic, hospital, pharmacy)
In Japan, payment is usually handled after your consultation at the cashier (kaikei). The steps are simple, but the details (cash vs card, receipts, pharmacy payment) can surprise first-time visitors.
This page explains what to expect and what to ask for, so cost and paperwork don’t slow you down.
What happens after the doctor visit?
A common flow is:
- Consultation ends
- You return to the waiting area
- The cashier calls your name/number (or you wait for your payment slip)
- You pay and receive papers (receipts, prescription, appointment slip, etc.)
- If you need medicine, you go to an in-hospital pharmacy or an outside pharmacy
Where do I pay? (cashier / payment machines)
– Cashier counter: kaikei
– Some hospitals use payment machines (like ticket machines) for outpatient payments.
Tip: Payment flow often differs between clinics and large hospitals.
At many small clinics, the cashier is the same reception area—after the consultation, you usually just wait and your name/number will be called.
At large hospitals, payment can be more complex (separate counters, payment machines, number tickets, or a “payment slip” you must take).
If you’re unsure, ask staff early and often—this is normal in Japan.
How can I pay? Cash or credit card?
Payment methods vary by facility:
– Many places accept cash (Japanese yen).
– Some hospitals accept major credit cards, but small clinics may be cash-only.
Tip: Always carry some cash, especially when visiting a small clinic.
Useful phrases:
– (Kurejitto kādo wa tsukaemasu ka?) = Can I use a credit card?
– (Genkin nomi desu ka?) = Cash only?
Will I pay at the hospital AND at the pharmacy?
Sometimes yes.
If you receive an outside prescription, you will usually pay:
– at the clinic/hospital (consultation/tests), AND
– at the pharmacy (medicine and dispensing fees)
Tip: This is normal in Japan. Don’t assume “one payment covers everything.”
What papers will I receive? (and which ones matter)
After payment, you may receive several papers, such as:
– Receipt (ryōshūsho)
– Itemized statement (meisai-sho)
– Prescription paper (shohōsen) for outside pharmacies
– Appointment slip / instructions for follow-up
Very practical tip:
If you are going to a pharmacy and you’re unsure which document is required, show the pharmacy staff everything you received.
This is faster than trying to guess which paper is “the important one.”
Do I need insurance to pay? How much will I pay? (Learn more)
If you have Japanese public health insurance
In principle, you pay a copayment (often 30%, depending on age and status). Show your insurance card (or My Number Card setup) at reception.
If you do NOT have Japanese health insurance
Many facilities will charge the full amount (100%).
Some hospitals may request a deposit or payment assurance—especially for uninsured patients.
Tip: If you have travel/overseas insurance, you often still pay upfront and claim reimbursement later (unless your insurer provides a payment guarantee to the hospital).
FAQ: Why did I pay twice (hospital + pharmacy)?
Because the consultation/tests and the dispensing of medicine are often billed separately.
If you need documents for an insurance claim (travel or overseas insurance)
To make reimbursement smoother, keep:
– receipts
– itemized statements (if available)
– any written diagnosis/instructions
– pharmacy receipts and medication documents
Tip: If you think you will file an insurance claim, ask for an itemized statement at the cashier. Some facilities may provide it on request, and policies may vary.
“Cashless” travel insurance (guarantee of payment)
Some hospitals can accept a “cashless” arrangement only if your insurer/assistance company sends a guarantee of payment (GOP) before your visit.
If no GOP is received, you may be required to pay the full amount yourself.
Practical move:
– Contact your insurer early (before the visit, if possible)
– Ask whether they can issue a GOP to the hospital/clinic
Related pages on this site
– How to make a medical appointment in Japan
– Reception & forms
– Doctor visit (what happens in the exam room)
– Insurance & costs
– Call 119 / Call #7119