In Japan, healthcare has two layers: small neighborhood clinics first, and big hospitals only by referral. If you skip the clinic and walk into a large hospital, it can cost you.

The ¥7,700 surprise

Large hospitals (specified-function hospitals and community-support hospitals with 200+ beds) must charge a selection fee to first-time patients who arrive without a referral letter — a minimum of about ¥7,700 (incl. tax), per department, on top of your normal bill. It's not a punishment: it keeps big hospitals free for serious cases.

What to do instead

• For a normal illness (fever, cold, stomach upset, minor pain), go to a local clinic.
• If you need a specialist, the clinic writes a referral letter — and then there's no extra fee.
• Keep the referral letter and bring it with you.

Not sure which clinic near you is open and a good fit? Tell us your area on LINE and we'll help.

The exception

A true emergency is different — for life-threatening symptoms call 119. If you're unsure how serious it is, call #7119 first.