Taking Your Child to the Doctor in Japan: Pediatricians, Free or Low-Cost Child Medical Care, #8000 and Vaccinations

Pediatrics is the default for children

In Japan, children are normally seen by a pediatrician (小児科, shōnika) rather than a family doctor. Pediatric clinics handle everything from fevers and rashes to vaccinations and growth concerns, usually until around the end of junior high school; teenagers may go to either pediatrics or internal medicine. A hospital's pediatric department is generally for referrals and emergencies, so for everyday illness start with a neighborhood clinic.

How much does a child's doctor visit cost? The child medical subsidy

Before they reach school age, children enrolled in Japanese public health insurance pay 20% of the bill, rather than the 30% adults pay. On top of that, every prefecture and every municipality runs a child medical expense subsidy (こども医療費助成, kodomo iryōhi josei) that covers some or all of the remaining co-payment. ^[1] The details are decided locally. As of April 1, 2025, the most common municipal rule is to cover outpatient and inpatient care until the end of the fiscal year in which the child turns 18 (1,576 of 1,741 municipalities for outpatient care). Most municipalities have no income limit; 1,319 charge nothing at the counter, while 422 ask for a small fixed amount per visit. ^[1] In practice, a child covered by insurance and the subsidy usually pays nothing, or a few hundred yen, to see a doctor. The subsidy applies only to treatment that insurance covers; checkups, vaccinations and over-the-counter products are excluded. ^[2]

The medical certificate card and what to bring

To use the subsidy you need a card called a medical certificate (医療証, iryōshō), issued by your city or ward office once your child is enrolled in your health insurance. Tokyo, for example, runs a subsidy program for infants and preschoolers (Maru-nyu) and issues the Maru-nyu certificate for children up to the March 31 after their sixth birthday; school-age children get a separate certificate. ^[2] At the clinic, present the certificate together with the child's My Number card registered as an insurance card or, if the child does not have one, the eligibility certificate (資格確認書). If your child is seen outside your prefecture, or at a clinic that does not process the certificate, you pay the co-payment and later claim it back from your municipal office with the receipts. ^[2] Also bring the mother and child health handbook (母子健康手帳, boshi kenkō techō), which records vaccinations and checkups, and any medicine the child is taking.

What if your child gets sick at night? #8000 and after-hours clinics

If your child falls ill in the evening or on a holiday and you are unsure whether to go to a hospital, call #8000, the national child medical telephone consultation line (子ども医療電話相談). Pediatricians and nurses advise you on how to handle the symptoms and whether to seek care. The service runs in all 47 prefectures, and dialing #8000 forwards you to your own prefecture's line. Hours differ by prefecture: some answer around the clock, others mainly from evening until morning. Each prefecture also publishes a regular phone number for phones that cannot dial #. ^[3] The line is in Japanese, so have a Japanese-speaking friend or a translation app ready. Most cities also run a night and holiday emergency clinic (夜間急病センター, yakan kyūbyō sentā, or 休日夜間急患センター) with a pediatric desk for illnesses that cannot wait until morning but do not need an ambulance.

When should you call 119 for a child?

Dial 119 for an ambulance without hesitation when a child aged 15 or under has any of the warning signs listed by the Fire and Disaster Management Agency: lips turning purple, or skin color that is obviously bad; severe coughing or wheezing with labored breathing, or weak breathing; stiff limbs; a headache with a convulsion; a convulsion that does not stop, or a child who does not regain consciousness afterward; being unresponsive or confused; a hard blow to the head followed by bleeding that will not stop, unconsciousness or a convulsion; severe vomiting or diarrhea with no fluids kept down and drowsiness; vomiting that will not stop, severe abdominal pain or blood in the stool; choking; serious burns, a traffic accident, near-drowning or a fall from height; hives over the whole body after an insect sting; and any baby under three months who seems unwell. The agency adds that parents should also call when the child simply seems different from usual. ^[4][7] The 119 operator will ask for your address, the child's age and what happened; many fire departments can connect a telephone interpreter, so stay on the line.

Vaccinations: routine ones are free, optional ones are not

Japan divides childhood vaccines into routine vaccinations (定期接種, teiki sesshu), given under the Preventive Vaccination Act, and optional vaccinations (任意接種, nin'i sesshu). Category A routine vaccines are publicly funded when your child receives them in your own municipality during the eligible ages, so parents pay nothing. Optional vaccines, such as mumps and seasonal influenza, are chosen by the family and generally paid for out of pocket. ^[5] The routine schedule begins at two months and includes rotavirus, pneumococcal, hepatitis B, the five-in-one vaccine (diphtheria, tetanus, pertussis, polio, Hib), BCG, measles-rubella, chickenpox (varicella), Japanese encephalitis, diphtheria-tetanus and HPV. Your municipality sends pre-screening forms (予診票, yoshinhyō) for each vaccine; take them and the handbook to a clinic, and the clinic records the date and lot number in the handbook. If your child was vaccinated abroad, bring the records so the pediatrician can work out what is still needed, because vaccines and timing differ between countries.

Well-child checkups and school health

Municipalities are required by law to hold health checkups for children at 18 months and at three years, and most also hold one at three to four months; some add other ages such as one month or five years. Group checkups at the municipal health center are generally free, and the results are written in the handbook. ^[6] Once children start school, the School Health and Safety Act requires a health examination every school year, covering height and weight, eyesight, hearing, teeth and a doctor's examination, with the results sent home.

Sick-child rules at daycare and kindergarten

Daycare centers (保育所) and kindergartens have attendance rules (登園基準, tōen kijun) for sick children, set with the local medical association on the basis of national guidelines. In general, a child who has a fever or diarrhea, or who is listless or vomiting, will be asked to stay home. The center will call you to pick up a child who develops a fever during the day. For infectious diseases such as influenza, chickenpox and mumps there are set exclusion periods, and the center may ask for a doctor's note (意見書) or a parent's declaration (登園届) before the child returns. Ask your center for its written rules when you enroll.

Medicines for children

Doses for children in Japan are calculated by the doctor from the child's weight and age, and prescriptions are commonly dispensed as powders (粉薬, konagusuri) or syrups rather than tablets. Do not give a child adult over-the-counter medicine or a dose worked out from adult packaging, and tell the doctor about any medicine, including supplements, the child already takes. Prescriptions are filled at a pharmacy, usually next to the clinic; see our guide to using a Japanese pharmacy.

Finding a pediatrician who speaks your language

Use our pediatrics search to find clinics and hospitals with pediatric departments, and the hospital search to filter by language support. If a clinic has no English-speaking staff, write down the child's symptoms, when they started, the temperature, and what the child has eaten and drunk, and show it at reception.

Glossary

• 小児科 (shōnika) — pediatrics
• こども医療費助成 (kodomo iryōhi josei) — child medical expense subsidy
• 医療証 (iryōshō) — medical certificate card for the subsidy, called 乳幼児医療証 or 子ども医療証 in many municipalities
• 母子健康手帳 (boshi kenkō techō) — mother and child health handbook
• 定期接種 (teiki sesshu) — routine vaccination; 任意接種 (nin'i sesshu) — optional vaccination
• 乳幼児健診 (nyūyōji kenshin) — well-child checkup
• 夜間急病センター (yakan kyūbyō sentā) — night emergency clinic
• 登園 (tōen) — attending daycare; 登園届 (tōen todoke) — return-to-daycare form