Moving To Japan With A Chronic Illness: The Check List

Your chronic condition doesn’t define you or hold you back from your dream of living in Japan!

Moving to Japan with a chronic illness—or even discovering you have one after you’ve arrived—can complicate what is already a significant life shift. The phrase can feel dismissive, especially when symptoms are invisible or misunderstood. It can be disorienting for anyone who has moved here and suddenly finds themselves without the support, resources or understanding they once had.

The dream of packing your life into a sleek carry-on and relocating to Japan transcends age, culture and circumstance. It’s daunting, stressful and sometimes downright terrifying—but also incredibly rewarding. Few experiences will teach you more about yourself and your priorities than starting over from scratch in a new country. For anyone moving to Japan with a chronic illness, or trying to manage one post-arrival, knowing what to prepare—from medical documents to access to care—can make all the difference.

The “Other” Checklist

It’s a nearly universal experience in our Information Age to type something along the lines of “checklist to move to Japan” or “how to move to Tokyo” into a search engine. You can read these types of posts forever to glean the wisdom of those who have come before you… However, one thing that is almost completely missing from this narrative is what to do if you‘re not of “normal” health.

When I moved to Japan, my family was terrified. Online posts about my life-altering and potentially life-threatening illness were nonexistent. Frantically, I reached out via forums and threads to get some anecdotal advice.

Now, I don’t want people out there who have additional medical needs to think that this is simply impossible for them. There will be hoops to jump through, and you will have to be more careful than others, but you deserve your chance, too. This is for people moving to Japan with chronic physical and/or mental illness to have a quick reference for some useful information. I’m here to let you all know that there is an entire community that knows just how you feel.

I want to make a new checklist—the “other” checklist. This is for all those extra things to keep you safe and sound as you transition into life in Japan. This list can never be exhaustive since different needs will require different care. So, please remember that rule number one is to talk with your specialists in your home country before taking off.

1. Medications

© Photo by iStock: EHStock

Please do not leave this out until the last minute. It is number one in this checklist for a reason. This is going to be absolutely crucial for you to research prior to your departure for your new life. In fact, if medications are critical to your continued treatment, it should be the second thing you type into that search bar.

Do Your Research

Japan has some of the strictest regulations on controlled substances in the world. Many medications that are readily available for various treatments in Canada or the U.S. are restricted or outright prohibited. A fantastic example of this is the dosages of what we would not even consider a ‘medication’ in North America. For example, the doses of Dimenhydrinate (Gravol/Dramamine) or Ibuprofen, compared to their Western counterparts, are less than half.

Similarly, the list of prohibited antidepressants/anxiety or antipsychotic medication can be a concern for many. Though, luckily, they are listed on the Ministry of Health, Labour and Welfare website.

Organise A Yakkan Shoumei (Medical Import Certificate)

If you want to bring more than a 30 day supply of any medication with you into Japan—and I suggest you do this if possible, to make your move less stressful—you will need to apply for and acquire a Yakkan Shoumei or a ‘Medical Import Certificate’ before leaving your home country.

The Yakkan Shoumei will allow you to essentially gain special permission to bring in large quantities of medications in a single trip. This actually applies to bringing in multiples of your favorite makeup or skincare, too. It is also required if you wish to mail yourself any medications from home to ensure that customs don’t whisk them away never to be seen again and leaving you in quite a pickle.

I do recommend, if at all possible for you, to bring as many supplies as possible with you to Japan. Finding specialists in Japan is not always an easy task and general practitioners will not give medical advice on specialized conditions. I wasn’t able to get a prescription until I found an endocrinologist even though my medications are needed to continue living. Give yourself time and resources to make methodical decisions on healthcare providers. Like in any other country, Japanese doctors can be really understanding and supportive or really, really not.

2. Climate Research

It’s a bit of a meme at this point for newly landed folks arriving in August or September (as many JETs and dispatch ALTs do) to be decimated by the sweltering humidity of Japanese summers or to be chilled to the bone by Hokkaido winters. Japan has many different types of weather. Compared to many places in the world, it is changeable and harsh too. It takes most people I have spoken with off guard without the first-hand experience.

This can affect many conditions. I arrived during a particularly brutal heatwave, which caused me a large amount of stress. I was traveling with months’ worth of a life-giving medication that needed to be kept refrigerated to keep its efficacy. On top of that, after being in a heat that my body hadn’t been acclimatized to, and due to an unknown kidney vulnerability, I was stricken with severe heat stroke and dehydration on day two of being in Tokyo.

You will want to be prepared for where you are moving in Japan. Make note of the time of year, as well as how your body handles different weather.

3. National Health Insurance

© Photo by Pixta: umaruchan4678

Japanese National Health Insurance (NHI) is mandatory for everyone. Employers must provide it to full-time employees, and it must cover pre-existing health conditions. If you’re a student or unemployed, you must register for it at your city hall. While Canadians like myself might gasp at times at the upfront costs, compared to other places (sorry, American readers), it’s pretty great. The coverage extends to 70 percent of your doctor’s visits and prescriptions. You pay out of pocket the remaining 30 percent.

Here is where things can get difficult for those of us with additional medical needs. In the event of needing to use your NHI to get prescriptions, to go to a clinic or to be treated at the emergency room, you must have your NHI card in your possession at the time of treatment or that entire lump sum is due out of your pocket then and there.

Sure, you can absolutely submit a claim for the amount if you are indeed covered, but an emergency trip to the ER could cost anywhere from ¥5,000 to over ¥50,000 and could even be required in cash if you’re particularly unlucky, depending on what they need to do for you.

That time I got sick after arriving in Japan? I was lucky enough to be covered by NHI for my work… but had not yet been issued my card. I had to pay nearly ¥6,000 in the month before being issued my card. Japanese bureaucracy when it comes to paperwork is not for the beginner local, if avoidable. Always have that card on you. Always!

4. Evacuation Information & Natural Disaster Preparedness

© Photo by iStock: Kolbz

Everyone knows that Japan has natural disasters. From earthquakes to tsunamis to typhoons, Japan has had to streamline its evacuation protocols. They have essentially mastered the entire thing.

To ensure you’re protected by these procedures, first get settled at an address. While completing the many things required at your ward office upon arrival, also ask for an English evacuation guide. Be sure to get emergency information specific to your ward in Tokyo or a city within Japan.

It’s also never too early to begin collecting items to be self-sufficient and sustainable in the event of needing a grab-n-go emergency kit. Make sure your kit can securely hold any medications or supplies needed to support your illness.

5. Finding A Doctor

© Photo by iStock: takasuu

This is probably going to be one of the more intimidating steps. Since you’ve already shown that you can get yourself to Japan, by this point, I think you’ve got this. Doctors work a little differently than I was used to in Canada. In case it’s also different from where you are from, let me give you a quick run-through.

In Japan, there is not really a ‘family doctor’ situation. From colds to fevers to general aches and pains, you go to a clinic and you see a general practitioner. From there, if it is decided that they are unable to help you, and a specialist is needed, they will write you a referral and will let you know that they can no longer assist you. If you have a chronic illness or comorbid conditions, then the number of doctors you see can add up quickly. I myself have three. It can be very frustrating to have to trek across Tokyo to refill a prescription after just waiting in a busy doctor’s office, but this is the way things are done in Japan.

The Unexpected Restrictions

What most people find hard to swallow is the restriction that even doctors have in terms of their patients. Despite the fact that I will need my medication for the rest of my life (and will not be able to operate as a human without it), I must go to my specialist every two months to renew that prescription and pay the associated fees. They are not small. Since specialists often work reduced hours or specific weekdays, you’ll need to speak with them about providing your workplace with evidence. This evidence will show that frequent visits are necessary for your continued health. I want to explore this topic more deeply in a future article, so I’ll digress here for now.

This list will be different for each of us. Although we have to live our lives differently from the average populace, it’s not impossible for us to move abroad. I hope this article about moving to Japan with a chronic illness can help people navigate the haze of what they have to do to stay healthy so that they can self-realize their dreams abroad.

These are my own experiences as a person living in Japan with a chronic illness. I hope it provides insights for those who wish to move to Japan and makes resources and information more accessible and less shrouded in mystery.