Healthcare

Health Care in Okinawa

Although language and culture differences can make it challenging to navigate the medical system, healthcare in Japan is widely available, efficient, and affordable. However, it is important to be aware that Japanese doctors do not usually discuss the patient's medical condition with the patient. This does not mean you do not have the right to ask questions. Just keep in mind that perseverance might be necessary to get the answers you feel you need from the doctor.

Please save all your receipts for doctor visits and prescription medicine. If you have out-of-pocket medical expenses of over ¥100,000 per year, you can deduct them from your taxes.

Dealing with the Language Barrier
All medical doctors and nurses have studied English, but their ability to speak the language varies. For this reason, it may be necessary to bring along someone who can translate. If you cannot find someone to translate for you, you can also print out a bilingual medical questionnaire and bring it with you to your appointment.

Another option is the Adventist Medical Center. Many doctors at the Center have been trained in the United States and speak excellent English.

Local Hospitals

Adventist Medical Center (アドベンチスト・メテイカルセンター)
(Located on Route 29 in the direction of Ryukyu University)
868 Kōchi, Nishihara-cho
Telephone: (098) 946-2833

Urasoe General Hospital (Urasoe Sōgō Byōin 浦添総合病院)
(Located off of Route 330, just south of the Iso tunnel)
Urasoe General serves many foreign patients and there are several doctors and nurses there who speak English well, both in the Emergency Room and other departments.
4-16-1 Iso, Urasoe
Telephone: (098) 878-0231

Ryukyu University Hospital (Ryūkyū Daigaku Byōin 琉球大学病院)
(Located at Ryukyu University)
207 Uehara, Nishihara-cho
〒903-0125 Telephone: (098) 895-3331

Visiting the Doctor

Many hospitals and clinics do not accept appointments, and service is provided on a first come, first served basis. It is therefore recommended that you go early in order to avoid a long wait. However, it is a good idea to call in advance to find out whether or not the hospital operates on an appointment-based system.

Choosing a doctor
Consumers may choose between large, general hospitals, and small specialty clinics. This means that if you are having a serious medical problem of uncertain causes, it is best to visit a larger hospital, where they will have a wider variety of specialties. However, if you have a good idea of what your medial complaint is, you may visit a specialist (either at a hospital or at a clinic) without a referral. For example, if you are having a skin problem, you can go straight to a dermatologist. However, some hospitals will charge higher fees if you arrive without a referral from a smaller clinic.

Here is a list of medical specialties:

If you go to a hospital, the staff at the reception desk will ask you to describe your symptoms or specify a medical specialty, so that you are seen by the right kind of doctor.

What to Bring
It is important to bring the following items when you visit the doctor:

• Health Insurance Card
• Hospital or clinic card. This card will be made the first time you visit a clinic or hospital. Please bring this card on any subsequent visits.
• Alien Registration Card
• Documentation of any medication you are taking. Be sure to discuss this with the doctor.
• Cash to pay the hospital bill

Pharmacies (Yakkyoku 薬局) and Prescriptions (Shohōsen 処方箋)
If you are prescribed medicine, you will either be sent to an in-house pharmacy or to a nearby pharmacy associated with the clinic or hospital. Prescription medicine for illnesses is covered by insurance, so you will be asked to present your insurance card at the pharmacy as well. If you purchase over-the-counter medications at a drug store, these will not be covered by insurance.

Normally, only small amounts of medication are given at one time, so if you have a chronic condition, you will have to visit the hospital every two months to renew your prescription.

Medication comes in a variety of forms in Japan, including pills, liquids, and powders. If you are given powdered medication and find it difficult to swallow, edible gelatin paper (oburato オブラート) can be purchased from pharmacies.

Dental Care

In searching for a good dentist, seek advice from friends or colleagues, as they may be able to recommend someone to you. Many non-Japanese visit the Adventist Medical Center where consultations can be given in English. Unlike other physicians, dentists nearly always operate on an appointment system.

The following is a list of dental clinics where some English may be spoken.

HIV and STIs (Sexually Transmitted Infections)

Getting Tested
Testing and treatment for HIV and other STIs is available at most hospitals, but because preventive medical care is not covered by insurance, you may have to pay for these tests out of pocket. However, free, anonymous HIV testing is offered at the health centers listed below. These centers can also test for other STIs, although they may charge a nominal fee.

If you take the "regular test," you will have to come back to the center in about a week to get results. The results of the same-day test are available about an hour after the test. English is not spoken.

*Appointments are required for the same-day tests in Naha and Okinawa City.

If you have any questions or concerns about AIDS or HIV, you may also contact the AGAPE AIDS/HIV Hotline for 24-hour English-language assistance. Telephone: (0120) 46-1995.

Mental Health

Counseling

If you should need any counseling, or have any trouble adjusting to life in Japan, there are counselors available to help you. If the counselors listed here are not able to fulfill your needs, they may be able to refer you to someone who can.

Name	Location	Telephone
Health Counseling Center Hoken Sōdan Center 保健相談センター	1360-1 Nakama, Urasoe	(098) 875-2100
Urasoe International Relations Association	3-40-6 Makiminato, Urasoe	(098) 879-3010
Transcultural Counseling Service	Ryukyu University Hospital	(098) 895-3199 Counselor: Maxine Randall

Help Lines

Although most of these English-language help-lines are based outside of Okinawa, they may be able to give you a referral number to someone who can help you in Okinawa.

Contraception and Pregnancy

Contraception

Prophylactics
The most common form of birth control in Japan is the condom. Condoms are sold in many 24 hour convenience stores and pharmacies (kusuriya 薬屋). The selection of condoms is limited in Japan, so you may want to bring your own, or have them shipped. Condoms are normally good for two years from the date of manufacture.

Hormonal Birth Control
The birth control pill is now legal in Japan as a method of contraception. Please see a gynecologist (sanfujinka 産婦人科) to get a prescription (up to two months at a time). A birth control prescription costs around ¥2,500 for a one month supply. Emergency contraception (the "morning after pill") is also available by prescription, usually under ¥1,000 (not covered by insurance).

If you plan to bring a supply of the pill with you to Japan, you can only legally bring in a one month supply. If you wish to bring more, you must mail an application (yakkan shōmeisho 薬監証明書) and a copy of your prescription to Ministry of Health, Labor, and Welfare at least three weeks prior to your arrival in Japan. If your application is accepted, you will be mailed a certificate, which you must bring with you to Japan. For more information about bringing birth control (or other prescription medicines) into Japan, please see the Ministry website .

If you plan to have birth control pills sent, only one month's supply may be sent at a time. Make sure the prescription and a note from your doctor are included in the package.

Pregnancy and Childbirth

Pregnancy Tests & Counseling
Home pregnancy tests are sold at pharmacies. "Check One" brand has English instructions. If find you are pregnant and are unsure of what to do, Tokyo English Life Line provides pregnancy counseling. Their counselors can advise you both about childbirth in Japan, and about abortion.

Pregnancy Services and Support
Because Japan has such a low birthrate, the government takes all kinds of measures to assist pregnant women and encourage childbearing. There are a dizzying number of services and programs for pregnant mothers and new parents. However, doctor visits and delivery are not covered by National Health Insurance unless there are medical complications.

When you have the pregnancy confirmed at a medical facility, your doctor will issue you a certificate. Take this certificate to City Hall and complete "pregnancy registration" (ninshin todoke 妊娠届) at the Urasoe Health Counseling Center (see Counseling section above). You will then be given a Mother & Child Health Handbook (boshi kenkō techō 母子健康手帳). With this you will be entitled to two free prenatal check-ups. However, it is usual to visit the doctor once a month, and you will have to pay for some visits out of pocket. Each time you visit the medical center, updated information will be written in the handbook and it will become a record of your pregnancy and child's development.

If you are pregnant, you are entitled to unpaid maternity leave from 42 days before your due date until 56 days after the delivery. National Health Insurance will reimburse you for 60% of your standard remuneration during this time. To receive this payment, you must fill out an application (kenkō hoken shussan teatekin seikyū-sho 健康保険出産手当金請求書) at the Social Insurance Office (see Health Insurance section). Applications are generally filed after the applicant returns to work, because the Social Insurance Office requires that the workplace confirm the dates of leave.

National Health Insurance will also award a one-time fixed payment of ¥350,000 (shussan ikuji ichijikin 出産育児一時金)for each child born. To apply for this payment, visit the National Health Insurance Section on the first floor of City Hall.

Infant Services and Support
Infants aged 3-4 months and 9-10 months are entitled to free medical check-ups at the Health Counseling Center. Contact the center for dates and times.

Polio and tuberculosis vaccinations for children are also provided free by the Health Counseling Center. Other standard vaccinations are also free, but you must visit a designated medical provider in Urasoe. The Health Counseling Center can provide you with a list of designated medical providers.

Health Insurance

Health Insurance is mandatory for anyone living in Japan for more than one year. If you or someone in your family has a full-time job, you will likely be enrolled in an insurance plan through that employer, in which case premiums will be deducted from your pay. If you do not have a plan through an employer, you must sign up for National Public Health Insurance on your own. To sign up, please visit the National Health Insurance Section of City Hall.

National Public Health Insurance (Kokumin Kenkō Hoken 国民健康保険)

National Health Insurance Procedures
Like your Alien Registration, your health insurance information needs to be kept up-to-date. Please visit City Hall to complete the appropriate procedures if:

• You need to enroll in National Health Insurance or switch your enrollment to Urasoe.
• You need to cancel your policy due to an upcoming move or because you will get other insurance.
• Your name, address, or number of dependents changes.
• Your Health Insurance Card is lost or damaged.

Health Insurance Enrollment and Premiums
Once you are enrolled in health insurance, you will receive one Health Insurance Card (Hoken-sho 保険証) for your whole household. This card must be presented when applying for medical treatment, or insurance coverage will not apply.

If health insurance premiums are not deducted automatically from your pay, you will also receive an insurance payment statement (hoken-ryō nōfusho 保険料納付書). Using this statement, you can pay your premiums at post offices or City Hall.

Benefits
National Health Insurance covers 70% of policyholders' and dependents' care in case of injury or illness. If you present your health insurance card when you visit the doctor, you will be charged 30% of total costs when you leave. National Health Insurance does not cover regular health check-ups, vaccinations, cosmetic surgery, or normal pregnancy. Policies offered through employers are generally similar.

In some cases, you can visit the National Health Insurance Section to be reimbursed for out-of-pocket costs. You can do this if:

• You had a medical emergency and thus were unable to present your insurance card at the hospital.
• Your medical costs for one month exceeded a certain limit. The limit depends on your age and income level, so please consult the National Health Insurance Section for further details.
• You purchased a corset or brace on the orders of your doctor.
• You had massage, acupuncture, or moxibustion therapy at your doctor's orders.
• You had a blood transfusion.

Social Welfare

For the Disabled

There are several different kinds of financial support for physically and mentally disabled people and their families. Please contact the Welfare Section for more information. The organizations listed below may also be helpful.

Aozora Support Center for the Mentally Handicapped
(Seikatsu Shien Center Aozora 生活支援センターあおぞら)
1-1-2 Nakama, Urasoe
Telephone: (098) 879-6644

This facility offers recreational space and counseling for people with mental handicaps and their families.

Urasoe Physically Disabled Welfare Association
(Urasoe-shi Shintai Shōgai-sha Fukushi Kyōkai 浦添市身体障害者福祉協会)
Located in the Urasoe Welfare Plaza (Urasoe Fukushi Plaza 浦添福祉プラザ)
234-1 Ahacha, Urasoe 901-2114
Telephone: (098) 879-7565

For the Elderly

If you are taking care of an elderly family member at home, there are quite a few support services offered by the city, such as financial assistance and instruction in home-nursing techniques.

If you are an elderly person living alone or with other elderly people, there are many services available to you as well. These include financial aid, grocery and meal delivery, laundry service, and others. Please consult with the Welfare Section if you have questions. The two organizations listed below also provide many enrichment programs for the elderly.

Social Welfare Center
(Shakai Fukushi Center 社会福祉センター)
1281 Nakama, Urasoe City

Elderly Welfare Center
(Rojin Fukushi Center 老人福祉センター)
1-1-2 Ahacha, Urasoe City
(Located in the Central Community Center
(Chūō Kōminkan 中央公民館))
Telephone: (098) 879-5501