Many expatriates with kids look for housing that is relatively close to the nearest school, kindergarten, or nursery. While there are lots of day care options and schools in Japan, the language barrier may be a problem.
Japanese parents with pre-school kids can have their children looked after by a babysitting agency. A local child care center (hoikuen) or a nanny service taking care of infants and toddlers at home (affectionately called hoiku mama) is another valid option.
However, public child care facilities tend to be Japanese-only. Therefore, expat parents often fall back on private day care services, bilingual nannies recommended by other expats, and the many independent kindergartens and pre-schools in the Tokyo-Yokohama region. The latter have several language options, especially for English-speaking children.
The language barrier is also the main reason why most expat children do not attend a Japanese school. Legally speaking, non-Japanese students have the right to receive extra Japanese lessons at any public school in Japan.
Since the lack of Japanese skills may still lead to difficulties and isolation, though, most expats prefer sending their kids to a private international school. These also have the distinct advantage that they may include pre-schools, day care services or after-school facilities for younger kids under the same roof. Unfortunately, they are often rather expensive.
In the Greater Tokyo Area, there are international schools catering to the US American, British, Canadian, Chinese, French, German, Indian, and Korean communities. Some of them also offer the International Baccalaureate. Please refer to our article on living in Tokyo for more information.
The international schools in the Kansai Region (Kyōto – Kōbe – Ôsaka) are mostly English-language institutions. In the Nagoya-Aichi area, there are also some international schools with English as their main language of instruction.
Here are some links to selected international schools in Japan:
The quality standards of medical care in Japan are very high. Moreover, the country has a public healthcare plan for all Japanese nationals, as well as for resident non-citizens and long-term visitors. Individuals have to enroll in one of three coverage options, depending on their type of employment and age. Coverage is provided by the Social Health Insurance (large companies), or the National Health Insurance which includes the Japanese Health Insurance Association (if employed by small- or medium-sized companies) and the municipal-run Citizens Health Insurance (for the unemployed or self-employed). Your insurance contributions are deducted directly from your salary, or you must remember to pay the NHI tax on a regular basis.
The NHI is also available for non-Japanese residents staying in Japan for a minimum period of 3 months (no visitor visa or short-term visa holders).
With regards to clinics and hospital costs both SHI and NHI patients are required to pay 30% of the total cost.
If you have private medical insurance, you may have to pay on the spot and file a reimbursement claim with your insurance company later. Some healthcare providers, however, do have direct billing services with some hospitals.
Various medical treatments are not included with the SHI or NHI at all, e.g. plenty of pre-natal care, deliveries and pregnancy terminations, voluntary vaccinations, orthodontics, health check-up exams, etc. Therefore, many expats take out an additional medical insurance from a private provider during their expat assignment.
While medical standards are indeed high, the language barrier is again a considerable problem. When going to see a doctor or visiting a clinic for primary care or a hospital for more serious illnesses, you should therefore not only bring your health insurance card, but also ask an interpreter to accompany you.
If you would like to avoid that hassle, ask your nearest embassy or consulate (or the PTA members at your kid’s international school) for recommendations of bilingual medical staff or check out the information on “Medical Facilities with English or Other Language-Speaking Staff” provided by the Japan National Tourism Organization
In the Greater Tokyo Area, you can also call the Tokyo Metropolitan Health and Medical Information Center for general information on medical services and referrals (03-5285-8181) from 09:00 to 20:00. Under the number 03-5285-8185, the center offers an emergency translation service for medical purposes, too.
Nonetheless, it is a good idea to always carry some Japanese-language emergency information or your medical history with you.
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