What to Bring to the ER

What to bring to the ER in Japan is a short ordered set: insurance proof, identity proof, your medication record, prior results when time permits, a charged phone, and payment means for the discharge bill.¹² In a true emergency, skip the list and get transport first; the crew gathers information on the way and the hospital sorts the rest after stabilization.

Confirm current details with official sources

Procedures, fees, and requirements can change. Confirm current details at the Ministry of Health, Labour and Welfare (MHLW) site and the Digital Agency site.

Overview

This checklist covers emergency hospital arrivals nationwide for insured residents, with notes for gap-coverage arrivals holding private insurance instead.¹ It follows the standard counter flow: show proof, get seen, pay at the billing counter on the way out.¹

Work the table in order. Insurance proof comes first because every later step prices from it. The medication record comes before the phone because the phone is the device that carries the record's app form.³⁴

Order	Item	Bring	Source
1	Insurance proof	Registered My Number Card or Eligibility Confirmation Form	3
2	Identity proof	Residence card or other official photo ID	2
3	Medication record	Medication notebook, paper or app	4
4	Prior records	Imaging, test results, medical certificate when held	1
5	Language help	Charged phone with translation app, or a companion	56
6	At the counter	Cash and a credit card for the discharge bill	12

The table above reflects the counter flow described by hospital first-visit guides as a whole.¹²

The diagram shows the reception to pharmacy sequence the checklist supports. Each row in the table maps to one step in that flow.¹

Insurance proof at the ER counter

The マイナ保険証 (maina hokenshō, "health-insurance-use-registered My Number Card") is now the standard item to show at hospitals and pharmacies.³ Staff verify qualification with a card reader instead of a plastic card. You show either this linked card or the 資格確認書 (shikaku kakuninsho, "Eligibility Confirmation Form") and receive insured care at the same copay ratio as before.³

Registration for health-insurance use is a one-time step through Mynaportal, a Seven Bank ATM, or the reader at a medical institution or pharmacy.³ Once the card shows as registered, it keeps working across moves and job changes without waiting for a new plastic card, as long as enrollment with the new insurer is complete.³

Former-style cards expired on 2025-12-01, and from 2025-12-02 the base mechanism is the registered My Number Card or the Eligibility Confirmation Form.³ A large-hospital international-patient page instructs residents to present the My Number Card or health insurance card at reception.²

Identity proof

Hospitals verify patient identity at registration and accept official photo ID such as a My Number card, health insurance card, driver's license, passport, or residence card.² Bring one identity document alongside insurance proof even when nothing in the referral paperwork names it. The exact ID asked for depends on the facility, so a hospital request does not prove every ER counter asks the same way.

Residence card as identity proof

The 在留カード (zairyū kādo, "residence card") functions as identity proof in this flow.² It does not substitute for insurance proof. Carry both when both exist.

Medication record and prior records

The medication book first

The お薬手帳 (okusuri techō, "medication notebook") is the single most useful item for anyone taking chronic medication.⁴ It is a free paper booklet or smartphone app in which every visited pharmacy logs drug name, dose, and date.⁴ Any licensed dispensing pharmacy can read and add to it, not only the issuing one.⁴

Before dispensing, the pharmacist checks the notebook for interactions with current drugs, duplicate prescriptions from different doctors, and noted allergies or reactions.⁴ In an ER that history hands over instantly without relying on memory or translation, which is why the booklet belongs on every emergency checklist, not only on routine refill errands.⁴

Bring the same booklet to every counter

Bring the medication notebook to every pharmacy and every new consultation, not only the one that issued it. A team at an unfamiliar counter reads the shared history instead of reconstructing it by interview.⁴

Prior records and imaging when time permits

Bring relevant prior records alongside the notebook when there is time to gather them. A national hospital instructs first-visit patients to bring the referral letter plus X-ray films or CDs and the medicine pocketbook, and to bring any medical certificate held.¹

No referral letter is expected in an emergency arrival. The three-month referral validity rule at large hospitals governs planned first visits, and it appears here only so readers do not delay urgent care over paperwork they do not need.¹

Phone and language preparation

English availability depends on the individual facility, not on a national standard. Where no English support exists, the working fallback is a translation app on a charged phone plus a written symptom note, or a Japanese-speaking companion.⁵⁶

Tokyo's Himawari service gives free phone consultation and institution information in English, Chinese, Korean, Thai, and Spanish, daily 09:00 to 20:00 year round, at 03-5285-8181 (as of 2023-01-01; confirm current hours with the Tokyo Metropolitan Government).⁵ Call charges fall on the caller.⁵ Outside Tokyo, coverage and hours vary by prefecture, so confirm the local equivalent before relying on it.

The AMDA International Medical Information Center provides telephone services in several languages, introduces facilities with staff who speak the patient's language, and explains the health-care system.⁶ Its Tokyo center takes calls at 03-5285-8088 and its Kansai center at 06-4395-0555.⁶

Charge the phone before leaving for the hospital

The medication app and the translation app live on the same device. An uncharged phone removes both at once, so charge before leaving and carry a cable or battery where possible.

Payment at discharge

Hospital flow runs from registration to consultation to a billing counter, where the calculated bill is paid at an automated payment machine.¹ The bill is settled at discharge, not prepaid. Carry both cash and a credit card, since accepted payment methods vary by facility.²

Insured residents pay their coinsurance share at the counter while uninsured patients pay the full amount. An international-patient hospital guide treats non-resident consultations as self-funded and notes that hospitalization or surgery may require a deposit equal to the estimated cost.² The detailed cost split belongs to a separate cost guide; the point here is that payment means ride along on the checklist.¹²

When it is a true emergency: bring nothing

In an immediate emergency, bring nothing and get transport first. Practitioner guidance describes the crew gathering information en route while the hospital sorts identity verification and billing after stabilization, though no fetched ambulance protocol confirms the exact sequence.¹

Carrying the registered My Number Card when it is already on the person still helps: emergency-transport demonstration projects use the card to pull medical, drug, and checkup information quickly.³ That is a reason to keep the card in the wallet daily, never a reason to delay transport to search for it.³

Good to know

Forgetting insurance proof means full payment first

Without verified insurance on the day, the patient pays the full amount at the counter and claims reimbursement later, which adds paperwork and waiting time (limitation: reimbursement mechanics vary by insurer).¹² Leaving the card unregistered produces the same result as forgetting it.³

A separate habit prevents most cases. Keep the registered My Number Card or the Confirmation Form with the identity document, and check the link status in Mynaportal after any job change or move.³

A dead phone removes both the medication app and the translator

The booklet's app form and the translation fallback both assume a working phone.⁴ A dead battery therefore removes the medication history and the interpreter at the same time. Charge before leaving and keep the paper booklet as backup where the app is the daily default.

Overseas records help only when the receiving doctor can read them

Hospital intake asks for films, CDs, and certificates without promising interpretation of foreign-language documents.¹ Bring the originals plus any Japanese translation held, and keep the medicine pocketbook alongside them.¹⁴

See also

• What to Bring to a Doctor's Visit
• The Medication Record Book (Okusuri Techo)
• Maina-Hokensho: Health Insurance Card Going Digital
• Finding an English-Speaking Provider
• Calling 119: When and How
• What an ER Visit Actually Costs in Japan

References

Footnotes

1. Center Hospital of the National Center for Global Health and Medicine (NCGM). "For First-Time Patients." https://www.hosp.jihs.go.jp/en/outpatient/020/index.html ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹ ↩¹² ↩¹³ ↩¹⁴ ↩¹⁵

2. NTT Medical Center Tokyo. "Guide for International Patients." https://www.nmct.ntt-east.co.jp/en/guide/first/foreigner/ ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹

3. Digital Agency, Government of Japan. "Use of health insurance card in My Number Card." English page, last updated 2026-02-19. https://www.digital.go.jp/en/policies/mynumber/insurance-card ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰ ↩¹¹

4. TokyoPharmacies. "What Is an Okusuri Techo, and Why Keep One in Japan?" Last reviewed 2026-07-24. https://tokyopharmacies.com/articles/okusuri-techo-medication-notebook ↩ ↩² ↩³ ↩⁴ ↩⁵ ↩⁶ ↩⁷ ↩⁸ ↩⁹ ↩¹⁰

5. Tokyo Metropolitan Government, Bureau of Public Health and Medical Care. "Medical information service for foreign patients (Himawari)." Page updated 2023-01-01. https://www.hokeniryo.metro.tokyo.lg.jp/iryo/iryo_hoken/medical_info_eng/himawari ↩ ↩² ↩³ ↩⁴

6. AMDA (Association of Medical Doctors of Asia). "AMDA International Medical Information Center." https://en.amda.or.jp/index.php?page=page&page_id=0044 ↩ ↩² ↩³ ↩⁴