TOKYO, Japan Wire - A tourism promotion body in Osaka is joining the prefectural government in efforts to increase awareness of a travel insurance policy to help tackle the issue of foreign visitors leaving medical facilities with unpaid bills.
The number of foreign visitors to Osaka Prefecture, in western Japan, reached a record high of 17.6 million in 2025, boosted by attendance at the World Exposition held between April and October, according to data published by the Osaka Convention & Tourism Bureau.
Amid the record numbers, the bureau said that cases of foreign tourists seeking medical treatment during their stay and leaving Japan without paying their bills remain a challenge for medical facilities across the prefecture.
According to an Osaka prefectural government survey with responses from 285 medical institutions, visiting foreigners who received medical treatment in the prefecture in fiscal 2024 left with over 71.9 million yen ($454,000) in unpaid bills.
Medical institutions cited weaknesses in systems facilitating the collection of payments as the largest contributing factor to the outstanding bills. The second most frequently cited factor was a lack of confirmation or communication of costs prior to emergency treatment.
In guidance on how to handle foreign patients at reception, the Ministry of Health, Labour and Welfare stresses the need for staff to present foreign patients with an estimate of treatment costs -- something it says is standard practice overseas but relatively uncommon in Japan.
In an effort to address the issue of unpaid bills, the Osaka Convention & Tourism Bureau and Osaka Prefecture announced in April plans to strengthen information and guidance on Japan Travel Insurance, an insurance policy targeting foreign visitors offered by Tokio Marine & Nichido Fire Insurance Co., which has a partnership with the prefecture.
From May, around 90,000 flyers detailing the policy’s coverage in English, Korean, and Chinese will be distributed at Kansai International Airport, tourist information centers, and hotels, among other locations in Osaka.
The insurance covers medical and repatriation costs of up to 10 million yen and can be purchased by visitors even after they arrive in Japan, with coverage starting from 800 yen for one day.
Travelers who purchase the insurance via a QR code on the flyers can get a discount on the Osaka e-Pass, which offers free entry to select attractions in the city.
The issue of foreign tourists receiving medical treatment in Japan and leaving without paying the fees is impacting medical facilities nationwide.
According to a health ministry survey, around 16 percent of medical institutions which treated foreign residents and visitors in September 2024 saw medical bills go unpaid. Charges left unpaid by visiting foreigners exceeded 60 million yen.
The survey covered around 5,500 medical institutions across Japan, with over 52 percent having treated foreigners.
Under current measures to tackle the issue, the health ministry shares information on foreign visitors with significant unpaid medical bills with the Immigration Services Agency, enabling stricter entry screenings should they return to Japan.
This article was submitted by a contributing writer for publication on Japan Wire.
