Does Japanese Health Insurance Cover Mental Health?
Yes, psychiatric care in Japan is covered by health insurance at the standard 30% cost-sharing for adults under 70, the same as any other medical visit. Counseling with a psychologist is the main exception: that is almost always paid out of pocket. For ongoing treatment, a national subsidy can cut your share from 30% to 10%.
What does insurance cover at a psychiatry clinic?
Doctor visits, diagnosis, medication, and monitoring tests. If you hold National Health Insurance (国民健康保険, kokumin kenko hoken) or employee health insurance (社会保険, shakai hoken), this applies at any insurance-accepting psychiatry clinic:
- First and follow-up consultations with the doctor
- Diagnosis and ongoing management of conditions such as depression, anxiety disorders, insomnia, ADHD, and bipolar disorder
- Prescribed medication, at the same 30% cost-sharing at the pharmacy
- Blood tests used to monitor your treatment
Nationality is irrelevant: if you are enrolled, your coverage is identical to a Japanese national's, and nearly everyone living in Japan longer than three months is required to enroll. At each visit, show your My Number card registered for health insurance (マイナ保険証, maina hokensho) or, if you do not use one, the eligibility certificate (資格確認書, shikaku kakuninsho) from your insurer; the old health insurance cards expired on December 1, 2025. Documents such as a medical certificate (診断書, shindansho) sit outside insurance and are charged separately by each clinic.
Why isn't counseling covered?
Because insurance pays only for the items on the national fee schedule, and a counseling session booked on its own is not one of them. Psychologists and counselors, including Certified Public Psychologists (公認心理師, konin shinrishi), are not physicians, and a session at a private counseling practice is self-pay. Insurance does cover some psychological support that a Certified Public Psychologist gives inside a medical institution on a doctor's instruction: an add-on to the psychiatrist's own consultation for certain conditions, introduced in 2024, and, from 2026, cognitive behavioral therapy delivered with a psychologist's support at certain institutions for listed conditions such as depression, panic disorder, and PTSD. These are specific items at specific clinics, so if you simply book a counselor, assume self-pay.
Some people use both at once: an insured psychiatrist for diagnosis and medication, plus a counselor for talk therapy.
How can you cut your share from 30% to 10%?
Through Jiritsu Shien Iryo (自立支援医療), a national subsidy for ongoing outpatient psychiatric treatment that reduces your cost-sharing for psychiatric visits and medication from 30% to 10% at the clinic and pharmacy listed on the certificate you receive, with an income-based monthly ceiling on top. Your psychiatrist writes the certificate and you apply at your city or ward office; the steps are in our Jiritsu Shien guide.
Are mental health costs tax deductible?
Mostly yes. Japan's medical expense deduction (医療費控除, iryohi kojo) covers physician-provided care and prescribed medication, and psychiatric treatment qualifies like any other medical care once your household's medical spending for the year passes the threshold. Fees paid to an independent counseling practice do not count. Keep your receipts; the details are in our tax deduction guide.
What if you have private or international insurance instead?
You may be able to claim reimbursement from your insurer instead. A clinic that operates outside the Japanese insurance system may issue itemized invoices you can submit to a private or expat insurer. Whether mental health is reimbursed depends on your policy, so read the mental health clause before assuming. If you are enrolled in Japanese insurance, using it is usually the simpler path for psychiatric care, with private coverage as a supplement, for example for counseling.
Frequently asked questions
This article is general information, not medical advice for your individual situation. If you're unwell, please see a doctor.
Medically reviewed by our psychiatrist (M.D.). Updated October 16, 2026.