Japan to Revamp Entry Rules for Tourists: What's Changing
As visitor numbers to Japan soar, so do the headaches. But despite a target of 60 million tourists a year by 2030, authorities aren't afraid of adding a few hoops. The government's betting visitors will come anyway.
Japan has outlined plans which will require all incoming tourists to have private health insurance. The move aims to curb a growing problem: foreign visitors receiving medical treatment and leaving the country without paying.
The proposed rules, expected to be included in the government's next economic policy package, are part of a broader overhaul of how Japan manages foreign tourists.
The health ministry says the goal is to ensure that all visitors can cover unexpected medical expenses, similar to existing rules in places like the Schengen area, the UAE, Turkey, Morocco and Jordan.
What Does This Entail?
Officials have said the new immigration and residency rules could eventually tie visa renewals to proof of insurance and tax compliance. Defaulters may also be barred from re-entry.
Under the proposed system:
Tourists without proof of insurance may be denied entry.
Immigration officers could access a list of past medical debt defaulters.
Visitors with unpaid medical bills may be barred from re-entering the country.
Hospitals could report outstanding charges to immigration authorities.
The policy shift follows growing concern among hospital administrators and policymakers about the financial strain on Japan's healthcare system. Medical institutions are increasingly unable to recover costs when uninsured tourists leave without paying.
However, it's not yet clear when the plan will roll out or what it will look like in practice.
The Strain on Healthcare
Japan saw a record 36.8 million visitors in 2024, the government hopes to receive 60 million tourists annually by 2030. But the influx has brought new challenges, especially for urban hospitals seeing higher volumes of emergency care requests from non-residents.
In September 2024 alone, more than 11,000 foreign visitors received medical treatment at around 5,500 hospitals nationwide. According to the health ministry, about 0.8% of those patients, roughly 90 people, left without paying their bills, resulting in more than JPY61 million ($425,000) in unpaid charges.
A separate survey by the Japan Tourism Agency, conducted between October 2023 and February 2024, found that nearly 30% of foreign visitors to Japan did not have insurance.
The trend is not new. In fiscal 2022, nearly 30% of surveyed medical institutions reported cases of unpaid bills from foreign patients, including both short-term tourists and long-term residents. That year, unpaid charges from non-Japanese patients totaled about $5.63 million — 1.4% of all unpaid medical fees in Japan.
Hospitals currently have limited options for recovering payments once a visitor leaves the country. Collecting from overseas patients is often impossible without upfront insurance coverage.
Foreign Residents Also Under Scrutiny
The focus isn't only on tourists. Foreign residents are also facing more pressure to contribute to Japan's National Health Insurance (NHI) system.
A government survey of 150 municipalities, conducted between April and December 2024, found that only 63% of eligible non-Japanese residents were enrolled in NHI, this is far below the 93% participation rate among Japanese citizens.
Some Other Changes for Tourists
In a related move, Japan is will also be revising its tax-free shopping program. Starting Nov. 1, 2026, visitors will pay the standard 10% consumption tax at the time of purchase and apply for a refund before departure. This will replace the current point-of-sale exemption system.
Additionally, from April 1 this year, purchases sent abroad via international parcel delivery will no longer qualify for tax exemption. Tourists will be required to present the tax-free items at customs during customs examination if requested.
Earlier this year, Japan also announced that the country's electronic travel authorization system will be implemented earlier than the initial target of 2030. The Japanese Electronic System for Travel Authorization would be applicable for travelers from 71 visa-exempt countries, including the U.S., U.K., Australia, Canada, Singapore, and France.
Latest Tourism Figures
Japan's tourism numbers continue to rise. In April 2025, the number of foreign visitors reached a record 3.91 million, up 28.5% from a year earlier, according to the Japan National Tourism Organization.
The cherry blossom season and the timing of Easter holidays contributed to the surge, with increased demand from Asia, Europe, the United States and Australia, JNTO said. The previous single-month record was 3.78 million in January 2025.
In the first four months of 2025, Japan welcomed 14.4 million visitors — a 24.5% increase year over year.
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Attackers laid siege to Predjama on numerous occasions, but a secret passageway (that still exists today) allowed the defenders to come and go at will. Located 62 kilometers (38 miles) from Ljubljana, the castle and its park-like grounds host the Erasmus Knight's Tournament, a medieval festival and jousting competition staged every July. This island bastion overlooking the Bay of Naples is the oldest castle on our list, tracing its roots to the 5th century BC when Greeks colonized the region. From Roman legionnaires to Napoleon's troops, many armies have occupied Aragonese over the years. The castle now belongs to the family of an Italian lawyer who purchased the fortified island in 1912 and began restoration of its battlements, churches, convents, crypts and gardens. In addition to views that stretch all the way across the bay to Mount Vesuvius, Aragonese Castle boasts outdoor cafes, a bookshop, art exhibits and outdoor movies. Prague's imposing citadel is also one of the few castles anywhere in the world that still boasts real political power — the official residence of the president of the Czech Republic. Among the other landmarks inside its spacious confines are St Vitus Cathedral, the Old Royal Palace, 10 gardens and a row of 16th-century cottages called the Golden Lane that once housed the castle guards. Guided tours, offered during daylight and evening hours, last around three hours. Reportedly damaged during Syria's recently ended civil war, Krak des Chevaliers remains one of the world's great castles — and the only one on our list that has experienced 21st-century conflict. Created in the 12th century by the Knights of St. John, the celebrated Krak is considered the epitome of a crusader castle in the Middle East and one of the greatest statements of medieval military architecture. The structure features two mighty walls separated by a moat on a steep hillside between Homs and the Mediterranean Sea. It's hoped that the end to the fighting in Syria will enable restoration and repair work. This article was first published in 2019. It was updated and republished in June 2025
