Japan is implementing stricter immigration controls targeting foreign visitors who leave medical bills unpaid, a move that could affect future entry procedures for all international travelers, including expats with family visiting from abroad. According to NHK, the government announced on November 26, 2025, that it will lower the threshold for sharing unpaid medical fee information with the Immigration Services Agency from the current 200,000 yen to a significantly reduced amount, though the exact new threshold has not yet been finalized. The policy change represents a significant shift in how Japan handles the persistent problem of unpaid medical expenses by foreign visitors. Under the new system, hospitals and medical institutions will report unpaid bills exceeding the new threshold to immigration authorities, who will then use this information during visa application reviews and entry screening processes. This means foreign nationals with outstanding medical debts could face stricter scrutiny or potential denial of entry on subsequent visits to Japan. For expats living in Japan, this development has important implications when hosting family members or friends from abroad. Visitors should be strongly advised to secure comprehensive travel insurance before arriving in Japan, as medical costs can escalate quickly without coverage. A single emergency room visit or hospital stay could easily exceed any reasonable threshold, potentially affecting future travel plans to Japan. The timing of this announcement coincides with broader tensions affecting international travel to Japan. According to separate NHK reporting from the same date, New Chitose Airport in Hokkaido is experiencing significant disruptions to Chinese flight routes. The airport operator estimates that approximately 30,000 to 40,000 fewer Chinese visitors will be able to travel to Japan due to flight cancellations and reductions, following the Chinese government's advisory for its citizens to exercise caution when traveling to Japan. These travel advisories appear connected to concerns about crimes targeting Chinese nationals in Japan, as reported by Livedoor News. The Chinese government has expressed concern about what it characterizes as multiple incidents affecting Chinese citizens in Japan, though specific details about the nature and frequency of these incidents remain limited in available reporting. The convergence of stricter medical fee enforcement and reduced Chinese tourism highlights the evolving landscape of international travel and immigration policy in Japan. For the expat community, these changes underscore the importance of understanding Japan's healthcare system and ensuring that visitors are properly prepared for potential medical needs. Experts recommend that expats advise their visitors to purchase travel insurance policies that specifically cover medical expenses in Japan, where healthcare costs can be substantially higher than in many other countries. Even routine medical care without insurance can result in bills reaching or exceeding 200,000 yen, and emergency procedures or hospital stays can cost significantly more. The government has not yet announced when the new medical fee reporting threshold will take effect, but the policy signals a clear intention to address the financial burden that unpaid medical bills place on Japanese healthcare institutions. Immigration authorities will likely integrate this information into their existing screening processes, which already consider factors such as visa history, purpose of visit, and financial stability. For expats planning to invite family or friends to Japan, proactive communication about travel insurance requirements is now more critical than ever. While the policy primarily targets visitors rather than residents, understanding these changes helps ensure that guests can enter Japan smoothly and avoid complications that could affect future travel opportunities. As Japan continues to balance welcoming international visitors with managing practical concerns like unpaid medical expenses, staying informed about immigration policy changes remains essential for the foreign resident community.