Where the Transition Stands (May 2026)
Unifying Japan's health insurance system around the My Number Card represents one of the largest administrative shifts of the postwar era. New issuance of traditional health insurance cards stopped on December 2, 2024, and the one-year transitional period ended in December 2025. As of May 2026, the only options at clinic reception desks are the "My Number Health Card" or an "Eligibility Certificate."
Three Document Types
| Type | What It Is | Who Has It |
|---|---|---|
| My Number Health Card | My Number Card linked to health insurance status | Cardholders who have completed insurance registration |
| Eligibility Certificate (Shikaku Kakunin Sho) | Card or paper proof of insurance eligibility | Issued by insurer to those without My Number |
| Eligibility Information Notice | Paper reference only | Sent to all enrollees — not accepted at reception |
Critical: Old Cards No Longer Work
Issuance stopped December 2, 2024. Old cards remained usable through December 2025 under the transition. From January 2026, they are completely invalid.
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Try for free →Using a My Number Health Card
- Tap your card on the face-recognition reader
- Authenticate by face or 4-digit PIN
- Choose whether to share past prescription and health-checkup data
- Done
Benefits include automatic application of high-cost medical treatment limits, sharing of prescription history with doctors and pharmacists, and seamless transfers when changing jobs or moving.
Eligibility Certificate Details
Insurers automatically issue Eligibility Certificates to those without My Number Cards, those who haven't registered the card for insurance use, those whose digital certificates have expired, and seniors aged 75+ who request one. Validity is up to 5 years. Clinics cannot refuse care presented with an Eligibility Certificate.
Common Problems at Clinics
- Reader errors — chip damage, network issues, failed face recognition
- Forgotten PIN — three wrong attempts locks the card; municipal office reset required
- Expired digital certificate — must be renewed every 5 years
- Job change / move lag — new insurance status takes weeks to propagate
Impact on Foreign Residents
Foreign residents with mid-to-long-term status (special permanent residents, permanent residents, students, work visa holders) are eligible for the My Number Card. Those enrolled in Japanese health insurance must hold either a My Number Health Card or an Eligibility Certificate.
Tourists and short-term visitors are not in the system and rely on travel insurance.
Language barriers persist: most face-recognition readers operate only in Japanese. Foreign-resident community translation services and English-friendly clinics are recommended.
Impact on the Elderly
About 65% of those aged 75+ hold My Number Cards as of April 2026. The remainder use Eligibility Certificates. Cognitive decline, masks, and forgotten PINs make Certificates the practical choice for many seniors.
What Employers Should Do
- Confirm health insurance acquisition processes for new hires are accurate and timely
- Avoid lags in employment-end resignation processing
- Review status-switching flows for overseas-assigned and returning employees
What Individuals Should Do
My Number Health Card Users
- Check digital certificate expiration via My Number Portal
- Store your PIN in a password manager
- Verify insurance linking is complete
Eligibility Certificate Holders
- Check the certificate's expiration
- Contact your insurer immediately if lost
- Always carry it to medical appointments
Outlook
Through 2026–2027, expect continued integration of insurer back-office systems, broader rollout of electronic prescriptions linked to the My Number Health Card, and integration with the My Number Driver's License (operational since September 2025). Standardization of electronic medical records and Personal Health Record adoption are also under discussion.
Conclusion
As of May 2026, paper health insurance cards no longer exist in Japan. Foreign residents, the elderly, and those changing jobs face the highest practical risk and should verify their status proactively. If problems arise, municipal counters and insurer help desks are first stops; persistent issues may warrant consultation with an attorney experienced in administrative procedure or consumer matters.
