Summary: Japan stopped using the old paper health insurance card. Old cards expired on 1 December 2025, and the grace period that still let clinics accept them ended on 31 July 2026. Today you see a doctor with one of two things: your My Number Card registered as a health insurance card, or a paper Shikaku Kakuninsho (資格確認書, Health Insurance Eligibility Certificate). A third document, the Shikaku Joho no Oshirase (資格情報のお知らせ), looks similar but cannot be used on its own. This guide explains the difference, who gets which one, and what to do if nothing has arrived. Checked: 18 October 2026.
The three documents at a glance
| Name | Japanese | Who gets it | Can you see a doctor with it alone? |
|---|---|---|---|
| My Number Card (as health insurance card) | マイナ保険証 | People who registered their My Number Card for health insurance use | Yes |
| Health Insurance Eligibility Certificate | 資格確認書 (shikaku kakuninsho) | People who have not registered their My Number Card for health insurance (sent without applying) | Yes |
| Eligibility Notification of Health Insurance | 資格情報のお知らせ (shikaku joho no oshirase) | People who use the My Number Card for health insurance | No. Show it together with the card |
What is a Shikaku Kakuninsho?
The Shikaku Kakuninsho is a paper certificate that replaces the old health insurance card for people who do not use the My Number Card at the clinic. MHLW says it can be used in the same way as the old card: you hand it to reception, and you pay your normal share of the bill (30% for most people aged 6 to 69).
It is issued by your insurer, not by the national government. That means the sender depends on your insurance:
- Company health insurance (shakai hoken): your employer’s health insurance society (kenpo kumiai) or the Japan Health Insurance Association (Kyokai Kenpo). It usually comes through your employer.
- National Health Insurance (kokumin kenko hoken): your city or ward office.
- Late-stage elderly medical care (75 and over): the prefecture’s association, through your city office.
Each certificate has its own expiry date, set by the insurer. Many cities send a new National Health Insurance certificate every summer, so check the date printed on yours.
Who gets one automatically
According to MHLW, everyone who has not registered their My Number Card for health insurance gets a Shikaku Kakuninsho free of charge, without applying. This includes people who do not have a My Number Card at all.
If you did register your card, you receive the Shikaku Joho no Oshirase instead. You can still ask your insurer for a Shikaku Kakuninsho if using the card is hard for you, for example because of a disability or because you need someone else to go to the clinic for you. Ask your insurer for its application form (shikaku kakuninsho kofu shinseisho).
The Oshirase is not a certificate
The Shikaku Joho no Oshirase is a letter or card-sized slip that shows your insurer number and insured person number. MHLW describes it as a backup: if the clinic’s card reader cannot read your My Number Card, you show the Oshirase (or the same details in the Mynaportal app) together with your card, so the clinic can confirm your insurance.
City notices for August 2026 repeat the same point: from August, you see a doctor with the new Shikaku Kakuninsho or the My Number Card, and the Oshirase is used together with the card. Keep the Oshirase at home or in your wallet, but do not rely on it alone.
No Kakuninsho in the mail: what to do
- Check whether your My Number Card is registered for health insurance. Log in to the Mynaportal app and look at your health insurance information. If it is registered, you will not get a Kakuninsho unless you apply. Use the card.
- Work out who your insurer is. If you work for a company and it enrolled you in its insurance, ask your employer’s HR or payroll staff. If you are on National Health Insurance, contact your city or ward office.
- Ask when it was sent. Certificates go to your registered address. If you moved, check that your address is up to date with both the city office and your employer.
- Ask for a reissue if it was lost. Insurers reissue lost certificates. Ask for their form.
If you just changed jobs, there is a gap of a few days to a few weeks while your new employer enrols you and the insurer sends the certificate. Ask the new employer when it will arrive. If there are days between the old job and the new one with no company insurance, you need National Health Insurance for that gap. Our guide on National Health Insurance bills explains the options after leaving a job.
If you need a doctor before it arrives
Do not skip care because the paper has not arrived. Tell reception that you are insured but your certificate is on its way, and show your residence card and any letter from your employer or city office. Clinics handle this case in different ways.
If the clinic cannot confirm your insurance, it may ask you to pay the full cost (100%). Keep the receipt. Later, you can apply to your insurer to get back the part insurance would have paid. This claim is called ryoyohi (療養費). The form, the documents and the time limit are set by your insurer, so ask them.
For where to go and what to bring on the day, see Seeing a doctor in Japan.
At the clinic: what to show
- With a Shikaku Kakuninsho: hand it to reception, as with the old card.
- With a registered My Number Card: put the card on the face-recognition card reader and confirm with your face or your 4-digit PIN. Bring the card itself; some clinics and pharmacies also accept a smartphone set up as a health insurance card, but not all do.
- If the reader fails: show the Oshirase or the Mynaportal screen with your card. If you cannot show either, MHLW says a clinic you have visited before can confirm your details verbally, and a new clinic can ask you to fill in a self-declaration form (hihokensha shikaku moshitatesho).
Checklist
- Find out whether your My Number Card is registered for health insurance (Mynaportal).
- If it is not, find the Shikaku Kakuninsho in your mail and check its expiry date.
- If it is, keep the Oshirase with your card.
- If nothing arrived, ask your employer (company insurance) or city office (National Health Insurance).
- Keep your My Number Card valid. Its electronic certificate and the card itself have expiry dates; see When does your My Number card expire?
FAQ
Can I still use my old paper health insurance card?
No. Old cards expired on 1 December 2025 at the latest. A temporary measure let clinics accept them until 31 July 2026, and that measure has ended.
Do I have to pay for a Shikaku Kakuninsho?
No. MHLW says it is issued free of charge to people who do not use the My Number Card for health insurance.
My residence card and My Number Card expire soon. Does that matter?
Your health insurance itself does not depend on the card, but an expired My Number Card cannot be used at the card reader. If your period of stay is extended, update your My Number Card at the city office too. See Extending your period of stay.
Can family members use my certificate?
No. Each insured person, including dependants, has their own certificate or registered My Number Card.
Related reading
- Seeing a doctor in Japan: clinic or hospital, what to bring, and the 7,000-yen no-referral fee
- National Health Insurance bill in Japan: how to read it
Sources
- 資格確認書について (About the eligibility certificate) – MHLW (Japanese, PDF)
- Using your My Number Card as a health insurance card – MHLW (English, PDF)
- Notice on the August 2026 certificates – Hiroshima City (Japanese)
This article explains procedures. It is not medical or legal advice. For your own case, ask your insurer or city office.
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