This is a translation of the Japanese original. The Japanese version is authoritative; figures follow Japanese tax law.
On 31 July 2026 the health insurance cards used until then stopped working. From August you see a doctor with either a My Number Card health insurance (Myna health insurance card) or the Eligibility Certificate (資格確認書) sent to you by your insurer. Enquiries are rising at National Health Insurance, the Japan Health Insurance Association and the Latter-Stage Elderly Medical Care System alike: "my family received one but I did not", "what is this piece of paper for", "there is an expiry date on it, so what happens when it passes". This article sorts out who does and does not receive an Eligibility Certificate, the expiry dates, the cases where you can apply even though you hold a Myna health insurance card, and what to do when nothing arrives, drawing on the guidance from the Ministry of Health, Labour and Welfare (MHLW), the Japan Health Insurance Association, the regional unions and the municipalities.
The short answer: it goes to people who do not have, or do not use, a Myna health insurance card. Those who have one receive a different sheet of paper
| Your situation | What arrives | How you see a doctor |
|---|---|---|
| You do not have a My Number Card | Eligibility Certificate (no application; issued automatically without application) | Hand the Eligibility Certificate in at the reception desk (just as with the old insurance card) |
| You have the card but have not registered it for health insurance use | Eligibility Certificate (no application) | As above |
| You have registered a Myna health insurance card | Notice of Insurance Eligibility Information (a single sheet) | Hold the Myna health insurance card over the card reader. At a medical institution with no reader, show the card together with the Notice |
| On the Latter-Stage Elderly Medical Care System (75 or over) and aged 85 or over | Eligibility Certificate (everyone, registered or not) | Either the Eligibility Certificate or the Myna health insurance card |
| On the Latter-Stage Elderly Medical Care System, 84 or under, and not a regular user of a Myna health insurance card | Eligibility Certificate | As above |
| You have a Myna health insurance card but cannot use it because you need assistance, have lost the card, are waiting for a renewal, and so on | Eligibility Certificate on application | Hand the Eligibility Certificate in |
The MHLW defines those who receive an Eligibility Certificate as "people who have not obtained a My Number Card" and "people who have obtained a My Number Card but have not registered it for health insurance use", and it ran an interim measure under which everyone on the Latter-Stage Elderly Medical Care System received one until the end of July 2026[MHLW]. From August that interim measure has ended, and whether you receive an Eligibility Certificate or a Notice of Insurance Eligibility Information now depends on whether you have registered and how you use it. Nothing arriving does not mean you have become uninsured: your eligibility itself continues for as long as you pay your premiums.
Expiry: 31 July 2027 for National Health Insurance and the Latter-Stage Elderly system; printed on the certificate for the Japan Health Insurance Association (up to five years)
| Insurance you are on | When the Eligibility Certificate is sent | Expiry | Renewal |
|---|---|---|---|
| National Health Insurance (municipality) | Mid to late July 2026 (each municipality decides; Utsunomiya posted them on 15 July) | 31 July 2027 (can be shorter because of a 70th or 75th birthday or the expiry of a residence status) | Renewed automatically and posted every July |
| Latter-Stage Elderly Medical Care System (75 or over) | Before the current Eligibility Certificate expires | 31 July 2027 at the latest | Renewed automatically every July |
| Japan Health Insurance Association (employees of small and medium-sized companies) | Issued through your employer | Printed on the certificate (set by the Association; up to five years) | Renewed automatically or on application before it expires |
| Health insurance societies and mutual aid associations | Depends on the society | Set by the society | As the society advises |
The City of Utsunomiya says that on 15 July it posted Eligibility Certificates to people with no Myna health insurance card registration as of 26 June 2026 and Notices of Insurance Eligibility Information to those already registered, and that the Eligibility Certificates expire on 31 July 2027[City of Utsunomiya]. The Tokyo Metropolitan Latter-Stage Elderly Medical Care Regional Union issues Eligibility Certificates to everyone aged 85 or over and to those aged 84 or under who do not use a Myna health insurance card regularly (people without six or more uses in the past year and at least one use in the past three months), and a Notice of Insurance Eligibility Information to everyone else, with an expiry of 31 July 2027 at the latest[Tokyo regional union]. For the Japan Health Insurance Association, "the expiry date is set by the Association, and the date set is printed on the Eligibility Certificate", up to a maximum of five years[JHIA].
For National Health Insurance and the Latter-Stage Elderly Medical Care System, a new Eligibility Certificate is posted automatically before the current one expires unless you register a Myna health insurance card. No application is needed. It will not reach you if you have not reported a change of address, so if you have moved, check that you filed the change of residence and a forwarding request with the post office.
The Notice of Insurance Eligibility Information is not a substitute for an insurance card. It is the paper you carry with the card
What reaches people who have registered a Myna health insurance card is a "Notice of Insurance Eligibility Information", printed with the symbol and number of your insurance, your share of the cost and so on. It does not let you see a doctor on its own. It has two uses: first, to let you check your own symbol and number; second, at a medical institution where the card reader has broken down or where online eligibility verification has not been introduced, to be shown together with the My Number Card so that your eligibility can be confirmed[JHIA]. You can also show the eligibility information screen of Mynaportal on your smartphone.
Put the other way round, if you have registered a Myna health insurance card, it is normal for no Eligibility Certificate to arrive. Before you ring the counter to say nothing has come, check whether you have ever registered for use on Mynaportal. Many people completed the registration at the counter when they collected their card and simply do not remember doing so.
Who can apply for an Eligibility Certificate even with a Myna health insurance card
- People who, because of age or disability, find the card reader (face recognition or the PIN) difficult to operate and need someone with them to assist
- People who do not have the card to hand because they have lost it or it is being renewed (including an expired electronic certificate)
- People living in a care facility who find it hard to leave the card in the facility's keeping
- People who use medical institutions that have not introduced online eligibility verification, or who use home-visit nursing (the Japan Health Insurance Association accepts applications in this case)
You apply to the insurer you belong to. For National Health Insurance and the Latter-Stage Elderly Medical Care System that is the municipal counter; for the Japan Health Insurance Association you submit an "application for the issue of an Eligibility Certificate" through your employer or directly; for a health insurance society it is the society's counter. The Tokyo regional union states that "a holder of a Myna health insurance card who wants an Eligibility Certificate, or who wants the optional items to have the cost-ceiling category printed on the certificate, must apply at the counter of their municipality"[Tokyo regional union]. You can also cancel the registration of your Myna health insurance card and switch to an Eligibility Certificate (through Mynaportal or an application to your insurer).
What to do when nothing arrives: check three things in order
- Check whether your Myna health insurance card is registered. Log in to Mynaportal and look at the "health insurance card" item. If it is registered, no Eligibility Certificate will arrive. What you should have received is a Notice of Insurance Eligibility Information.
- Check your address and the head of your household. National Health Insurance posts the whole household's documents to the head of the household. They sometimes come back because you moved without transferring your resident record, because the forwarding period at the post office has run out, or because there was no nameplate and the post could not be delivered.
- Contact your insurer and have one reissued. The municipality for National Health Insurance and the Latter-Stage Elderly system, the prefectural branch for the Japan Health Insurance Association, the society for a health insurance society. If you need to see a doctor before then, tell the reception desk that your Eligibility Certificate is being applied for; if your eligibility cannot be confirmed, pay the full 100% for the time being and later apply for the 70% to be refunded as a "reimbursement claim for medical costs".
Leaving a company and joining National Health Insurance, moving from the Japan Health Insurance Association to a health insurance society when you change jobs, moving to the Latter-Stage Elderly Medical Care System when you turn 75 — in every case the new insurer issues the document and the old Eligibility Certificate can no longer be used. For how to choose after leaving a job, see the three health insurance options after leaving a job; for the premiums from age 75, see the prefectural ranking of Latter-Stage Elderly Medical Care premiums.
You generally do not need a ceiling-amount application certificate. With an Eligibility Certificate, apply for the category to be printed on it
When medical costs run high, for example for a hospital stay, a Myna health insurance card removes the need for a ceiling-amount application certificate: what you pay at the counter is automatically capped. People who see a doctor with an Eligibility Certificate can apply to their municipality or insurer to have the cost-ceiling category printed on the certificate, which puts them in the same position. The out-of-pocket ceilings themselves also changed in August 2026, so for how to read the categories see the ceiling-amount application certificate and the Myna health insurance card.
Frequently asked questions
May I hold both an Eligibility Certificate and a Myna health insurance card?
People who applied and were issued one can hold both. The benefits are the same whichever you use. However, certificates issued automatically without application go to people with no Myna health insurance card registration, so once you register, no Eligibility Certificate will be sent from the next renewal onwards.
What happens for my children?
It is decided by the registration status of the child's own My Number Card. Even if the parent is registered, if the child is not, an Eligibility Certificate arrives for the child alone. National Health Insurance sends it to the head of the household; the Japan Health Insurance Association sends the dependants' documents via the insured person (the parent).
Summary
- Conventional health insurance cards will no longer be usable after July 31, 2026; from August, medical visits will require either a My Number health insurance card or a certificate of eligibility.
- Certificates of eligibility will be sent to people who do not have a My Number card and those who have not registered their card for insurance use. Everyone aged 85 or older under the Late-Stage Elderly Healthcare system will receive one.
- Those who have already registered receive a notice of insurance eligibility information instead, which cannot be used on its own for medical visits.
- For National Health Insurance and Late-Stage Elderly Healthcare, certificates are valid for up to July 31, 2027, and are renewed and mailed automatically by the authorities before expiry. For Japan Health Insurance Association (Kyokai Kenpo) members, the expiry date is printed on the card itself (valid up to 5 years).
- If a certificate does not arrive, check in this order: registration status on the My Number Portal, the registered address and household head, then contact the insurer.
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Reference links (sources)
This article is based on the materials below. Because the timing of posting and the expiry dates differ from insurer to insurer, follow what is written on the document you receive.
Note: this article is general information. For the treatment under a health insurance society or a mutual aid association, check that organisation's own guidance.