Introduction
When you go to a clinic, are you still handing over your old paper insurance card?
Japan stopped issuing new traditional health insurance cards on December 2, 2024, and the one-year transition period ended on December 1, 2025. Since then, a grace period has allowed expired cards to still be used for medical visits at the regular 10-30% copay rate. That grace period ends on July 31, 2026.
Starting August 1, if you show up to a hospital without a My Number Insurance Card (maina hokensho) or a Certificate of Qualification (shikaku kakuninsho), you’ll be asked to pay the full medical bill upfront. You have about two months left. If you haven’t prepared yet, now is the time.
TL;DR
- The grace period for expired insurance cards ends July 31, 2026. No further extensions
- From August 1, you’ll need either a “My Number Insurance Card” or a “Certificate of Qualification” to see a doctor at insurance rates
- The Certificate of Qualification is sent automatically for free to anyone without a My Number Insurance Card (no application needed)
- A My Number Card application takes about one month from application to receipt. Applying in June is the safe window
Disclaimer: This article is based on announcements by the Ministry of Health, Labour and Welfare and Nikkei reporting from March–May 2026. Information is current as of May 2026.
Timeline: What Happened and What’s Coming
| When | What happened |
|---|---|
| December 2, 2024 | New issuance of traditional health insurance cards ended (start of one-year transition period) |
| December 1, 2025 | One-year transition period ended; existing cards no longer valid in principle |
| December 2025 – March 2026 | Grace period: expired cards still accepted for insured medical visits |
| March 19, 2026 | MHLW announced extension of grace period until July 31 |
| July 31, 2026 | Grace period ends. The health minister stated there will be no further extensions |
| August 1, 2026 onward | Old insurance cards become completely invalid. My Number Insurance Card or Certificate of Qualification required |
The Minister of Health, Labour and Welfare stated at a press conference that “we are not considering any further extensions beyond July.” This is the final grace period.
(Source: Nikkei — Grace Period for Expired Insurance Cards Extended to July)
Two Options Starting in August
To receive insured medical care from August onward, you need one of the following.
Option 1: My Number Insurance Card
This is your My Number Card with the health insurance function activated.
What you need:
- A My Number Card (apply for one first if you don’t have it)
- Insurance card registration (set up through the My Number Portal app)
How to use it at the hospital:
Place your My Number Card on the face-recognition card reader at reception, then verify your identity using one of the following.
- Face recognition — the reader’s camera scans your face for verification
- PIN entry — enter the 4-digit number you set when you received your card
- Visual verification — reception staff confirms your photo manually (a fallback when face recognition and PIN don’t work)
You’ll then be asked on-screen whether to share your “past medication history,” “specific health checkup results,” and “high-cost medical care threshold.” You can decline and still receive care.
Option 2: Certificate of Qualification
A document for people who don’t use the My Number Insurance Card. It contains the same fields as the old paper insurance card: name, date of birth, insurer number, expiration date, and so on.
How to get it:
- People without a My Number Insurance Card receive it automatically for free (no application needed)
- Mailed from your health insurance association or municipal office
- Has an expiration date (typically 1–5 years, varies by insurer), so check the dates when it arrives
How to use it at the hospital:
Just show the certificate at the reception desk. The flow is the same as the old paper insurance card: no card reader, no face recognition, and no PIN required.
If you need a high-cost medical care threshold certificate, you must apply for it separately through your health insurance provider. The My Number Insurance Card connects this automatically, but the Certificate of Qualification does not.
Even if you don’t want a My Number Card, the Certificate of Qualification lets you receive insured care.
(Source: MHLW — About the Certificate of Qualification)
What to Do Now: Your Checklist
If you have a My Number Card
- Open the My Number Portal app
- Tap “Health Insurance Card Registration” and complete the setup
- Confirm the registration is active
That alone is enough to keep you covered from August onward.
If you don’t have a My Number Card
Option A: Apply for a My Number Card
- Apply online, by mail, or at your municipal office
- Receive your card (about 1 month after application)
- Register the insurance function through the My Number Portal app
Option B: Wait for the Certificate of Qualification
- It will be sent automatically if you haven’t registered for the My Number Insurance Card
- If it doesn’t arrive, contact your health insurance provider directly
The My Number Card takes about one month to receive after application. To be ready before the July 31 deadline, apply in June at the latest.
(Source: MHLW — My Number Card as Health Insurance Card)
Multilingual Support for Non-Japanese Speakers
The Ministry of Health, Labour and Welfare publishes guides about the My Number Insurance Card in 15 languages.
Available languages: English, Korean, Chinese (Simplified and Traditional), Spanish, Portuguese, Tagalog, Vietnamese, Indonesian, Nepali, Thai, Burmese, Khmer, and Mongolian.
Your company’s HR or general affairs department (soumu) can sometimes help with the Certificate of Qualification process as well.
(Source: MHLW — My Number Insurance Card Multilingual Resources)
Related articles:
- Guide to Japan’s Healthcare System
- Residence Card and My Number Card Integration Guide
FAQ
Q. Can non-Japanese residents receive the Certificate of Qualification?
A. Yes. If you’re enrolled in Japan’s health insurance system, you can receive it regardless of nationality.
Q. What happens if I visit a doctor after August without either card?
A. You’ll be asked to pay the full medical cost upfront at the counter. You can later apply for a refund of the insured portion (70–90%) by proving your insurance eligibility, but the process takes time, so we recommend preparing in advance.
Q. Should I wait for the integrated residence card and My Number Card?
A. The Specified Residence Card system starts on June 14, 2026, but using it as an insurance card still requires separate registration through the My Number Portal. There’s no need to wait. You can register today.
Key Takeaways
- ✅ Old insurance cards stop working on July 31. No more extensions
- ✅ If you have a My Number Card, just register the insurance function in the My Number Portal app
- ✅ No My Number Card? The Certificate of Qualification arrives automatically. If it doesn’t, contact your insurer
- ✅ My Number Card applications take about one month. Apply in June to be safe
About two months remain until August 1. If you have a My Number Card, you’re set as soon as you register the insurance function in the My Number Portal app. If you don’t have one, applying in June should leave you enough time to receive the card by the end of July. And if you’d rather not use the My Number Insurance Card, your Certificate of Qualification will arrive automatically. Just wait for it.
If you’re unsure about any of the procedures or documents, ask your company’s HR or general affairs team, your municipal office, or check the MHLW’s 15-language guides. There are several places you can turn to even if your Japanese isn’t strong. Acting early means you can walk into a clinic in August without stress and receive insured care just like before.
