If you’ve tried to use your old plastic health insurance card at a clinic recently and had it rejected, you’re not imagining things. Japan’s paper health insurance card (健康保険証) stopped being issued back in December 2024, every existing card expired by December 1, 2025, and the grace period that let clinics accept expired cards through manual verification ran out at the end of July 2026. As of August 2026, only two things get you seen at a Japanese clinic or pharmacy without a fight at the front desk: a Myna Hokensho (your My Number Card linked to health insurance) or a Shikaku Kakuninsho (Certificate of Eligibility). If you’re a foreign resident and haven’t sorted this out yet, here’s exactly what to do — including the name-mismatch problem that catches a lot of us specifically.
📋 Quick Navigation: What actually changed · Your two options · The foreign-name problem · FAQ
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What actually changed with Japan’s health insurance card
This has been a slow-motion transition, not a sudden switch, which is exactly why so many people missed it:
- December 2, 2024: Insurers stopped issuing new paper health insurance cards.
- December 1, 2025: Every paper card still in circulation officially expired.
- Through July 2026: A grace period let clinics manually verify coverage even with an expired card.
- August 2026 onward: That grace period is over. Clinics and pharmacies now require either a Myna Hokensho or a Shikaku Kakuninsho — the old plastic card, expired or not, no longer works.
If your registration paperwork or a clinic visit has felt confusing lately, this is why. The good news: fixing it is free and usually takes under 30 minutes.
Your two options: Myna Hokensho or Shikaku Kakuninsho
| Option | What it is | How to get it |
|---|---|---|
| Myna Hokensho マイナ保険証 |
Your My Number Card (residence card–linked ID) registered for health insurance use | Link it at a convenience store kiosk, your city/ward hall, or the Mynaポータル app |
| Shikaku Kakuninsho 資格確認書 |
A free paper certificate proving you’re enrolled in insurance — the fallback if you don’t have or don’t want to use a My Number Card | Contact your insurer: city/ward hall for National Health Insurance (国民健康保険), or your employer’s HR/health insurance union for company Shakai Hoken |
If you’d already registered a My Number Card for health insurance before the deadline, you likely have nothing to do. If you hadn’t, most insurers auto-mailed a Shikaku Kakuninsho to enrolled households by late 2025 — check your mail (including anything you may have set aside unopened, which happens to a lot of us with Japanese-only envelopes). If you can’t find yours, request a replacement from your insurer directly; it’s free and there’s no penalty for asking.
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TIFE runs regular meetups where new and long-term residents trade real answers on Japan’s admin systems — not just what the pamphlet says, but what actually works.
The foreign-name problem: why your card reader might reject you anyway
Even after you’ve registered, there’s a specific issue that trips up foreign residents more than anyone else: the name on file with your insurer may not exactly match the name on your My Number Card. A romanized name recorded one way by your employer’s HR and a different way (or in katakana) by your city hall is enough to make the clinic’s card reader fail, even though you’re fully enrolled and eligible.
If this happens to you:
- The clinic can usually still treat you and verify coverage manually on the spot — don’t panic or leave without care.
- Afterward, contact your insurer (city hall for NHI, or your health insurance union for Shakai Hoken) and ask them to correct the name spelling/reading on file so it matches your residence card exactly.
- Keep a photo of your Shikaku Kakuninsho or a note of your insurer’s phone number on your phone as a backup for the next visit while the correction processes.
Japan Health Insurance Card 2026 FAQ
- Can I still use my old paper health insurance card at all? No — as of August 2026, the grace period for expired paper cards has ended. Clinics require a Myna Hokensho or Shikaku Kakuninsho.
- Do I have to get a My Number Card to keep using health insurance? No. The Shikaku Kakuninsho is a free alternative for anyone who doesn’t have or doesn’t want to link a My Number Card.
- Is there a fee to get a Shikaku Kakuninsho? No, it’s issued free by your insurer.
- What if my name is spelled differently across my documents? Contact your insurer to correct the registered name so it matches your residence card — this is a common issue for foreign residents and is fixable, not a barrier to coverage.
- I never received anything in the mail — what do I do? Contact your insurer (city/ward hall for National Health Insurance, or your employer’s HR for company Shakai Hoken) and request a Shikaku Kakuninsho be reissued.
- Does this affect National Health Insurance and company Shakai Hoken equally? Yes, both insurance types moved to the same Myna Hokensho / Shikaku Kakuninsho system.
Quick reference
- Paper cards stopped issuing: December 2, 2024
- All paper cards expired: December 1, 2025
- Grace period ended: July 31, 2026
- Now required: Myna Hokensho (My Number Card linked) or Shikaku Kakuninsho (free certificate)
- Action: Check your mail for a Shikaku Kakuninsho, or link your My Number Card at a convenience store kiosk or city hall
- Related: Healthcare in Japan for Foreigners | Setting Up Life in Japan: Bank, SIM, Health Insurance & Residence Card | TIFE Moving to Japan
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