Health Insurance Card Expired in Japan? Use Shikaku Kakuninsho (2026 Clinic Playbook)

Information current as of March 2026 based on Japan’s Digital Agency guidance, the Ministry of Health, Labour and Welfare (MHLW) online eligibility verification Q&A, and municipality/insurer guidance linked below. Procedures can vary by insurer and municipality.

If you Googled “shikaku kakuninsho Japan” because your health insurance card suddenly “expired,” you’re not alone. In March 2026, I’m still seeing foreign residents show up to clinics with the wrong paper (often the Notification of Qualification Information (資格情報のお知らせ / Shikaku Joho no Oshirase)) or get stuck when the My Number reader fails—then they’re asked to pay 100% or come back later.

I used to work as a Medical Coordinator for Foreign Patients at a hospital in Osaka, and the biggest problem was rarely “no system.” It was that patients couldn’t access the system smoothly at the counter—especially when documents, rules, and Japanese explanations didn’t match what they expected.

The 2024–2026 switch explained (what stopped, what changed, key dates)

The “health insurance card expired” problem in 2026 is usually not about you losing insurance. It’s about how clinics confirm eligibility after Japan stopped issuing new traditional cards and shifted to My Number–based verification.

What stopped on December 2, 2024

Japan stopped issuing new traditional health insurance cards (健康保険証) on December 2, 2024. According to the Digital Agency’s FAQ, existing cards remained usable until their printed expiration date, but only up to a maximum of December 1, 2025.

After December 2, 2024, if your status changed (job change, move, etc.) or your card expired, you were expected to use either a My Number Card registered as insurance (マイナ保険証 / Myna Hokensho) or an alternative document issued by your insurer.

What changed on December 2, 2025 (why many people got stuck)

By December 2, 2025, the transition “grace period” ended for everyone—because the old cards could be used only until December 1, 2025 at the latest. That’s why clinics started telling people: “From now on, it’s MyNa (マイナ保険証 / Myna Hokensho) or a Qualification Confirmation Certificate (資格確認書 / Shikaku Kakuninsho).”

In plain English: even if you are still insured, the thing you used to show at reception stopped being a valid “proof” for routine processing.

Why March 2026 is still special

To prevent people from being forced into 100% payment just because they brought the wrong thing, there has been a temporary measure that allows some clinics/pharmacies to treat you as insured until March 31, 2026 if they can confirm your eligibility through alternative verification. A clear example is explained in a public notice from the Public School Mutual Aid Association.

Important: this doesn’t mean “the old card is back.” It means “don’t reject the patient—verify them another way.” After April 1, 2026, you should assume the clinic will be stricter.

Which paper/card you need: Myna Hokensho vs Qualification Confirmation Certificate vs Notification

Most delays happen because the documents look similar, and the Japanese names are confusing. Here’s the practical difference you need for a same-day clinic visit.

1) Myna Hokensho (マイナ保険証): the most universal option

Myna Hokensho means: your My Number Card is registered to be used as a health insurance card. MHLW explains that registration is required, but you can also do the initial registration right at a clinic/pharmacy card reader when you visit for the first time (if the reader supports it), as stated in the MHLW Q&A.

If it works, it’s fast: insert/tap, do face recognition or PIN, and the clinic checks eligibility electronically.

Common failure in 2026: your My Number electronic certificate can expire after 5 years even if you still physically have the card. The Digital Agency’s expiration page explains the 5-year certificate and the grace period.

2) Qualification Confirmation Certificate (資格確認書 / Shikaku Kakuninsho): the “paper/plastic alternative” that actually works

Qualification Confirmation Certificate (資格確認書 / Shikaku Kakuninsho) is the eligibility confirmation certificate that functions as the alternative for people who don’t have a My Number Card, or haven’t registered it as insurance. The Digital Agency explains (in English) that an eligibility confirmation form/certificate is provided free of charge by your insurer (company insurer, municipality, etc.) for those not using MyNa registration in the Digital Agency’s “Confirmation of Qualification” page.

Depending on your insurer, it may be a card-like plastic document, a postcard-size paper, or another format. What matters is that it is the Qualification Confirmation Certificate (資格確認書) and has your insurer details.

3) Notification of Qualification Information (資格情報のお知らせ / Shikaku Joho no Oshirase): useful, but easy to misuse

Notification of Qualification Information (資格情報のお知らせ / Shikaku Joho no Oshirase) is an “eligibility information notice.” People often bring it because it looks official and “new,” and some insurers send it around the transition.

However, the Digital Agency explicitly warns that you cannot receive insured medical treatment only with the ‘Notification of Qualification Information’ in its official explanation. (There are temporary measures up to March 31, 2026 in some situations, but it’s still not the document you should rely on as your primary proof.)

When the Notification can help: MHLW’s Q&A notes that in facilities that do not have online eligibility verification, you may need to show your My Number Card plus a Mynaportal screen/PDF or the Notification (資格情報のお知らせ) along with a valid card/certificate, as described in the MHLW Q&A.

Experience box: what foreigners say they received (and why it’s confusing)

One foreign resident wrote on Reddit that the “gray card” they received was an eligibility certificate, and that it “isn’t a full card” and can be confusing if you expected the old insurance card format.

Reddit discussion: “Confused about health insurance & my number card”

Individual experiences may vary. Always confirm your document name: look for “資格確認書 (Shikaku Kakuninsho)” vs “資格情報のお知らせ (Shikaku Joho no Oshirase)” on the document itself.

How to get the right document fast (company insurance vs National Health Insurance)

When you need a clinic today, you don’t have time for “wait for the next mailing.” Your fastest route depends on which insurer you’re enrolled in.

Step 0 (for everyone): identify your insurer type

• Company insurance (社会保険 / 社会保険の健康保険): you’re enrolled through your employer (協会けんぽ / Kyokai Kenpo, a health insurance association / 健康保険組合 / Kenko Hoken Kumiai, or a mutual aid association / 共済組合 / Kyosai Kumiai).
• National Health Insurance (国民健康保険 / 国保): you enrolled at your city/ward office.

If you’re not sure, check any recent insurance-related paper for names like Kyokai Kenpo (協会けんぽ), Kenko Hoken Kumiai (健康保険組合), Kyosai Kumiai (共済組合), or National Health Insurance (国民健康保険).

If you have company insurance (through work)

Fastest fix: contact your company HR/benefits desk and ask what you should present at the clinic in 2026, and whether they can issue a Qualification Confirmation Certificate (資格確認書 / Shikaku Kakuninsho) if you are not using a MyNa-registered card. The Digital Agency notes that the issuance method differs by insurer, so you must confirm with your own insurer/employer in the official guidance.

Useful phrases for HR/benefits:

• 資格確認書を発行していただけますか？ (Shikaku kakuninsho o hakkou shite itadakemasu ka?) — Can you issue me a Qualification Confirmation Certificate?
• 病院で保険資格を確認できず困っています。 (Byouin de hoken shikaku o kakunin dekizu komatte imasu.) — The clinic can’t verify my insurance and I’m stuck.
• 今日受診したいので、最短で受け取れる方法を教えてください。 (Kyou jushin shitai node, saisoku de uketoreru houhou o oshiete kudasai.) — I need to see a doctor today; what’s the fastest way to receive it?

If your My Number Card exists but you never registered it as insurance, you can often register at the clinic/pharmacy terminal during your first visit, per the MHLW Q&A. That can be the fastest “no paperwork” solution—if the reader works.

If you have National Health Insurance (国保 / NHI)

Fastest fix: go to your city/ward office’s National Health Insurance counter (often labeled 国民健康保険課 / Kokumin Kenkou Hoken-ka) and ask about your current valid document for clinic visits.

Many municipalities used to renew NHI cards annually (often around summer), and now send different documents depending on whether you use MyNa registration. For example, Numazu City’s English notice explains that paper insurance cards were discontinued and that a Qualification Confirmation Certificate may be sent instead.

Useful phrases at city hall:

• 国民健康保険の資格確認書が必要です。 (Kokumin kenkou hoken no shikaku kakuninsho ga hitsuyou desu.) — I need a qualification confirmation certificate for National Health Insurance.
• マイナ保険証の登録ができているか確認したいです。 (Maina hokenshou no touroku ga dekite iru ka kakunin shitai desu.) — I want to confirm whether my MyNa health insurance registration is active.
• 今日病院に行きたいのですが、窓口で使える書類はどれですか？ (Kyou byouin ni ikitai no desu ga, madoguchi de tsukaeru shorui wa dore desu ka?) — I need to go today; which document will be accepted at the clinic counter?

Foreign resident nuance (important): your document validity may be tied to your residence period. Osaka City explicitly notes that for foreign residents whose residence period ends by a certain time, the Qualification Confirmation Certificate (資格確認書) validity may be set to the residence period end date (see Osaka City’s guidance). If your residence status is being renewed, plan ahead.

If your My Number Card itself (or its validity) is the real issue

For many foreign residents, the My Number Card’s validity is linked to residence status. Japan’s Immigration Services Agency states that the My Number Card expiration date for foreign residents is the same as the residence card’s period of stay on its official My Number Card page.

Also, even if your My Number Card looks valid, the electronic certificate can expire and break MyNa insurance usage. The Digital Agency explains that electronic certificate renewal is done at your municipal office and is generally free.

If you are suddenly stuck and need official guidance in English by phone, the Digital Agency lists My Number contact options here: Inquiries about My Number System (includes a toll-free number and foreign-language options).

If the clinic can’t verify you: what to do on the spot

This is the “don’t waste your day” section. Even if you’re insured, clinic reception is often strict because they must bill correctly—so your goal is to help them verify you quickly.

On-the-spot checklist (do these in order)

1. Ask them to try online eligibility verification again (sometimes it’s just a reader workflow issue). MHLW’s materials for medical institutions describe methods including face recognition, PIN input, and visual confirmation modes when needed.
2. If you have MyNa (マイナ保険証 / Myna Hokensho): confirm your electronic certificate isn’t expired and try PIN/face again. If your face recognition fails, ask if they can switch modes.
3. If you have a Qualification Confirmation Certificate (資格確認書 / Shikaku Kakuninsho): hand it over first. Say clearly, “This is my Qualification Confirmation Certificate (資格確認書).”
4. If you only have the Notification (資格情報のお知らせ / Shikaku Joho no Oshirase) or an expired old card (March 2026 only): politely ask whether they can confirm your eligibility via online checks and proceed with insured billing.
5. If the clinic truly can’t verify: decide whether you can pay 100% now and claim reimbursement later, or go to your insurer/city hall first to get the correct document.

What to say at reception (copy/paste Japanese)

• オンライン資格確認で資格確認できますか？ (Onrain shikaku kakunin de shikaku kakunin dekimasu ka?) — Can you verify my eligibility through online eligibility verification?
• 資格確認書を持っています。 (Shikaku kakuninsho o motteimasu.) — I have a Qualification Confirmation Certificate.
• マイナ保険証の読み取りがエラーになります。 (Maina hokenshou no yomitori ga eraa ni narimasu.) — The MyNa insurance card reader is giving an error.
• 今日は10割負担を避けたいです。確認できる方法はありますか？ (Kyou wa juuwari futan o saketai desu. Kakunin dekiru houhou wa arimasu ka?) — I want to avoid paying 100% today; is there another way to confirm?

To reduce wasted trips, you can also check whether a clinic/pharmacy supports My Number card verification using MHLW’s official list: Medical institutions/pharmacies that support My Number Card verification (the page itself warns that real-world operations can vary by facility).

If they say “you must pay 100%” (how reimbursement usually works)

Sometimes the clinic can’t verify you on the spot, or the staff don’t know the fallback procedures. In that case, you may choose to pay 100% and apply for reimbursement afterward (療養費 / Ryoyouhi), depending on your insurer and circumstances.

Tokyo’s official medical info site for foreign residents notes that if you visit without proof of coverage, you may have to pay 100% at the window (and then handle reimbursements/insurance processes afterward): Tokyo Medical Information Site (Insurance).

A concrete example from a city NHI FAQ (useful as a “what documents they ask for” reference) is Ichinomiya City’s explanation of refunds after paying in full when you forgot your qualification document: Ichinomiya City FAQ (療養費).

Useful phrases when paying and preparing for reimbursement:

• 10割で支払いますので、領収書をください。 (Juuwari de shiharaimasu node, ryoushuusho o kudasai.) — I’ll pay 100%, so please give me the receipt.
• 診療報酬明細書（レセプト）の発行はできますか？ (Shinryou houshuu meisai-sho (reseputo) no hakkou wa dekimasu ka?) — Can you issue a detailed statement (receipt/claim statement)?
• あとで療養費の申請をしたいです。 (Atode ryoyouhi no shinsei o shitai desu.) — I want to apply for reimbursement later.

Not sure which document you should bring, or need someone to explain this at the counter in Japanese today? Ask on LO-PAL.

Experience box: “My company collected my old card, then I had no proof”

Another foreign resident described that during a company change/reorganization, the employer collected the old insurance card and they had to rely on temporary paper proof until they could complete My Number–related steps.

Reddit discussion: “What’s happening with MyNumber cards in the future?”

Individual experiences may vary. The correct “fastest fix” depends on your insurer (company vs municipality) and the documents you already have.

Quick FAQ

Can I use “Notification of Qualification Information” (資格情報のお知らせ) by itself?

Normally, it is not treated as a standalone document for insured treatment, as stated in the Digital Agency’s explanation. However, up to March 31, 2026, some clinics may still be able to verify you via online checks and proceed without forcing 100% payment (see the temporary-measure notice).

My My Number card reader suddenly fails—did I lose insurance?

Not necessarily. Common causes include electronic certificate expiration or data update timing after job/move changes. Use a Qualification Confirmation Certificate (資格確認書) if you have it, and consider renewing your electronic certificate at your municipal office as explained by the Digital Agency.

Can I register MyNa insurance at the clinic?

Often yes. MHLW’s Q&A notes you can register at the face-recognition card reader during your first visit in many cases: MHLW online eligibility verification Q&A.

I paid 100%—what should I do first?

Keep all receipts and ask what documents your insurer needs for reimbursement (療養費). If you are on NHI, your city/ward office will handle it; if on company insurance, contact your insurer/HR. Tokyo’s official site for foreign residents summarizes the “pay 100% without proof” reality here: Tokyo Medical Information Site (Insurance).

Related Articles

• Visa renewal pending? Keep your My Number Card valid
• My Number Card application for foreigners in Japan 2026: the fast, nationwide guide
• Food poisoning in Japan: when to go to hospital (foreigner guide)

Need More Help? Ask on LO-PAL

Don’t risk taking time off work only to be sent home because of a missing document or a language barrier. On LO-PAL, you can match with a local Japanese helper to call your insurer/HR, accompany you to the ward office, and support you at clinic reception so you can get it done on the first try.