Japan Abolished Physical NHI Cards — Here’s What That Means for You
Japan stopped issuing physical health insurance cards (保険証 / hokensho) on December 2, 2024. If you are studying in Japan in 2026, you need either a My Number Card (マイナンバーカード) registered as your health insurance card, or a temporary Eligibility Confirmation Certificate (資格確認書 / shikaku kakuninsho) to see a doctor. The old paper cards expired at the latest on December 1, 2025. The system has now fully transitioned.
This is one of the most significant changes to Japan’s healthcare system in decades — and most international students arriving now have never held a traditional hokensho at all. If you are a new student or preparing to study in Japan, understanding the My Number Card system is no longer optional. This guide walks you through everything: what changed, how to get your card, how to register it for health insurance use, and what to do if you do not have it yet. For full background on Japan’s National Health Insurance (NHI) system, see our Japan NHI guide for students.
What Changed and Why
The Old System
Until December 2, 2024, every person enrolled in Japan’s National Health Insurance (NHI) received a physical insurance card — the 保険証 (hokensho). You carried it to every clinic and hospital visit, and staff used it to verify your insurance coverage.
The New System
From December 2, 2024, Japan’s government stopped issuing new hokensho cards. The system now runs on the マイナ保険証 (Myna Hokensho) — your My Number Card registered and used as a health insurance certificate. Clinics and hospitals use card readers to verify your NHI enrollment in real time by scanning your My Number Card.
Why Japan Made This Change
Japan’s Digital Agency pushed this transition as part of a broader digitization agenda:
- Real-time verification: Card readers instantly confirm your insurance status and coverage level — no more expired cards, no manual data entry
- Automatic high-cost cap: The system applies the Kougaku Ryouyouhi (高額療養費) high-cost medical expense cap automatically, without you needing a separate Gengaku Certificate (限度額適用認定証)
- Reduced administrative burden: Insurers, hospitals, and municipalities no longer manage millions of physical cards
- Consolidated identity: One card for taxes, residence, insurance, and increasingly, government services
Key Dates
| Date | What Happened |
|---|---|
| December 2, 2024 | New hokensho cards stopped being issued |
| December 1, 2025 | All existing hokensho cards expired (final deadline) |
| From December 2, 2025 | Only Myna Hokensho or 資格確認書 accepted at clinics |
| June 14, 2026 | New “Specified Residence Card” (特定在留カード) launches — combines My Number Card and Zairyu Card into one document |
What Is the My Number Card?
The My Number Card (マイナンバーカード) is Japan’s national ID card for all residents — Japanese citizens and foreign nationals alike. It contains:
- Your 12-digit Individual Number (My Number / マイナンバー)
- A chip with digital signature capabilities
- Your photo, name, address, and date of birth on the face
- Optionally: health insurance registration, online government service access
Foreign residents are eligible for a My Number Card if they are registered in the municipal resident registry — which applies to anyone staying in Japan for more than three months.
For international students: Your My Number Card expires on the same date as your Zairyu Card (在留カード / Residence Card). When you renew your visa/residence status, you must also renew your My Number Card.
How to Get a My Number Card: Step-by-Step
Before You Start: What You Need
You must first have:
- A valid Zairyu Card (在留カード) with your current address printed on it
- Your Individual Number (the 12-digit number assigned when you registered your address)
If you are newly arrived, you receive your Individual Number notice by registered mail a few weeks after completing address registration at your city hall or ward office.
Step 1: Find Your Individual Number
Your 12-digit My Number was assigned when you first registered your address at your local city/ward hall. It was sent to you via registered mail on a notification card (通知カード / tsuchi card) or an Individual Number Notice (個人番号通知書 / kojin bangou tsuchi-sho).
If you lost this notification, visit your local ward office with your Zairyu Card and passport — they can confirm your number.
Step 2: Apply for the Card
There are three ways to apply:
Option A — Smartphone application (easiest, recommended)
- Locate the QR code on your notification card
- Scan it with your smartphone camera
- You are directed to the application site (available in multiple languages)
- Upload a selfie-style photo meeting the requirements (plain background, face clearly visible, taken within six months)
- Confirm your details and submit
Option B — Online at a PC
- Go to the My Number Card application portal
- Enter your application ID (printed on the notification card)
- Upload a photo and submit
Option C — Postal mail (English form available)
- Download or obtain a paper application form — an English-language version is available
- Attach a printed photo (4.5 cm × 3.5 cm)
- Mail to the address printed on the notification card
Option D — In person at city/ward hall
- Some municipalities allow in-person applications with assistance from multilingual staff
Step 3: Wait for Collection Notice
Processing takes approximately 3–4 weeks. You will receive a postcard (交付通知書 / kofu tsuchi-sho) at your registered address once the card is ready.
Step 4: Collect in Person
You must collect the card in person at your city hall or ward office. Bring:
- The collection notice postcard
- Your notification card or Individual Number Notice
- Your Zairyu Card
- Your passport
At the counter, you set a 4-digit PIN for the certificate function and a 6–16 character password for the digital signature function. Staff will guide you through this.
The card is issued free of charge.
Step 5: Link to NHI (Myna Hokensho Registration)
Getting the card is not enough — you must register it as your health insurance card (Myna Hokensho / マイナ保険証). There are three ways:
Via Mynaportal (online)
- Go to mynaportal.digital.go.jp
- Log in using your My Number Card and a card reader (or smartphone with NFC)
- Navigate to “Health insurance card registration” (健康保険証利用登録)
- Follow the prompts to confirm your NHI enrollment and register your card
At a hospital or clinic terminal
- Most hospitals and large clinics have My Number Card reader terminals at reception
- Insert your card, enter your PIN, and select “Register as health insurance card”
- Registration is immediate
At a Seven Bank (セブン銀行) ATM
- Insert your My Number Card
- Follow the on-screen instructions to register for health insurance use
After registration, your card is verified at clinic card readers to confirm your insurance coverage in real time.
What If You Don’t Have a My Number Card Yet?
You can still see a doctor. Here’s how:
The 資格確認書 (Shikaku Kakuninsho / Eligibility Confirmation Certificate)
The shikaku kakuninsho is a free fallback certificate issued by your insurer (typically your city/ward’s NHI section) that proves you are enrolled in NHI. It functions identically to the old hokensho at clinics — you present it, and you pay the standard 30% co-pay.
Who receives it automatically:
- NHI enrollees who had not registered their My Number Card for insurance use by November 2025 were mailed a shikaku kakuninsho automatically by their municipality before December 2025.
If you just enrolled in NHI and have no card yet:
- When you enroll at the city/ward hall, ask for a shikaku kakuninsho at the NHI counter (国民健康保険窓口)
- It is issued on the spot or mailed within a few days
- Valid until July 31, 2027 (current certificates — this date may be extended)
Important limitations:
- The shikaku kakuninsho does not automatically apply the high-cost medical expense cap — you must apply separately or request the Gengaku Certificate (限度額適用認定証)
- It cannot be used for some digital services that require the My Number Card
- It does not appear on digital systems — clinics must manually record your details
The bottom line: the shikaku kakuninsho keeps you covered while you get your My Number Card sorted. But get the card — it’s the more functional long-term solution.
Emergency Situation: No Card, No Certificate
If you arrive at a clinic with neither a Myna Hokensho nor a shikaku kakuninsho:
- Pay the full cost upfront (100%) — clinics are not obligated to provide discounted treatment without proof of insurance
- File a reimbursement claim at your ward office’s NHI section later, bringing your receipt and proof of NHI enrollment
- The municipality refunds the 70% NHI share — this can take 2–3 months
The best prevention: carry your shikaku kakuninsho while waiting for your My Number Card.
How This Affects NHI Enrollment for New Students
The NHI enrollment process itself has not changed. You still:
- Arrive in Japan and receive your Zairyu Card at the airport
- Register your address at city/ward hall within 14 days
- Enroll in NHI at the same office visit
- Pay approximately ¥12,000–25,000/year in income-adjusted premiums
What is new: the ward office will now also prompt you to apply for a My Number Card if you do not already have one. Many municipalities provide application assistance at the same counter.
Practical advice for new arrivals:
- Apply for your My Number Card on the same day you register your address — it starts the 3–4 week processing clock immediately
- Ask for a shikaku kakuninsho while you wait for the card
- Once you receive your card, register it for NHI use via Mynaportal or at a clinic terminal
The Myna Hokensho in Practice: Using It at a Clinic
Once your My Number Card is registered for health insurance:
- At reception: Insert your My Number Card into the card reader terminal (most clinics have them at reception)
- Enter your PIN (4-digit number you set when collecting the card) or use face authentication (some terminals)
- Confirm insurance verification: The terminal displays your insurer and coverage — confirm it is correct
- Select your preference for receiving clinical summary documents and having information shared with the clinic
- Your visit proceeds normally — you pay 30% at checkout
The automatic high-cost cap benefit: If your monthly medical costs would exceed ¥35,400 (the low-income cap), the system applies the cap automatically when you pay with your Myna Hokensho. With the old hokensho, you needed to apply for a separate certificate in advance. This is one of the biggest practical advantages of the new system.
The June 2026 Update: Special Residence Card
From June 14, 2026, Japan introduces the Tokutei Zairyu Card (特定在留カード) — a new card that combines the My Number Card and the Zairyu Card into a single document.
What This Means for Students
| Feature | Current (two cards) | From June 2026 (one card) |
|---|---|---|
| Identity | Zairyu Card | Tokutei Zairyu Card |
| Health insurance | Myna Hokensho (separate registration) | Built into the card |
| Online services | Mynaportal via My Number Card | Same card |
| Processing time | ~3–4 weeks for My Number Card | ~10 days longer than standard Zairyu Card |
Important: Applying for the Tokutei Zairyu Card is optional. You can continue using separate cards if you prefer. The system accepts both.
New arrivals from June 2026 onward can apply for the Tokutei Zairyu Card at the same time they complete address registration — getting everything done in one step.
Practical Tips for International Students
Keep Your Documents in Order
- Carry your shikaku kakuninsho (or Myna Hokensho) at all times — not just when you think you might need it
- Know your PIN: The 4-digit clinic PIN is different from other PINs. Write it down and store it safely
- Renew on time: Your My Number Card expires with your Zairyu Card. Apply for renewal at least 3 months before expiry
Language Support
- Most city/ward offices have multilingual staff or interpreters for foreign residents — ask when you arrive
- The Mynaportal website is available in English, Chinese, Korean, Spanish, Portuguese, and more
- The AMDA International Medical Information Center (03-5285-8088) provides multilingual medical guidance
When Changing Address
Moving to a new municipality within Japan requires:
- Report your new address at the new city/ward hall within 14 days
- Your NHI enrollment transfers — you receive updated premium notices
- Your My Number Card address is updated at the same visit (bring the card)
- If your shikaku kakuninsho has your old address, request a new one
FAQ
Are physical health insurance cards still accepted in Japan?
No. Physical hokensho cards expired at the latest on December 1, 2025. Since December 2, 2025, clinics and hospitals verify insurance using the My Number Card (Myna Hokensho) or the Eligibility Confirmation Certificate (資格確認書). If you have an old hokensho, it no longer works.
Can I see a doctor without a My Number Card?
Yes, with a shikaku kakuninsho (Eligibility Confirmation Certificate). This free document, issued by your city/ward’s NHI office, works at all clinics and hospitals and gives you the same 30% co-pay. You can request one at your ward office’s NHI counter.
How long does it take to get a My Number Card?
Approximately 3–4 weeks from application submission to card pickup. You must collect the card in person. Apply as early as possible — ideally on the same day you register your address in Japan.
Is the My Number Card free?
Yes. Application and issuance are completely free of charge. There is no fee for any foreign resident to apply for a My Number Card.
What if I do not link my card to NHI?
You receive a shikaku kakuninsho automatically. But the Myna Hokensho has real advantages: automatic high-cost cap application, real-time insurance verification, and digital access to your healthcare records via Mynaportal.
What happens when my visa is extended?
Your My Number Card expires on the same date as your Zairyu Card. When you renew your residence status, go to the ward office to update your My Number Card expiry accordingly. This is done at the same time as receiving your updated Zairyu Card.
What is Mynaportal?
Mynaportal (マイナポータル) is Japan’s government digital services portal at mynaportal.digital.go.jp. You log in using your My Number Card (with a card reader or NFC-enabled smartphone). Through it, you can register your card for health insurance, check your insurance history, apply for various government services, and view your medical expense records for tax purposes.
What is the Tokutei Zairyu Card launching in June 2026?
The Tokutei Zairyu Card (特定在留カード) is a new combined identity document launching June 14, 2026. It merges the Zairyu Card and My Number Card into a single card. Applying for it is optional — you can still carry separate cards. But for new arrivals from June 2026 onward, it simplifies the process: one application, one card, one pickup.
Does the high-cost cap still apply without a Myna Hokensho?
Yes, but you have to apply for it separately. You need a Gengaku Certificate (限度額適用認定証) from your ward office in advance, and present it at the hospital. The Myna Hokensho applies the cap automatically without any extra paperwork — which is a major reason to get and register the card.
Does my private insurance from home country exempt me from NHI?
No. All residents of Japan staying 3+ months must enroll in NHI regardless of any private or international insurance they hold. There is no legal opt-out. Private insurance can supplement NHI but does not replace it. See our Japan NHI guide for full details on costs and coverage.
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