There is a lot of confusion among the public about Japan’s plan to integrate public health insurance cards with My Number identification cards and how the changes are being implemented.
While the government will stop issuing new health insurance cards on Monday, most people will remain unaffected by the move in the short term as existing health insurance cards can still be used for another year.
Here’s what you need to know about the integration of the two cards.
What happens on Monday?
The government is moving to merge health insurance cards with My Number cards. As part of that process, it will discontinue the issuance of physical health insurance cards on Monday.
However, given the slow integration process, there is a one-year grace period for everyone to make the switch. This is because nearly a quarter of the country’s population has not acquired a My Number card yet.
People without My Number cards can still use their existing health insurance cards for their visits to hospitals, dental clinics and pharmacies during the grace period — which ends on Dec. 1, 2025 — as long as they remain valid.
After that, health insurance cards can no longer be used and everyone will need to have a My Number card for medical visits.
Information about the My Number card and how you can get one is available in English at https://www.kojinbango-card.go.jp/en/.
The integration of health insurance cards with My Number cards has been an option since October 2021, but its uptake has been slow.
In October, the month for which the latest data is available, only 15.7% of patients at hospitals across the country used their My Number cards as proof of insurance; the rest stuck with health insurance cards.
What is the purpose of the switchover and why has the transition been slow?
My Number is an ID that can be used to pay taxes and apply for other government services. The government introduced the system to digitalize its services.
By integrating health insurance cards with My Number cards, health care providers can share a patient’s medical information more efficiently. Patients can give their doctor permission to look up records of prescriptions and health screenings, potentially leading to more seamless health care.
Another advantage of the system is reducing paperwork. For example, under the public health insurance system, patients undergoing expensive medical procedures can apply to have part of the cost reimbursed. Patients with insurance-integrated My Number cards won’t have to go through the trouble of paying the expenses at the counter and the process will be hassle-free, the health ministry says.
The adoption of the My Number card has been slow because it was initially voluntary. But in October 2022, then-digital minister Taro Kono declared it was the government's goal to scrap health insurance cards and integrate them with My Number cards by the fall of 2024. The move was pushed back slightly to December, due in part to a series of glitches in the system that eroded public confidence and spurred anxiety about personal information and privacy leaks.
Will I be denied insurance coverage if I don’t get a My Number card by December 2025?
No. You will still be able to receive insured care if you show an insurance eligibility certificate, which will be mailed to everyone who hasn’t applied for a My Number card or those who have them but have not linked them to their health insurance cards. The paper certificate will be issued free of charge. The certificate is valid for up to five years and can be renewed by the insurer.
I have a My Number card. Can I use it at medical institutions?
Just getting a My Number card is not enough. You need to register your health insurance card with your My Number card. You can do this either by using card readers at the hospital or pharmacy you visit, through the Mynaportal page or by using Seven Bank’s ATMs. PC users accessing the Mynaportal page would need their own IC card reader plugged into the computer, while smartphone users will need to install the Mynaportal app.
Many medical institutions have reported technical issues with My Number card readers, and there are also fears of more issues in the event of power outages or network failures.
In the event of a technical issue, the health ministry advises medical institutions to confirm the patients’ IDs with their My Number cards and either a Mynaportal page displaying their insurance eligibility on a smartphone or a document confirming their eligibility, which is mailed to every resident.
I recently received a document in the mail from my health insurance union about my eligibility. Is this the insurance eligibility certificate?
No. Insurance unions around the country are sending every member a document called "Shikaku Johо no Oshirase" ("Notification of Insurance Eligibility"). Some have received the document already while others will get one early next year. This document lists an individual's health insurance card number and can be used in the event of card reader errors at the hospital if presented together with a My Number card.
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