Printed on your letter

資格確認書

shikaku kakuninsho

Health insurance eligibility certificate

Last checked: 6 October 2026

This is proof of your health insurance, used in place of the old health insurance card (保険証). For now, you get it free and without applying if you do not use your My Number card as your health insurance card (マイナ保険証). Show it at every hospital, clinic and pharmacy.

What to do now

Check your name and date of birth, and note the expiry date (有効期限). Keep it with you and show it whenever you see a doctor.

What it is: Proof that you are covered by public health insurance. With it, you pay your usual share of medical costs, as with the old card.
Who sends it: Your health insurer: the city or ward office if you are in National Health Insurance, or your employer’s health insurance if you are covered at work.
When it arrives: When you join, and again before the old one expires. For National Health Insurance, Kawasaki and Nagoya send new ones in July, and Osaka in October.
Valid until: Until the expiry date (有効期限) printed on it. Each insurer sets it, from 1 year (Kawasaki, Nagoya) up to 5 years. In some cities, such as Kawasaki and Osaka, it ends earlier if your period of stay ends first.

How to read it

Tap a number to see what it means. Yellow marks the expiry date.

Simplified drawing. Size, colour and layout differ by insurer and city.

Step by step

Check that it says 資格確認書 and that your name, sex and date of birth are right. If something is wrong, contact the office that sent it.
Note the expiry date (有効期限). In many cities, a new one is mailed to you before it ends, without applying.
Show it at the counter each time you see a doctor or get medicine at a pharmacy.
Tell your city office within 14 days when you move to another city or join your employer’s health insurance. National Health Insurance does not end by itself (Setagaya). Also tell them if you leave Japan.
If you lose it or it is damaged, ask the office that sent it for a new one (再交付).

Where to show it

Hospital or clinicShow it at reception, as you did with the old health insurance card.
PharmacyShow it when you hand in your prescription.

It works on its own. You do not need to show your My Number card with it.

When it stops working as normal

After the expiry date (有効期限), it can no longer be used. Look for the new one in your mail before then.
From the day you join your employer’s health insurance, the city’s certificate can no longer be used. In Nagoya and Yokohama, if you use it anyway, the city may ask you to pay back what it paid.
If your period of stay ends, your National Health Insurance ends too, and you cannot use the certificate (Itabashi).
If National Health Insurance premiums stay unpaid for 1 year or more without a special reason, the law says you pay the full cost at the clinic first. You can claim the insured share (特別療養費) back later, but the city may use it for the unpaid premiums (Sapporo). Kobe, for example, swaps the certificate for one marked 特別療養. Children up to the end of March after they turn 18 are not affected. If you need care and cannot pay the full cost, ask your city office.

Good to know

Most of this happens without you doing anything.

For now, it is free, and you do not need to apply if you do not have a My Number health insurance card (マイナ保険証).
Many cities mail the new one before the old one expires. If it has not arrived by the time stated (for example, the end of July in Nagoya, or the end of October in Osaka), contact your city office. In Osaka it comes by registered mail that is not forwarded; if you are out, the post office leaves a notice.
If your visa renewal is still being decided when your certificate is about to expire, take your residence card stamped 更新中 (renewal in progress) to the city office. Itabashi and Koto, for example, then issue a certificate you can use in the meantime.
If your My Number card’s electronic certificate has expired, your insurer sends you a 資格確認書 after some time, without applying.
If you have a マイナ保険証 but find it hard to use, for example because of age or disability, or your My Number card is lost or being renewed, you can apply for a 資格確認書.

Common questions

What is the difference between 資格確認書 and 資格情報のお知らせ?

A 資格確認書 works on its own at the clinic. A 資格情報のお知らせ is sent to people who use their My Number card as their health insurance card. It cannot be used on its own: show it together with your My Number card if the clinic cannot check your insurance on its system.

Can I still use my old health insurance card (保険証)?

No. All old cards expired by 1 December 2025, and clinics stopped accepting expired ones after 31 July 2026. Use a 資格確認書 or a マイナ保険証.

Why does my certificate expire sooner than my family’s?

In some cities, a foreign resident’s certificate ends with their period of stay (在留期間). Kawasaki and Osaka do this, and in Setagaya the certificates of foreign residents, except permanent and special permanent residents, are valid for a shorter time. When your period of stay is extended, many cities send a new certificate without a visit: Koto and Itabashi do, but Koto asks people with 特定活動 status to come in.

I am moving to another city or leaving Japan. What do I do?

Moving to another city: return the certificate to your old city and get a new one from the new city, as Nagoya explains. Leaving Japan: tell your city office so that your National Health Insurance ends. In Yokohama, you bring the certificate to that procedure.

I work for a company. Who sends mine?

Your employer’s health insurance. With Kyokai Kenpo (協会けんぽ), for example, your employer ticks a box on the form when you join if you need one, so tell them. If you are already insured, you apply to Kyokai Kenpo yourself. You cannot use it after you leave the job: return it to your employer.

Show this at the counter

Show this to the staff if you go to the office in person.

資格確認書について相談したいです。日本語があまり分かりません。有効期限と、なくしたときや引っ越すときの手続きを教えてください。

In EnglishI would like to ask about my eligibility certificate (資格確認書). I do not understand much Japanese. Please tell me the expiry date and what to do if I lose it or move.

Official sources