With the shift to the My Number health card, what does the company do? The qualification-confirmation certificate and dependent procedures

In short: The conventional health insurance card stopped being newly issued on 2 December 2024 (Reiwa 6). Already-issued cards were usable for up to one year (or until the stated expiry if that came first), but that period has now passed. Employees who do not hold a My Number health card (a My Number Card registered for health-insurance use) are issued a "qualification-confirmation certificate" by the insurer, and by presenting it they can receive insured medical care as before. All the company can do is correctly file the acquisition and dependent notifications; the qualification decision is made by the insurer.

"I hear the health insurance card has been abolished, but our employees don't hold a My Number health card. What is the company supposed to do?" — around the shift to the My Number health card, questions like this continue in the general-affairs and HR field. This article, for the staff of small and medium-sized companies who handle employees' social-insurance procedures, sets out who receives the qualification-confirmation certificate, the procedures for dependents and new enrollees, and the points to convey to employees.

When did the conventional health insurance card stop being usable?

New issuance ended on 2 December 2024 (Reiwa 6).

From that day, the conventional paper and card-type health insurance cards were no longer newly issued. However, cards already issued by then were covered by a transitional measure making them usable for up to one year from issuance (or until the expiry stated on the card if that came first).

Category	Content
End of new issuance	2 December 2024 (Reiwa 6)
Transitional measure for issued cards	Usable for up to one year from issuance (or until the stated expiry if earlier)
Present (as of August 2026)	The transitional period has ended; care is received with a My Number health card or a qualification-confirmation certificate

In other words, when an employee now sees a doctor, they either use a My Number health card or present a qualification-confirmation certificate. As a company, grasping which state each of your employees is in is the starting point.

What is issued to employees who do not hold a My Number health card?

A qualification-confirmation certificate is issued.

The Health Insurance Act, Article 51-3 provides a mechanism whereby, when an insured person is in a situation where they cannot receive electronic qualification confirmation (confirmation via a My Number health card), the insurer issues or provides a qualification-confirmation certificate. Issuance on application is the principle, but the same article provides that, when deemed necessary, the insurer may issue it ex officio (without an application) for the time being. This is why the certificate is issued to those without a My Number health card without waiting for an application.

Item	Content (Health Insurance Act, Article 51-3, etc.)
Who issues it	The insurer (Kyokai Kenpo, a health insurance society, etc.)
Who is covered	Insured persons and dependents who do not hold a My Number health card (a registered My Number Card)
Method of issuance	Issuance on application is the principle; ex officio issuance is also possible for the time being
Validity	Set by the insurer within a range not exceeding five years from the date of issuance (it may be set shorter, e.g. for ex officio issuance)
What it enables	Presenting it at a medical institution's counter, insured medical care is received as before

With a qualification-confirmation certificate, insured medical care can be received even without a My Number Card. It is important to convey correctly to employees that it is not the case that "you cannot see a doctor unless you make a My Number health card."

Note that if the individual number (My Number) is not correctly stated on the acquisition notification, the insurer may issue the certificate ex officio and set a shorter validity. Stating the My Number correctly on the acquisition notification at the time of joining therefore, in the end, makes the employee's procedure go smoothly. The social-insurance enrollment decision itself is summarized in what happens to social insurance when you hire someone for short hours.

How do the procedures for dependents and new enrollees change?

The content of the notifications the company files does not change much from before. What changed is the entrance to receiving care — from "handing out a physical card" to "confirming with a My Number health card / having a qualification-confirmation certificate issued."

Situation	Company's procedure	Point
A new employee joins	Notification of acquisition of insured status	State the individual number correctly. For those without a My Number health card, the insurer issues a qualification-confirmation certificate
An employee gains a dependent	Notification of dependent (change)	The dependent's certificate is sent to the insured person. Whether to certify the dependent is decided by the insurer
An employee leaves	Notification of loss of insured status	After loss of status, the certificate can no longer be used. Follow the insurer's guidance on whether it must be returned

The dependents' certificates are, in practice, sent together to the insured person (the employee themselves). However, they are not issued to those, among the insured person and dependents, who use a My Number health card. Grasping, by household, who holds a My Number health card and who needs a qualification-confirmation certificate makes it easier to answer inquiries.

For the dependent-certification standard itself, together with the income walls, see what happens if you temporarily exceed the 1.3 million yen wall and are dependents not recognized unless they live in Japan. For the expansion of coverage, see what changes with the expansion of social-insurance coverage in 2027.

What should the company convey to employees?

What the company should convey are two things: that the entrance to receiving care has changed, and that care can be received with a qualification-confirmation certificate even without a My Number health card.

The key points of the guidance are as follows.

1. Convey the method of receiving care: those who have registered a My Number health card use their My Number Card; those who have not use a qualification-confirmation certificate. The conventional card is no longer usable.
2. Convey that the certificate arrives automatically: those without a My Number health card are issued a qualification-confirmation certificate by the insurer without applying (ex officio issuance for the time being). Keep it safe when it arrives.
3. Convey that making the card is the individual's and municipality's procedure: the application for the My Number Card itself is made by the person to their municipality, not by the company. It is not something the company does on their behalf.
4. Gather the information needed for procedures: accurately grasp individual numbers and dependent information for the acquisition and dependent-change notifications.

What the company can do goes as far as correctly filing the acquisition and dependent notifications and informing employees of the change in the entrance to care. The final decision on who is recognized as an insured person or a dependent is made by the insurer (Kyokai Kenpo, a health insurance society, etc.).

Note that the acquisition and dependent notifications are the work of a Shakai Hoken Roumushi. The application for the My Number Card itself is a procedure between the employee and the municipality, not something the company does on their behalf.

Frequently asked questions

Q. Can the conventional health insurance card no longer be used now?
A. It cannot. New issuance ended on 2 December 2024 (Reiwa 6), and even for issued cards the transitional period of up to one year (or until the stated expiry if earlier) has passed. Care is now received with a My Number health card or a qualification-confirmation certificate.

Q. Can employees who do not hold a My Number health card no longer see a doctor?
A. They can. Insured persons and dependents without a My Number health card are issued a qualification-confirmation certificate by the insurer, and by presenting it at the counter they receive insured medical care as before. It is issued ex officio for the time being, without an application (Health Insurance Act, Article 51-3).

Q. Does the company issue the qualification-confirmation certificate?
A. No. The one that issues the qualification-confirmation certificate is the insurer (Kyokai Kenpo, a health insurance society, etc.). What the company does is procedures such as the acquisition and dependent-change notifications, and stating the individual number correctly makes issuance to the employee go smoothly.

Q. Should the company apply for the My Number Card on the employee's behalf?
A. The application for the My Number Card itself is a procedure the employee makes to their municipality; it is not something the company does on their behalf. The company's role is to correctly file the social-insurance acquisition and dependent notifications and to inform employees that the entrance to care has changed.

Sources

• End of new issuance of the conventional health insurance card. New issuance of the conventional paper and card-type health insurance cards ended on 2 December 2024 (Reiwa 6). Already-issued cards were covered by a transitional measure making them usable for up to one year from issuance (or until the expiry stated on the card if that came first) (Ministry of Health, Labour and Welfare and Government Public Relations Online guidance on the "My Number health card"; accessed 28 August 2026).
• Health Insurance Act, Article 51-3 (qualification-confirmation certificate). When an insured person is in a situation where they cannot receive electronic qualification confirmation, they may request the insurer to issue or provide a qualification-confirmation certificate, and the insurer issues or provides it promptly. The validity is set by the insurer within a range not exceeding five years from the date of issuance. Also, when deemed necessary, the insurer may issue or provide it ex officio for the time being (e-Gov Law Search, Health Insurance Act, Act No. 70 of 1922; accessed 28 August 2026).
• Practice of issuing the qualification-confirmation certificate. Insured persons and dependents who do not hold a My Number health card are issued a certificate without applying. In practice, dependents' certificates are sent to the insured person, and they are not issued to those who use a My Number health card. For ex officio issuance and the like, the validity may be set shorter (Kyokai Kenpo, "About the My Number health card and the qualification-confirmation certificate"; accessed 28 August 2026).
• The party applying for the My Number Card. The application for and issuance of the My Number Card itself is a procedure between the person and the municipality (Digital Agency and Ministry of Internal Affairs and Communications guidance on the My Number Card; accessed 28 August 2026).
• The final decision on who is recognized as an insured person or a dependent is made by the insurer (Kyokai Kenpo, a health insurance society, etc.). Please confirm the specific forms, deadlines, and whether the certificate must be returned in each insurer's guidance.

This article does not decide whom to consult. The social-insurance acquisition and dependent notifications are the work of a Shakai Hoken Roumushi. The application for the My Number Card itself is a procedure between the employee and the municipality. For fees when consulting 四葉社会保険労務士事務所, see the fee schedule; for frequently asked questions, see the FAQ.

This article is general information. The certification of individual qualification and dependent status is decided by the insurer. Whether the system applies and individual procedures are handled by a qualified professional after a consultation, in light of the latest primary sources (the Ministry of Health, Labour and Welfare, the Japan Pension Service, each insurer, the Digital Agency, etc.) and individual circumstances. Written by Joji Uramatsu (Shakai Hoken Roumushi, Gyoseishoshi, Registered Real Estate Transaction Specialist).