My Number Cards for Health Insurance: How Long will This Confusing Situation Continue?

Editorial

15:25 JST, August 21, 2025

There are few policies to which the proverb “Haste makes waste” is so aptly applied. One such policy is the transition to the so-called My Number insurance cards, which combine the functions of health insurance certificates with My Number identification cards.

In 2023, the government decided to abolish paper health insurance certificates by December this year and integrate them into My Number insurance cards. Those who do not have a My Number insurance card will be required to use “certificates of eligibility,” which will be valid only for a limited time.

However, even after this decision, the usage rate of My Number insurance cards has not increased, forcing the government to implement one change after another as exceptional measures.

First, in April this year, the government decided to distribute certificates of eligibility to all individuals aged 75 and older, regardless of whether they have a My Number insurance card. All the certificates have already been distributed.

Next, in June, the government allowed self-employed and other individuals enrolled in national health insurance programs to continue to use paper health insurance certificates even after their expiration dates. And then, starting this month, people aged 75 and older also were allowed to use expired paper health insurance certificates in the same manner as self-employed and other individuals.

The successive rule changes are placing a burden on frontline medical institutions and other places. A hospital in Saitama City has revised its manuals every time the central government changed its policies. Nevertheless, confusion reportedly often arises at reception desks among hospital staff and patients.

The government’s initial plan was to continue using both the My Number insurance cards and paper health insurance certificates. However, the sudden decision to abolish paper health insurance certificates is one of the reasons for the confusion.

In the first place, combining My Number cards, which are left up to individuals to acquire on a voluntary basis, with the universal health insurance coverage system, which ensures all residents access to medical care, was problematic.

Since using the My Number insurance cards allows doctors to access patients’ medical records, it is advantageous for doctors as it can prevent drugs from being overprescribed.

However, the usage rate of My Number insurance cards was only 31% of the total number of visits by patients to medical institutions and other places where the cards can be used. As mistakes, such as cards being linked to another person’s information, have repeatedly occurred, many people may still feel uneasy about using them.

The exceptional measures established by the central government are valid for a maximum of one year. To avoid further confusion, it is necessary to allow both the My Number insurance cards and paper health insurance certificates to be used.

Meanwhile, regarding the My Number insurance cards, another problem is that when the five-year validity period of the embedded electronic certificate expires, if renewal procedures are not performed afterward, the card will lose its function as a health insurance certificate. This fiscal year, 15.8 million cards are set to expire.

To prevent a situation in which people who have obtained the cards cannot use them for medical visits due to their expiration, the central government should make the problem well-known to those who will be affected by it.

(From The Yomiuri Shimbun, Aug. 21, 2025)