Is this a bill for the premium? Do I pay something?

No. This shows that you are eligible for NHI medical care — it is not a bill. The premium is paid separately, via a 納付書 (payment slip) or direct debit. No payment is triggered by this document itself.

I heard the paper insurance card is gone. Can I still see a doctor?

Yes. Only the paper 健康保険証 was phased out. Show a マイナ保険証 (My Number Card used as a health card) or the 資格確認書 issued by your municipality at the counter and you are covered as before.

My document is about to expire / has expired. What do I do?

Most municipalities mail a new 資格確認書 automatically before expiry. If nothing has arrived or a renewal is required, contact the NHI counter printed on the document. Unpaid premiums can delay issuance.

I started a job with a company health plan. What about the NHI document?

Once you join a company health plan, you must file to leave NHI — it does not happen automatically. Take proof of your new coverage to the NHI counter and notify them. Staying double-enrolled can mean paying two premiums.

Insurance / Pension

国民健康保険資格確認書: Japan National Health Insurance Eligibility Card Explained

This document shows that you are enrolled in 国民健康保険 (National Health Insurance, or NHI) and are eligible to receive medical care — it is not a bill asking for payment. Because the paper 健康保険証 (health insurance card) has been phased out, eligibility is now shown either through a マイナ保険証 (using your My Number Card as your health card) or a 資格確認書 (eligibility confirmation document) issued by your city or ward. You present the 資格確認書 at hospitals and pharmacies just like the old card. Most have an 有効期限 (validity period) and either arrive automatically before expiry or require a renewal. Names, membership numbers and expiry dates differ per person, so always check what is printed on your own document.

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Who receives it

People not covered by a company health plan — the self-employed, freelancers, those between or after jobs, and others who meet the requirements — enrol in National Health Insurance and receive this from their city or ward office. If you have not registered your My Number Card as a health card, or still need one, you are issued a 資格確認書. Nationality does not matter: if you have a resident registration and are enrolled in NHI, the treatment is the same. Because NHI is managed by household, documents for family members may arrive together.

What to do

1Check whether the document is a 資格確認書 or a renewal/switch notice, and note the name, membership number and 有効期限 (expiry).
2If your My Number Card is registered as a health card, you can check in at hospitals with the card; otherwise present the 資格確認書 at the counter.
3If the expiry is near or passed, check the enclosed notice for whether a new 資格確認書 arrives automatically or a renewal is required.
4Paying the NHI premium is separate from this eligibility document — it is done by a 納付書 (payment slip) or direct debit; this document itself is not a bill.
5If your situation changes (moving, starting or leaving a job), notify the NHI counter at your city or ward without waiting for expiry. Ask the section printed on the document if anything is unclear.

About the deadline

A 資格確認書 usually has an 有効期限 (expiry) printed on it. An expired one cannot be used at hospitals, so make sure a renewed document has arrived. Most municipalities mail a new one automatically before expiry, but unpaid premiums can delay issuance or renewal. If you start a company health plan or move to another municipality, a separate switch notification is needed. Delaying that can mean paying the full medical cost yourself temporarily, so handle it early.

Common misunderstandings

Is this a bill for the premium? Do I pay something?: No. This shows that you are eligible for NHI medical care — it is not a bill. The premium is paid separately, via a 納付書 (payment slip) or direct debit. No payment is triggered by this document itself.
I heard the paper insurance card is gone. Can I still see a doctor?: Yes. Only the paper 健康保険証 was phased out. Show a マイナ保険証 (My Number Card used as a health card) or the 資格確認書 issued by your municipality at the counter and you are covered as before.
My document is about to expire / has expired. What do I do?: Most municipalities mail a new 資格確認書 automatically before expiry. If nothing has arrived or a renewal is required, contact the NHI counter printed on the document. Unpaid premiums can delay issuance.
I started a job with a company health plan. What about the NHI document?: Once you join a company health plan, you must file to leave NHI — it does not happen automatically. Take proof of your new coverage to the NHI counter and notify them. Staying double-enrolled can mean paying two premiums.

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国民健康保険 資格確認書: Japan National Health Insurance Eligibility Card Explained