Insurance / Pension
後期高齢者医療: Japan Latter-Stage Elderly Medical Notices Explained
This document relates to the 後期高齢者医療制度 (Latter-Stage Elderly Medical System) that covers people aged 75 and over. Some documents show your eligibility for medical care (a 被保険者証 insurance card or 資格確認書 eligibility document); others tell you the premium (a payment notice). At 75, you are enrolled in this system automatically, switching over from your previous National Health Insurance or company plan (people 65+ with certain disabilities may also qualify). You use the eligibility document at hospital counters, and pay the premium via pension deduction or a payment slip. Amounts and expiry dates differ per person, so always check what is printed on your own document.
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Everyone 75 and older receives this from the prefecture's 後期高齢者医療広域連合 (regional union, with the city or ward as the counter). When you turn 75, you switch automatically from your previous health insurance to this system and are issued a 被保険者証 or 資格確認書. People aged 65-74 certified with certain disabilities may also join. Nationality does not matter if you have a resident registration. The premium applies to each enrolled person individually.
What to do
- 1Check whether the document shows eligibility (被保険者証 / 資格確認書) or is a premium notice.
- 2For an eligibility document, check the name, membership number and expiry, and present it at hospital and pharmacy counters (a マイナ保険証 may also work).
- 3For a premium notice, check the amount, due date and payment method (特別徴収 pension-deduction or 普通徴収 payment-slip).
- 4For 普通徴収 (payment slip), pay by the due date using a method on the notice; you can also apply for auto-debit to avoid paying each time.
- 5If an expiry is near or you have doubts about the amount or payment, contact the municipal latter-stage elderly medical section printed on the document yourself.
About the deadline
Eligibility documents (被保険者証 / 資格確認書) have an expiry, and a new one is usually mailed before it. An expired one cannot be used at hospitals, so check that a new document has arrived. Premium payment slips (普通徴収) have a due date; missing it can incur late charges, and long-term non-payment can cause disadvantages. With 特別徴収 (pension deduction) you do nothing. If paying is difficult, ask the municipality before the due date.
Common misunderstandings
- Can I no longer use my previous health insurance card?
- At 75, you switch automatically from National Health Insurance or a company plan to this system. From then you use this system's 被保険者証 / 資格確認書 (or a マイナ保険証) at hospitals. No procedure is normally needed — the documents are sent to you.
- How do I pay the premium?
- Most people have it deducted from their pension (特別徴収). Those with a small pension or newly enrolled pay themselves by payment slip or auto-debit (普通徴収). Which one applies is stated on the premium notice. The amount varies by income and prefecture.
- How does a 資格確認書 differ from a 被保険者証?
- Both show that you are eligible for latter-stage elderly medical care. Because the paper card is being phased out, people not using a マイナ保険証 are issued a 資格確認書, which you present at the counter just like the old card.
- My document is about to expire. Do I need to renew it?
- Most municipalities mail a new eligibility document automatically before expiry. If nothing has arrived or anything is unclear, contact the municipal latter-stage elderly medical section printed on the document. Unpaid premiums can delay issuance.
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This page is general information. For your own case, confirm with the office that issued the document, or with a qualified professional.