The Mainichi Shimbun answers common questions readers may have about Japan's full-scale transition to the "My Number" health insurance card system allowing My Number ID cards to function as health insurance cards, and the coinciding discontinuation of the existing ones on Dec. 2.

Question: Will paper health insurance cards no longer be usable after Dec. 2?

Answer: Existing health insurance cards that are already issued can still be used for up to one year as a transitional measure. As the ones used by company employees, public servants and their dependents don't have an expiration date, they will remain valid until Dec. 1, 2025.

Meanwhile, there is an expiration date on the ones used by self-employed individuals and freelancers enrolled in Japan's National Health Insurance program, meaning they will only be valid until that date. However, it's important to be mindful of the fact that the paper health insurance cards will become invalid in cases such as when a person changes jobs or moves.

Q: If you don't have a My Number health insurance card, do you have to pay the full amount for receiving care at medical facilities?

A: No, that is not the case. If you present a "status confirmation certificate," you will still only need to pay the standard co-payment of 10% to 30% to receive treatment. You don't need to apply to obtain the certificate, as it will be sent by health insurance associations and other organizations after Dec. 2 to those who do not have a My Number health insurance card yet. The certificate will be valid for up to five years, with different expiration dates for each individual, but it can be renewed indefinitely.

Q: Is the document you receive from the local government marked as "notification of status information" the same as the status confirmation certificate?

A: No, that is not the certificate. This notification contains a person's insurance card number and will be sent to all individuals, including those who already have a My Number health insurance card. It is a preliminary document to be presented to medical facilities in case devices to scan My Number cards suffer a system error, to ensure that medical treatment can be smoothly provided. However, you cannot receive medical care only using this notification.

Q: Why is the government promoting the use of My Number insurance cards?

A: By utilizing medical treatment and diagnosis data to standardize the work of health care professionals and the system and data storage they use, the government aims to realize a digital transformation in health care, which can lead to disease prevention and improve the quality of medical care.

A service to share electronic medical records between hospitals has been launched, and by combining this with an electronic prescription system that digitizes paper prescriptions, it will also be possible in the future to quickly share a patient's medical history and other information.

Furthermore, the government hopes to reduce the expenses of issuing paper health insurance cards, which is said to cost around 10 billion yen (roughly $66 million) annually.

Q: Are there any actual benefits for patients to use the My Number health insurance card system?

A: For example, by having access to past hospital visits and information on medication, one can easily avoid unnecessary prescriptions of similar drugs at separate medical facilities, and health care professionals may be able to identify medication that shouldn't be taken together.

The government emphasizes that sharing a patient's medical history will help them receive appropriate treatment from doctors.

When using the "High-Cost Medical Expense Benefit," which limits the amount of money patients have to pay themselves for expensive medical treatment including costly surgeries, patients were required to pay the full amount at the reception desk and wait for a partial refund. The My Number health insurance card system will no longer require patients to pay in advance.

Q: What if you don't want doctors to see your past medical history?

A: There are card readers for scanning My Number ID cards at hospitals and pharmacies, and patients can select whether or not to provide past medical information on the device screen. Only with the patient's consent will details of previously prescribed medications, treatments and surgeries be shared with health care professionals.

Q: How widely used are My Number ID cards as health insurance cards?

A: As of the end of October, 75.7% of the Japanese population had a My Number ID card. Among them, 82% had registered to use the My Number health insurance card system. However, only 16.57 million people, or 21.4% of registered users, actually used the ID cards at medical facilities in October. On a case-by-case basis, this figure remained at 15.67%.

Q: Why isn't the usage rate increasing?

A: The low usage rate is likely due to many incidents in which incorrect information, such as data belonging to another person, was registered on My Number ID cards. The government conducted a simultaneous investigation in 2023 and apparently identified that the problems were due to errors made by local governments during manual processing. The government confirmed that there is no issue with the system itself and is encouraging people to use their My Number ID cards as health insurance cards.

Q: Is it true that you can remove the health insurance card function linked to your My Number ID card?

A: Yes, it became possible to undo the integration starting in late October. Company employees and others can now apply for cancellation through their health insurance associations, while self-employed individuals can apply through their local municipalities. The process apparently takes about a month, but once the function is removed, individuals can use the status confirmation certificate from Dec. 2.

(Japanese original by Naoko Furuyashiki, Business News Department; and Kouki Matsumoto, Science & Environment News Department)