The paper health insurance certificate has been abolished, and the field has moved to a system based on the "Myna insurance card." Beyond patient handling, the issues for clinics include how the EMR/rececon should respond—and the network security that comes with online eligibility verification. This article organizes the transition and EMR response points, based on official information.
Disclaimer: This is general information. Handling and fee rules change via revisions/notices; always confirm the latest primary sources (MHLW / regional bureau notices).
The transition timeline
The Myna insurance card is a My Number Card registered for use as a health insurance certificate. Key timeline:
- Dec 2, 2024: New issuance of paper certificates ended; the system moved to a Myna-card basis.
- Previously issued valid certificates had a transitional period of up to one year (or until expiry).
- Dec 2, 2025: The transition ended and paper certificates expired; thereafter, patients use the Myna insurance card, or an eligibility certificate if unregistered.
Transitional handling was provided to avoid confusion, and using a smartphone as the Myna card has begun at supported facilities. Details may change—always confirm the latest official information.
The eligibility certificate
Patients without a Myna insurance card (or unregistered) are issued an eligibility certificate by the insurer, free and without application; presenting it allows insured care as before. Clinics must have a reception flow that handles both the Myna card (reader) and the eligibility certificate (symbol/number entry).
Online eligibility verification and network security
For the clinic, the Myna card is the entry point to online eligibility verification. A face-authentication reader confirms up-to-date eligibility and—with consent—medication and checkup information.
Crucially, online eligibility verification presumes network connectivity. Since it became, in principle, mandatory in April 2023, nearly all clinics must premise network-connection security (closed networks, perimeter defense, endpoint measures)—directly tied to the safe management the three-ministry guidelines require (see Implementing the Three-Ministry Guidelines).
What the EMR/rececon must support
| Support | Content |
|---|---|
| Integration with eligibility verification | Retrieved eligibility auto-reflected in the rececon |
| Medication/checkup reference | With consent, view past info in the exam room |
| Eligibility certificate | Reception via symbol/number entry |
| Fewer rejections/errors | Ingesting up-to-date eligibility prevents rejections from expired certificates |
If these become manual or double work across systems, reception/billing burden actually increases. Having eligibility verification through to claim creation connected as one is the key to a smooth transition.
Key points of the 2026 revision
With medical DX, fee schedules increasingly reward Myna-card/online-eligibility use. Additions such as the "electronic clinical information coordination fee," and support for electronic prescriptions and the EMR information-sharing service, bear on billing requirements.
Because point values and requirements are revised each cycle, this article avoids asserting figures—always confirm MHLW/regional bureau notices and interpretive notices. The point is that these additions presume "a system able to leverage the DX infrastructure including the Myna card," so your EMR/rececon readiness directly affects eligibility to bill.
With AI Karte
Pottech's AI Karte is a rececon-integrated, AI-native design. Because eligibility and medication data retrieved via online verification live on the same data platform, it handles both Myna-card and eligibility-certificate patients smoothly. AI claim-checking helps avoid missing DX-related additions, and a three-ministry-compliant security design (see Designing Security for an AI EMR) supports safe operation during the transition.
Conclusion
The transition is not a mere change of reception method but the building of DX infrastructure. Considering eligibility-certificate handling, network security, and the 2026 additions, whether the EMR/rececon responds as one integrated system matters. As rules change with revisions, always confirm the latest official information. Please feel free to contact us.
References and sources
- MHLW, "About Using the My Number Card as a Health Insurance Certificate"
- MHLW, "About the Eligibility Certificate"
- MHLW, "About Online Eligibility Verification"
This is general information. Rules and fees change via revisions/notices; confirm the latest primary sources in practice.