About medical care benefits(급부에 대해서)

The National Health Insurance scheme provides partial coverage for medical expenses in the event that you become ill or injured and visit a medical institution for diagnosis and treatment.

When visiting a medical institution for treatment, you must show your health insurance card at the reception desk, otherwise you will be liable for the full amount. The amount you will pay is as follows.

Everyone who signs up for the National Health Insurance scheme is issued with a health insurance card.
Please show your health insurance card at the reception desk when visiting a medical institution for treatment.

If you have a medical certificate for a person with severe physical/intellectual disabilities, Welfare Medical Card, Medical Certificate, etc., you can receive subsidized medical treatment. Please show your certificate at the reception desk when visiting a medical institution for treatment.
For more details, please inquire at the Health Insurance and Pension Division in the ward where you live.

Those who are enrolled in the City of Yokohama's National Health Insurance scheme and who have recently turned 70 years of age will be sent a National Health Insurance Card and National Health Insurance Recipient Card for Seniors at the end of the month they were born (the previous month for those born on the 1st). This card states the amount of personal contribution you will make under the copayment system. You will be able to use this card from the month after you turn 70 (the same month for those born on the 1st). When visiting a medical institution for treatment, please show your National Health Insurance Card and National Health Insurance Recipient Card at the reception desk.

The National Health Insurance scheme provides a number of different medical care benefits. These include medical costs, high medical costs,high medical costs (outpatient annual aggregate),high cost longterm care, costs for meals and daily life during hospitalization, transfer costs, a lump-sum allowance for childbirth, funeral costs, a childcare allowance for children with disabilities, an injury and sickness allowance,etc. For more details, please inquire at the Health Insurance and Pension Division in the ward where you live.

If you were unable to show your health insurance card upon arrival at a medical institution due to a medical emergency, etc., you can receive a reimbursement of the medical costs incurred on this occasion. To receive this benefit, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this benefit if a period of 2 years has elapsed from the day after you paid the total amount for costs.

1. Receipts
2. Statement specifying the name of the injury or illness and the content of medical care
3. Health insurance card
4. Bank book or other document allowing confirmation of the payee's account details

*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

1. Statement specifying the name of the injury or illness and the content of medical care (please attach a Japanese translation*)
2. Receipts (please attach a Japanese translation*)
3. Original passport of the person who received treatment
4. Letter of consent (form available at ward offices)
5. Health insurance card
6. Bank book or other document allowing confirmation of the payee's account details

*Documents can be translated by anyone. You can also translate them yourself. Please write down the name and address of the translator.
*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

If your medical costs for a particular month were high and you meet the criteria for high medical costs, an application form will be sent to the head of the household, and you can receive benefits by returning the form to the Insurance and Pension Division of the ward where you live with the enclosed return envelope.Please note that you will no longer be entitled to apply for this benefit if a period of 2 years has elapsed from the first day of the month after you received your treatment.
For more details, please see the section on high medical costs.

If your total outpatient medical costs for a year were high and you meet the criteria for high medical costs (outpatient annual aggregate), an application form will be sent to the head of the household, and you can receive benefits by returning the form to the Insurance and Pension Division of the ward where you live with the enclosed return envelope.Please note that you will no longer be eligible to apply for this benefit if a period of 2 years has elapsed from the day after confirmation of this application form.

If your medical costs and nursing care costs for the year were high and you meet the criteria for high cost long-term care, an application form will be sent to the head of the household, and you can receive benefits by returning the form to the Insurance and Pension Division of the ward where you live with the enclosed return envelope. Please note that you will no longer be eligible to apply for this benefit if a period of 2 years has elapsed from the day after confirmation of this application form.

Those who have been issued with an Eligibility Certificate for Ceiling-Amount Application and Reduction of the Standard Amount of Patient Liability Certificate can receive a reduction on the costs for meals and living while in hospital. To qualify for this, please show your Eligibility Certificate for Ceiling-Amount Application and Reduction of the Standard Amount of Patient Liability Certificate and health insurance card upon admission to hospital. Those who were unable to show their Eligibility Certificate for Ceiling-Amount Application and Reduction of the Standard Amount of Patient Liability Certificate and paid more than required can receive a reimbursement of the difference. To receive a reimbursement, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this benefit if a period of 2 years has elapsed from the day after you paid the full amount of costs.

1. Receipts from a medical institution
2. Health insurance card
3. Bank book or other document allowing confirmation of the payee's account details

*Please see the section on high medical costs to find out more about how these are issued.
*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

Patients who have trouble getting around and whose symptoms suggest that they cannot be provided with adequate treatment at a particular medical institution can receive a benefit to help cover the costs incurred in the event they are transferred to another hospital as a matter of emergency at the instructions of a doctor. To receive this benefit, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this benefit if a period of 2 years has elapsed from the day after you paid the costs required for transferal.

1. Written opinion from a doctor stating the need for the patient to be transferred
2. Receipts for costs incurred in the course of transferal
3. Health insurance card
4. Bank book or other document allowing confirmation of the payee's account details

*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

If you give birth in Japan and agree to use the direct payment system* at a medical institution, you will receive a 500,000 yen reduction on your final bill for childbirth expenses at the medical institution concerned. Please note that the direct payment system cannot be used if you give birth overseas.
If you did not make use of the direct payment system in Japan, if the costs of childbirth did not reach 500,000 yen, or if you gave birth overseas, you can receive a lump-sum allowance for childbirth. To receive this allowance, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this allowance if a period of 2 years has elapsed from the day after you gave birth.
*It is normally the role of the head of household to apply for the lump-sum allowance for childbirth. By using the direct payment system, you enter into a contract with the medical institution where you will give birth to apply for and receive the lump-sum allowance for childbirth in lieu of the head of household. When using this system, the lump-sum allowance for childbirth will be paid directly to the medical institution concerned. As such, 500,000 yen will be subtracted from your bill for childbirth expenses when you leave hospital.
*420,000 yen for those who gave birth before March 31, 2023.

1. A document certifying the amount of childbirth expenses you paid issued by the medical institution concerned
2. A letter of agreement with the medical institution concerned
3. Mother and Child Health Handbook
4. Health insurance card
5. Bank book or other document allowing confirmation of the payee's account details

*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

1. A document certifying the fact that you have given birth (a certificate from a doctor, etc. Please attach a Japanese translation*)
2. Original passport of the person who received treatment
3. Letter of consent (form available at ward offices)
4. Health insurance card
5. Bank book or other document allowing confirmation of the payee's account details

*Documents can be translated by anyone. You can also translate them yourself.
*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

In the event someone passes away, the person conducting a funeral for the deceased individual (chief mourner) can receive a benefit to help cover the costs. To receive this benefit, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this allowance if a period of 2 years has elapsed from the day after the funeral was held.

1. Documents showing who held the funeral and the date of the funeral
2. A form of identification for the person making the application
3. Health insurance card
4. Bank book or other document allowing confirmation of the payee's account details

*When transferring funds to the account of someone other than the applicant, a personal seal (in the applicant's name and using vermilion ink) is required.

If you have a child who develops a congenital disorder or abnormalities within 2 years of birth, and you have been enrolled in the City of Yokohama's National Health Insurance scheme continuously from when this child was born until you apply, you can receive a childcare allowance for children with disabilities. To receive this allowance, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this allowance if a period of 2 years has elapsed from when your child developed the disorder.

1. Medical certificate
2. Mother and Child Health Handbook
3. Health insurance card
4. Bank book or other document allowing confirmation of the payee's account details

*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

You can receive this benefit if you meet all of the following criteria.

1. You are enrolled in the City of Yokohama's National Health Insurance scheme and are in receipt of wages.
2. You are infected with COVID-19 or have symptoms such as a fever and are suspected of having contracted COVID-19,and are no longer able to engage in work because you are recuperating.
3. You have been off work for 3 consecutive days of work and for some other days from the 4th day onward.
4. You were unable to receive your wages for the duration of your time off work, or you received a reduced wage payment.

To receive this allowance, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply. Please note that you will no longer be entitled to apply for this benefit if a period of 2 years has elapsed from the day after you were absent from work.

1. Application for Injury and Sickness Allowance(total 4 sheets)(form available at ward offices)
2. Health insurance card
3. Bank book or other document allowing confirmation of the payee's account details

*When transferring funds to the account of someone other than the head of household, a personal seal (in the head of household's name and using vermilion ink) is required.

Under the high medical costs system, a person enrolled in the City of Yokohama's National Health Insurance scheme can receive a refund of part of the costs paid for medical care in a single month if his or her medical costs were exceptionally high for that month. Please note that you will no longer be entitled to apply for this benefit if a period of 2 years has elapsed from the first day of the month after you received your treatment.

There are two ways you can apply for assistance through the high medical costs system.

1. Advance reduction of costs at the medical institution
2. Application at your ward office's Health Insurance and Pension Division after you have paid the costs at the medical institution

You can have your medical costs reduced at the medical institution if you show your health insurance card together with an Eligibility Certificate for Ceiling-Amount Application at the reception desk. To be issued with an Eligibility Certificate for Ceiling-Amount Application, please bring along the following items to the Health Insurance and Pension Division in the ward where you live and apply.

• Health insurance card

Under the City of Yokohama's National Health Insurance scheme, if it is deemed that an individual qualifies for a reimbursement under the high medical costs system, the head of household will be sent an Application for Reimbursement of High Medical Costs towards the end of 2 - 3 months from the month when the individual received treatment entailing high medical costs. When you receive the application form, you can receive benefits by returning the form to the Insurance and Pension Division of the ward where you live with the enclosed return envelope.
For more details, please inquire at the Health Insurance and Pension Division in the ward where you live.