medical expenses Grant Application Documents (for National Health Insurance Section Payment Section No. 5)

This is an application document for children, first-degree, and severely disabled medical expenses. For more information about the application, please refer to the following link. In addition, not all applications are posted.

Last update date October 10, 2023

<If you wish to apply by mail, please contact the Asahi Ward Office Insurance Pension Section in advance>

1.Application for Subsidies for Medical Expenses for Pediatric Treatment

①Application form for granting Medical Certificate for infant (consent form) Transfer of pediatric medical care recipients registration form (PDF: 179KB)

①registration form (Excel: 26KB) Application form for granting Medical Certificate for infant (consent form) Transfer to pediatric medical care recipients

<Example> Application form for granting Medical Certificate for infant (consent form) Transfer of pediatric medical care recipients registration form (PDF: 315KB)

②Child medical expenses Payment Application Form (PDF: 1,464KB)

②Application for Child medical expenses (Excel: 372KB)

<Example> Child medical expenses Payment Application Form (PDF: 1,666KB)

Note) The child medical expenses supply application form and the input form is a set of two sheets. Please do not print on both sides.

Subsidies for Medical Expenses for Pediatric Treatment

２．Application form for grant of medical expenses Severely Disabled Persons and medical expenses grant

①medical expenses supply application (severe disability, single-parent home, etc.) (PDF: 84KB)

<Example> medical expenses Application Form (PDF:870KB)

medical expenses Grants for Severely Disabled

medical expenses subsidies for single-parent families

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