<when you want mail application, please contact Asahi Ward government office Insurance and Pension Division payment responsible beforehand>
①Application for re-issue books (PDF: 58KB) such as identifications of person insured
２．Limit application, standard burden reduction authorization application
①Limit application authorization application (income earner 1, active play regular income earner 2 at the same level as active play) (PDF: 31KB)
②Limit application, standard burden reduction authorization application (low-income person 1, low-income person 2) (PDF: 33KB)
※Application varies according to division.
[note 1] Limit application certificate becomes necessary only for income earner (less than taxable income 6.9 million yen) at the same level as active play and residence tax tax exemption household. As by showing health insurance card to medical institution, it is window burden to self-pay limit depending on burden ratio about other person, limit application certificate is unnecessary.
[note 2] Please confirm link about the details such as burden division. In addition, please note that it limits to the person or family of the household to be able to answer on the telephone about burden division.
３．Specific illness certificate dossier
①Specific illness authorization application (PDF: 65KB)
②Certificate (PDF: 108KB) which affects specific illness certification application
４．Medical expenses supply application
①Medical expenses supply application (PDF: 184KB)
５．Standard burden balance supply application
①Meal medical treatment the balance supply application (PDF: 163KB)
①Funeral costs supply application (PDF: 199KB)
②Petition for funeral costs supply application (PDF: 136KB)
①Premium payment method change monkey appearance book (PDF: 302KB)
②Premium special collection return monkey appearance book (PDF: 197KB)
①Petition (PDF: 82KB) about application about payment costs and the receipt
②Transfer previous engagement seat change application (PDF: 131KB)
③Destination application (PDF: 142KB)
④About required documents of destination application (PDF: 230KB)
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To downloading of Adobe Acrobat Reader DC