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About application by mail (severe person with a disability, single-parent family supports medical expenses children)

Last update date January 27, 2020

Grant application (birth, transference)

Please send the following to Totsuka Ward government office Insurance and Pension Division. We issue Medical Certificate by mail.

Change, re-grant (change of Address and health insurance card, loss of Medical Certificate)

Please send the following to Totsuka Ward government office Insurance and Pension Division.

Medical expenses supply application

Please send the following to Totsuka Ward government office Insurance and Pension Division.

Precaution

  • Supply application and input vote two pieces become one set. Please do not do duplex printing.
  • When there are multiple receipts, several application, input votes are necessary, too. At first, we fill in one piece and copy necessary number of sheets with reference to the following "ways of thinking of the number of applications" and seal all applications (private seal to use vermilion for. Please do stamp mark impossibility).
Way of thinking of the number of applications

As for the application, one piece becomes necessary for every medical institution (Medical consultation fee) together with patient for each hospitalization, outpatient department together with medical treatment (composition) month.
[example of necessary number of sheets]

  • A: Three pieces of necessary number of sheets of application
    • ○○Doctor's office (for January, 2007 medical treatment: two pieces of receipts)
    • ○○Doctor's office (for February, 2007 medical treatment: one piece of receipt)
    • △△Drugstore (for January, 2007 compounding of medicines: two pieces of receipts)
  • B (we are hospitalized from January through February for 19 years, and outpatient has a medical examination after the discharge): Four pieces of necessary number of sheets of application
    • ○X university hospital Pediatrics (for January, 2007 hospitalization: two pieces of receipts)
    • ○X university hospital Pediatrics (for February, 2007 hospitalization: one piece of receipt)
    • ○X university hospital Pediatrics (for February, 2007 outpatient: one piece of receipt)
    • ○X university hospital Ophthalmology (for February, 2007 outpatient: two pieces of receipts)

Destination

〒244-0003
16-17, Totsukacho, Totsuka-ku
Totsuka Ward government office Insurance and Pension Division Medical Certificate for infant charge

Medical expenses supply application

Please send the following to Totsuka Ward government office Insurance and Pension Division.

Precaution

  • When there are multiple receipts, several applications are necessary, too. At first, we fill in one piece and copy necessary number of sheets with reference to the following "ways of thinking of the number of applications" and seal all applications (private seal to use vermilion for. Please do stamp mark impossibility).
Way of thinking of the number of applications

As for the application, one piece becomes necessary for every medical institution (Medical consultation fee) together with patient for each hospitalization, outpatient department together with medical treatment (composition) month.

[example of necessary number of sheets]

  • When there is receipt of outpatient department and dispensing pharmacy for two months
    • ○○Doctor's office (for January, 2007 medical treatment: two pieces of receipts)
    • ○○Doctor's office (for February, 2007 medical treatment: one piece of receipt)
    • △△Drugstore (for January, 2007 compounding of medicines: two pieces of receipts)
    • Three pieces of necessary number of sheets of application of this case
  • When we are hospitalized and consult outpatient after the discharge
    • ○X university hospital Pediatrics (for January, 2007 hospitalization: two pieces of receipts)
    • ○X university hospital Pediatrics (for February, 2007 hospitalization: one piece of receipt)
    • ○X university hospital Pediatrics (for February, 2007 outpatient: one piece of receipt)
    • ○X university hospital Ophthalmology (for February, 2007 outpatient: two pieces of receipts)
    • Four pieces of necessary number of sheets of application of this case

Destination

〒244-0003
16-17, Totsukacho, Totsuka-ku
Totsuka Ward government office Insurance and Pension Division National Health Insurance Section payment responsible

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