About application by mail (medical expenses subsidy such as child, severely disabled, single-parent home)

〒230-0051
3-20-1, Tsurumichuo, Tsurumi-ku, Yokohama-shi
Insurance and Pension Division, Tsurumi Ward Office

Please send the following items to Insurance and Pension Division, Tsurumi Ward Office.

• medical expenses Application Form (PDF: 53KB)＜Example of entry (PDF: 211KB)＞
• Receipt of medical institutions (original)
• employee health insurance's payment decision letter (copy permitted) ※Required if employee health insurance receives insurance benefits such as high medical costs and additional benefits.

• If you have more than one receipt, you will need more than one application form. First, fill out one sheet, copy the necessary number of sheets by referring to the "Thinking of Application Forms" below, and seal all applications (private seal using vermilion). Please do not have a stamp.
• The received receipt cannot be returned, so please make a copy if necessary.
• Compensation cannot be provided if the mail is not sent to the ward office due to postal accidents. When applying, please make a copy of the documents mailed at your own risk, and use the postal tracking service such as specific record mail or registered mail.

One application form is required for each patient, medical institution (Medical consultation fee), every month of medical treatment (dispensing), and for each hospitalization / outpatient.

[Example of necessary number of sheets]

• 2 months of outpatient and dispensing pharmacy receipt
  • ○○Clinic (for outpatients in January 2007: 2 receipts)
  • ○○Clinic (February 2007: 1 receipt)
  • △△Pharmacy (dispensed in January 2007: 2 receipts)
  • In this case, there are three necessary number of sheets applications in this case.
• If you are hospitalized and go to an outpatient clinic after discharge
  • ○× University Hospital Pediatrics (inpatient in January 2007: 2 receipts)
  • ○× University Hospital Pediatrics (inpatient in February 2007: 1 receipt)
  • ○X University Hospital Pediatrics (February 2007: 1 receipt)
  • ○× University Hospital Ophthalmology (for outpatients in February 2007: 2 receipts)
  • In this case, there are four necessary number of sheets applications.

〒230-0051
3-20-1, Tsurumichuo, Tsurumi-ku, Yokohama-shi
Tsurumi Ward Office Insurance and Pension Division In charge of subsidies for medical expenses Severely Disabled Persons / Single Parent Family medical expenses