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Specific medical expenses (designated incurable disease ) subsidy program (request for refund)

As we revised format of specific medical expenses bill (No. 8 style) and specific medical expenses (care payment) bill (No. 9 style) again in Yokohama-shi in August, 2020, we will tell. Sorry for your inconvenience, but if there is stock, we replace that it is new and would appreciate your using in the designated medical institution state. Please refer to 045-671-4040 (weekdays 8:45-17:00) if you have any questions in mention.

Last update date August 3, 2020

About request for specific medical expenses (designated incurable disease ) subsidy program refund

With refund of specific medical expenses

In interval before identification of recipient arriving after the application of specific medical expenses (designated incurable disease ) subsidy program to identification of recipient by treatment of designated incurable disease of mention,
We can refund a part of the self-pay when designated medical institution (we include drugstore, temporary nursing at home station.) based on the incurable disease method was consulted.
You have you read carefully, and please apply for this page.
 

About documents necessary for refund such as medical expenses

Specific medical expenses bill (Excel: 27KB)
Specific medical expenses bill (PDF: 177KB)
In the case of request for refund when you used medical insurance, please use the style mentioned above.
 
Specific medical expenses (care payment) bill (Excel: 26KB)
Specific medical expenses (care payment) bill (PDF: 118KB)
In the case of request for refund when you used The Long-term Care Insurance, please use the style mentioned above.
 

About how to use specific medical expenses bill

①Please list identification of full name, recipient number, date of birth, self-pay upper limit monthly basis, recipient validity of surface [patient] column beforehand.
(entry of [claimer] column, [transfer] column is unnecessary at this stage. In addition, we fill in the back side on the medical institution side.)
↓ 
②We submit one piece for each medical facility to appoint hung over to ... "day when identification of recipient arrived" on "day when we applied" and ask for making.
↓ 
③If specific medical expenses bill comes back from designated medical institution, we fill in surface [claimer] column and [transfer] column.
In addition, seal in private seal to use mention and vermilion of [commission column] of the surface bottom for when we list in [claimer] column and [transfer] column toward other than the patient is necessary.
(if all patient and the claimer, transfer are belonging to equivalence, entry of commission column is unnecessary.)
↓ 
④[claimer] We seal ㊞ of column. In addition, seal in private seal to use vermilion for is necessary.
↓ 
⑤If we fill in day to send to city hall on date of the surface top right corner, and bill which we asked for to plural medical institutions is prepared, please mail in one envelope in a mass.
(ward office Elderly and Disabled Support Division window of house ino ward can have you submit. In addition, please understand when there are omission of entry and defects in submission documents as notification comes from Health and Social Welfare Bureau health business section incurable disease measures charge.)
In addition, if, in medical treatment time of specific medical expenses bill, other designated medical institutions have already used the amount of self-pay upper limit management vote,
Please attach copy of the amount of self-pay upper limit management vote.
 

Please be careful about the following cases

[when we cannot accept specific medical expenses bill]
●[claimer] It "is signed the name signature in substitution for seal" "sealed ㊞ of column (when we entrust [commission column]) stamp mark and thumbmark" or "there is not seal".
●We make modifications using whiteout or modified tape. (when there is correction, you fill in two lines, and please seal in correction seal.)
 
[in this case there is not refund of specific medical expenses ]
●Self-pay ratio of public medical insurance is 10%, 20%, and the total sum of monthly self-pay does not exceed self-pay upper limit monthly basis of identification of recipient mention.
●Certificate issuance fee more than certificate issuance fee when there is not refund of medical expenses and 1,140 yen.
●(incurable disease ) Specific medical expenses bill which designated outside medical institution made.
●Medical expenses which it costs for identification of recipient before the start date for validity of mention.
●Medical expenses which it costs for treatment except designated incurable disease of mention to identification of recipient.
●When you can refund at window of designated medical institution of capital before this month.
(you would refund minute at window of medical institution in this month, and please refer to medical institution.)
 
[about amount of money transferred to account and specific medical expenses payment decision notification arriving after the transfer]
●[specific medical expenses payment decision notification] This is not notice to demand payment from patient.
It becomes notifications such as payment amount of money, financial institution name which had transfer, branch names.
●High medical costs which calculates payment amount of money based on specific medical expenses bill, and is paid by public medical insurance
We deduct self-pay upper limit monthly basis minute and make transfer.
 
[about request for the before March, 2018 use] 
Please perform request for refund such as medical expenses until medical treatment minute using bill of Kanagawa to Kanagawa in March, 2018.
Kanagawa homepage "collection of styles" (designated incurable disease medical expenses subsidy program)
http://www.pref.kanagawa.jp/cnt/f531594/p866580.html (the outside site)
 

Statement of specific medical expenses refund by heir

When we demand refund of specific medical expenses after recipient of specific medical expenses died,
It is necessary to attach documents (certificate of family register, resident certificate) which it can identify as the following petitions in specific medical expenses bill to be legal heir.
Petition (PDF: 86KB) about application about Yokohama-shi identification medical expenses and the receipt
Petition (Excel: 19KB) about application about Yokohama-shi identification medical expenses and the receipt
 

Application, reference

Submission to ward office window

Application by mail

〒231-0015 1-8, Onoecho, Naka-ku, Yokohama-shi Kannai Arai Building
It is addressed to City of Yokohama, Health and Social Welfare Bureau health business section incurable disease measures person in charge

Adobe Acrobat Reader DC (old Adobe Reader) is necessary to open file of Portable Document Format.
Person who does not have can download free of charge from Adobe company.
Get Adobe Acrobat Reader DCTo downloading of Adobe Acrobat Reader DC

Inquiry to this page

Health and Social Welfare Bureau health business section incurable disease measures charge

Telephone: 045-671-4040 (weekdays 8:45-17:00)

Telephone: 045-671-4040 (weekdays 8:45-17:00)

Fax: 045-664-5788

E-Mail address [email protected]

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Page ID: 700-364-388

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