In certain cases, if you paid the full medical care cost at a medical care institution or other facility, you may later be reimbursed by the Health Insurance Society for the portion covered by health insurance as a benefit.
[To apply because you did not have your My Number Card as your Health Insurance Certificate or similar document with you; you accidentally used your previous health insurance; you purchased eyeglasses to treat juvenile amblyopia, etc.; or you purchased a compression garment] Application Form for Medical Care Expenses
If you were required to pay the full medical care cost for unavoidable reasons, because your health insurance enrollment was still being processed or you could not present your My Number Card as your Health Insurance Certificate due to sudden illness
Receipt (original)
Medical cost details or pharmaceutical statement (i.e., rezept) (original)
* Please request medical cost details or a pharmaceutical statement at the counter of the hospital or pharmacy. The itemized statement issued together with the receipt is not accepted for these procedures.
If the medical care institution cannot issue the medical cost details or pharmaceutical statement, take this document to the medical care institution and ask them to have it filled out.
(Different forms are required for outpatient care, prescriptions, and inpatient care.)
If you accidentally used your previous health insurance
Receipt for repayment to the former insurer (original)
Medical cost details sent from the former insurer (Submit them unopened in the sealed envelope.)
If you had therapeutic eyeglasses prepared to treat juvenile amblyopia, etc.
Receipt (original)
* The receipt must show the patient’s name and include a description that it is for therapeutic eyeglasses.
Doctor’s prescription for therapeutic eyeglasses to treat amblyopia, etc. (original or copy acceptable)
If you purchased a compression garment
Receipt (original)
Itemized statement showing the details of the compression garment purchased (original)
Doctor’s instructions for fitting the compression garment (original)
If you purchased prosthetic equipment
Receipt (original)
* If the receipt does not include a breakdown of the cost of the prosthetic equipment, also submit the itemized statement (cost breakdown).
Doctor’s certificate for the fabrication and fitting of the prosthetic equipment
Prosthetic equipment fabrication confirmation letter (original)
Please be sure to complete the forms provided on the continuation pages of the Application Form for Medical Care Expenses (Prosthetic Equipment).
Photos of the prosthetic equipment
[Notes on photographing the prosthetic equipment]
Photograph only the prosthetic equipment itself, without attaching it to the affected area. We need to confirm the details of the actual prosthetic equipment to be used by the patient.
(1) Photo of the prosthetic equipment taken from above
(2) Photos of the prosthetic equipment taken from the left and right sides
(3) Photo of the underside (sole) of the prosthetic equipment
(If there are any engravings or markings on the sole, make sure they are clearly visible.)
(4) Photo of the interior of the prosthetic equipment
(Open the opening wide so that any size indications or logos are clearly visible.)
(5) Photo of the insole removed from the prosthetic equipment, taken from the side
(Make sure that the contours or uneven surfaces are clearly visible.)
* If the prosthetic equipment is provided as a pair (left and right), submit photos of each one.
See the descriptions of how to take and submit photos on the continuation page of the Application Form for Medical Care Expenses (Prosthetic Equipment).
If you purchased limbal-supported rigid contact lenses for disfigured corneas caused by ocular sequelae of Stevens-Johnson syndrome or toxic epidermal necrolysis
* Contact the Sony Health Insurance Society for how to apply.
If you received a live blood transfusion
* Contact the Sony Health Insurance Society for how to apply.
Massage, acupuncture, moxibustion
Shown here are only examples of completed forms. Contact the Sony Health Insurance Society if you need an Application Form for Medical Care Expenses (Acupuncture, Moxibustion, Massage).
Receipt (original)
The receipt must include the total amount paid up front, the patient’s name, date of treatment, and a description of what the treatment was for.
[Attach the following documents in accordance with the specific treatment]
(1) Letter of consent from a doctor (original)
Must be submitted in the initial month of treatment and every six months thereafter.
A letter of consent from the current attending doctor is required regarding the relevant condition.
If receiving manual correction of deformities, a letter of consent from the attending doctor is required every month.
(2) Treatment report (copy) (Required if a treatment report fee has been claimed)
(3) Home-visit treatment confirmation form (original) (Required if a doctor recognizes that the patient has difficulty walking and home-visit treatment fees are being paid)
(4) Statement of reasons for continued treatment over one year and 16 or more sessions per month and patient condition (original) (Required for long-term treatment*1)
*1 Long-term treatment refers to treatment that has continued for at least one year from the initial treatment date and at a frequency of 16 or more sessions per month.
Apply separately for each recipient of treatment, each month of treatment, and each treatment facility.
Overseas Medical Care Expenses
Shown here is only a completed form. Contact the Sony Health Insurance Society if you need detailed information and an Application Form for Overseas Medical Care Expenses.
Apply for Medical Care Expenses separately for each month of treatment, each medical care institution, and inpatient/outpatient care. The local doctor must complete and certify documents (1) and (2).
(1) Medical consultation details (original)
(2) Itemized receipt (original)
(3) Receipt (original)
(4) Passport (copy)
→ Copy the page showing the passport number (ID photo page) and the pages showing entry and exit stamps.
Attach Japanese translations if the medical consultation details and itemized receipt are both written in a foreign language. (The applicant’s own translation is accepted.)
Transportation Expenses
* Contact the Sony Health Insurance Society for how to apply.
