IBM Japan Health Insurance Association

IBM Japan Health Insurance Association

  • Small
  • Medium
  • Large
  • japanese
  • English

Application form lists

Insurance card and application-related forms

After retirement health insurance-related forms

Childbirth/Death/Other benefit application

Forms Sample
 
  • Application Form for Medical Care Expenses (acupuncture) *Claim to Health Insurance Society
 
  • Application Form for Medical Care Expenses ( moxibustion/massage) *Claim to Health Insurance Society
 
 
 
 
 
 
 
  • Application Form for Overseas Medical Care Expenses  
    (Since this form is a five-sheet carbon-copy form, it is not available to download. Request it from the Health Insurance Association.)

When examination in the health insurance society is completed, the benefit mentioned above is transferred to the company in a total around 24th of the next month on the end of the month. The personal payment is transferred to the registered bank account.
If you apply using just your Social Security and Tax Number, you will be required to submit additional documents. Consult with the Association in advance. If you enter your Health Insurance Card Symbol and Number, you do not need to indicate your Social Security and Tax Number.

Open PDF files above by Adobe(R) Acrobat(R) Reade.
(free)

PAGE TOP