If you paid the entire medical care cost up front

In some cases, you will pay the full medical care costs to the medical care institution or other facility up front, after which you will be reimbursed by the Health Insurance Association for your insurance benefits. These benefits are paid if the Association determines that it would be difficult for you to receive medical care benefits (benefits received by showing your health insurance card at the medical care institution).

Description

Procedures

FAQ

If you paid the entire medical care cost up front
If you become sick or are injured overseas
If you cannot walk to or between hospitals

If you paid the entire medical care cost up front

Required documents	Application Form for Medical Care Expenses
Required documents	Attachments required: See the table below.
Deadline	At the earliest possible date
Applies to	Insured persons and dependents eligible for payment for the reasons shown below
Submit to	〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association
Notes	See the table below concerning reasons for eligibility for payment and required documents to attach. If you were treated overseas, you will need to submit the Application Form for Overseas Medical Care Expenses. Request a copy of this application form from the IBM Japan Health Insurance Association. If you need an application form for Medical Care expenses (Acupuncture, Moxibustion or Massage), please contact the IBM Japan Health Insurance Association. See here more details.

Reason for eligibility for payment of medical care expenses	Attachments required to application form
If you underwent treatment without your health insurance card due to sudden sickness	Receipt (original) Rezept (Medical cost details) (original)
If you accidentally used your previous insurer's your health insurance card	Receipt (original) from payment to your previous health insurer Rezept (Medical cost details) (original) sent from your previous health insurer (submit in a sealed and unopened envelope)
If you received a live blood transfusion Note: Not paid for a blood transfusion from a relative, including a parent, spouse, or sibling	Receipt (original) Blood transfusion certificate
If you purchased and used prosthetic equipment, such as an artificial arm or leg, an artificial eye, or a corset, as instructed by a physician	Receipt (original) Certificate from an insurance doctor (original) If applying for orthopedic footwear, a photo of the footwear (showing that the patient actually wears the footwear)
If you had eyeglasses or contact lenses prepared and purchased to treat juvenile amblyopia or other condition in a child of less than nine years of age:	Receipt (original) Copy of lens prescription from an insurance doctor Copy of Patient's checkup results
If you underwent acupuncture, moxibustion, massage or similar treatment with an insurance doctor's approval: Note: Available only for a limited range of conditions	Receipt (original) Written consent from an insurance doctor (original)
If you purchased limbal-supported rigid contact lenses for disfigured corneas due to ocular sequelae after experiencing Stevens-Johnson syndrome or toxic epidermal necrolysis:	Receipt (original) Instruction from an insurance doctor (original)

If you purchased a compression garment or similar item

Treatment of lymphedema of the arms or legs occurring after surgery for malignant tumor involving lymph node dissection (extensive resection) in the groin, pelvic region, or axillary region; primary lymphedema of the arms or legs

Documents to attach to application form	Written instructions to wear compression garment or similar item (after surgery for malignant tumor/primary lymphedema) Receipt (original)
Type of compression garment	Compression stocking, compression sleeve, compression glove (compression bandage only if the doctor recognizes that these should not be used)
Notes	No more than two compression garments or similar items per body part may be purchased at a time. Repurchase made at least six months after the previous purchase is eligible for payment of medical care expenses.

Treatment for intractable ulcer due to chronic venous insufficiency

Documents to attach to application form	Written instructions to wear compression garment or similar item (treatment for intractable ulcer due to chronic venous insufficiency) Receipt (original)
Type of compression garment	Compression stocking (compression bandage only if the doctor recognizes that this should not be used)
Notes	No more than two compression garments or similar items per body part may be purchased at a time. Eligible for payment of medical care expenses only once (cases involving recurrence after healing are eligible for payment again)

If you become sick or are injured overseas

Required documents	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.)
Required documents	Attachments required: Attending physician’s statement issued by the overseas hospital (original) Itemized receipt issued by the overseas hospital (original) Japanese translations of the above A copy of a document verifying your overseas travel (such as a passport) A letter stating that you agree to the health insurance association making detailed inquiries to the overseas medical care institution or other organization about your treatment
Deadline	At the earliest possible date
Applies to	Insured persons or dependents who have undergone examination or treatment at a medical care institution overseas
Address inquiries to	[Those traveling overseas on business] Submit the application form and required documents through the head of your section. [Those traveling overseas for other purposes] 〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association
Notes	The amount of the benefits will be based on the treatment costs as established under domestic health insurance. Benefits cannot be paid if the attending physician’s statement is not attached, due to the difficulty of calculating costs eligible for insurance benefits.

If you cannot walk to or between hospitals

Required documents	To claim transportation expenses: Application Form for Transportation Expenses Receipt (original)
Deadline	At the earliest possible date
Applies to	Insured persons or dependents transported to or between hospitals by doctor’s orders because illness or injury impedes normal movement
Submit to	〒103-0015 10F, Daiwa River Gate South Wing, 36-2, Nihonbashi, Hakozaki-cho, Chuo-ku, Tokyo IBM Japan Health Insurance Association
Notes	This benefit is paid if a doctor determines there is a need for temporary, emergency transportation and the Health Insurance Association determines that all of the following conditions apply: The medical care for which transportation is required is appropriate as insurance treatment. The sickness or injury for which the medical care is required makes it difficult for the patient to move. In an emergency or other unavoidable case.