Yokohama City Independence Support Medical Care (Mental Outpatient Medical Care)

In principle, medical expenses will pay 10% of those who are continuously receiving treatment for psychotherapy or pharmacotherapy due to mental illness.

From February 25, 2025 (Tuesday), some applications for independence support medical care (psychiatric outpatient medical care) can now be applied online using smartphones and PCs.
★Those who can apply online
・You have a My Number card and are in an environment where you can log in to the minor portal (two types of PINs are required)
・Being the examinee (guardian if the examinee is under 18 years of age)　※Agents are not allowed to apply online.
・The resident registration of the examinee is in Yokohama City
・One of the following applications:
★Type of application that can be applied online
・Application for renewal (only times required to submit a medical certificate)
・Application for change
・Application for re-grant
・Out-of-city transfer application
You will not be able to apply online in the following cases.
X New application
X Reapplying
X Application for renewal of “needed” times
X Return of recipient ID
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For more information about online applications, see "About online applications."

From December 2, 2024, the current insurance card will no longer be issued, and the system will be shifted to a system based on the use of a health insurance card (minor insurance card) of My Number Card. When applying for independence support medical care (psychiatric outpatient medical care), we will check the health insurance card information of the examinee in one of the following 1 to 4, so please prepare it. (Local governments do not have readers at medical institutions, so please cooperate.)

About use of health insurance card of my number card (outside site) (Ministry of Health, Labour and Welfare)

▶In ward window staff and paperwork center, we cannot answer question about insurance card. If you have any questions, please check with the following window in advance before applying. .
・Thing about Yokohama-shi National Health Insurance, Kanagawa latter-stage elderly medical insurance
・Social insurance…Health insurance union that has joined
・Thing about my number and minor portal (outside site)
・Q & A (outside site) regarding the use of a health insurance card for My Number Card
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▶How to confirm health insurance card information flyer (PDF: 463KB)
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▶To Medical Institutions
In Yokohama City, the display of health insurance card information has been changed from the recipient ID issued after December 2, 2024.

◆Please confirm the details of the insurance you have subscribed to in the one presented by the examinee (such as a minor insurance card or qualification confirmation). (including those who use both social security and social insurance)
◆Information on insurance cards is also lost from the “Independence Support medical expenses (Mental Outpatient Medical Care) Payment Certification Input Confirmation Form (Personal Copy)” issued after receiving the application at the ward window or mail.
◆The display of symbol numbers, etc., has disappeared from the recipient ID and personal copy, but since the confirmation of the insurance card information at the time of application has not been lost, it is necessary to submit a copy of the insurance card information at the time of application.

Those who are receiving treatment for psychotherapy or pharmacotherapy through continuous outpatient visits due to mental illness.
※The target mental illness is that the ICD codes on the medical certificate are F0 to F9 and G40 (Epileptic).

◆For "mental disorders" and "pathy caused by mental disorders", medical treatments performed without hospitalization in hospitals and clinics are eligible.
※ For conditions arising in connection with treatment or symptoms, only conditions within the range of outpatient treatment by a physician in charge of psychiatric outpatient care are covered.
◆In general, medical insurance covers 70% of medical expenses's medical insurance and 30% of the remaining medical expenses's own expenses. However, in principle, 10% of medical expenses's expenses will be borne by the designated medical institution (hospital, day care, pharmacy, home-visit nursing station).
◆Expenses such as treatments, medications, medical certificate fees, etc. that are not covered by medical insurance are not eligible.

As a general rule, medical expenses's out-of-pocket expenses at the counter will be 10%. Depending on the household's income and condition, the monthly limit is set.

◆"Households" in the independence support medical system are certified on a medical insurance basis.
It's different from resident certificate. For example, families with different medical insurance are in the same household in resident certificate, but are in different households under the independence support medical system. Please refer to the table below to know who municipal tax income percent is added by the medical insurance you have.

◆Municipal tax income percent is listed in "city prefectural tax tax payment letter of advice", "decision letter of special collection tax amount", "taxation certificate".
However, since the amount stated is not the same, it is only a guide. The amount obtained by dividing the stated municipal tax income percent by 8 and multiplying by 6 is the closest amount. Please confirm the official classification on the recipient ID sent. If you are likely to have a large municipal tax income percent and may not be eligible for the system, if you are worried, please consult before asking the hospital to write a medical certificate.
◆Person corresponding to "severe and continuation" in household with municipal tax income percent more than 235,000 yen is targeted for system by special measures until the end of March, 2027. If special measures are not extended, they will not be eligible for the system.
◆Tax-exempt household income includes non-taxable income such as disability pension and Special Child Raising Allowance.
◆If the examinee is under the age of 18, the personal income of the tax-exempt household is determined by the parent's income.

The monthly burden upper limit means that in one month, if the total amount of the burden reaches the monthly burden upper limit of the person while paying 10% of the self-pay, that month will bear more burden It is not necessary to have it.

If it is recognized as "a person who needs continuous treatment and generates high medical expenses burden", the monthly co-payment limit will be set to reduce the financial burden.
The range of "severe and continuous (high-cost treatment continuation)" is when one of the following 1-3 applies.
１．Those who are eligible for medical insurance (if high medical costs has been paid at least four times within the past 12 months)
２．Those whose main mental disorder falls under the following categories in ICD-10 (International Classification of Diseases)
・F０： Organic mental disorder including symptomaticity (cerebral dysfunction such as dementia)
・Ｆ１: Mental and behavioral disorders caused by the use of psychoactive substances (such as mental disorders caused by alcohol or drugs)
・Ｆ２: Schizophrenia, schizophrenia and delusional disorders
・Ｆ３: Mood disorders (manic depression, depression, etc.)
・G40: epilepsy
3. A physician with at least 3 years of experience in psychiatric care has been diagnosed as requiring continuous intensive outpatient care (including medical care to maintain and prevent deterioration) for mental disorders with the following symptoms: Those who have been certified as those who have been diagnosed as requiring continuous intensive outpatient care (including medical care to maintain condition and prevent deterioration).
・Disorders of emotions and behavior
・Anxiety and disturbance

There are three ways to apply.
・Application for window at your ward office window (Elderly and Disabled Support Division)
・Application by mail
・Online application (only some applications and conditions apply)　※From February 25, 2025
Please confirm what you need for application from the link below before applying.

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※It takes about two months from the time of application to the time you are certified and receive your beneficiary ID. Please understand that the number of days required to issue the certificate will vary depending on the reason for the application.
※If you pay 30% during the period from application to receipt of your beneficiary ID, you may be able to refund it at a later date.
For details, please refer to the information (PDF: 198KB).

◆The validity period of independence support medical care is one year. (Please check the validity period of the recipient ID.)
◆The date on which the renewal application can be started is printed on the recipient ID, so if you wish to continue using the system, be sure to apply for renewal. Please note that after the validity period, you will not be able to receive independence support medical care until you reapply. (You can't go back.)
◆Regarding the renewal application, Yokohama City will not notify you individually in advance, so please check the validity period of the recipient ID yourself.
◆Every time you use a hospital, pharmacy, or visiting nursing station, be sure to show your recipient ID and the upper limit management slip (only for those who have been issued). If you forget to present it, you will not be able to receive independence support medical care. (Refunds will not be available at a later date.)

Medical institutions that provide the independence support medical system are designated systems because they are planned medical care in advance and secure high-quality medical care. .
◆Only medical institutions (including day care, pharmacies, and visiting nursing stations) selected by the user in advance from medical institutions designated as designated independence support medical institutions are eligible for independence support medical care. (It does not apply to hospitals and pharmacies that are not listed on the recipient ID.)
◆Medical institutions that can be selected are one hospital, two pharmacies, and one visiting nursing station.
※Hospital registration is in principle one place, but if there is no overlap in medical care and there are unavoidable circumstances, you can apply for two places registration. (There is a review.) Click here for details (Information) (PDF: 340KB)
◆Please check this page for a list of medical institutions that can be designated as designated medical institutions. (Even if you have a recipient ID of Yokohama City, you can select a designated independence support medical institution in another city.)
◆Even if the pharmacy is listed on the beneficiary card, if the medicine is prescribed by a prescription from a hospital or clinics that is not listed on the beneficiary card, independence support medical care will not be applied to the prescription at the pharmacy. In addition, if the prescription date of the medicine is out of the validity period, independence support medical care will not be applied even if the dispensing date is within the validity period.
◆If you want to change the medical institution you are using, you need to apply for a change. From the date of receipt of the change application (or the date after the acceptance date specified by the applicant), you can use independence support medical care at a new medical institution. (You can't go back to the date.)

For those who have a monthly burden upper limit, we will issue a "self-pay upper limit management slip".
◆When you are consulted, be sure to show the upper limit management slip at the window of the hospital or pharmacy along with the recipient ID. (At medical institutions, pharmacies, and home-visit nursing stations, you will be asked to fill in the copayment amount.)
◆If the out-of-pocket amount reaches the "maximum amount", there will be no out-of-pocket expenses at the consultation in that month thereafter.
◆If you run out of the upper limit management slip page, please call the paperwork center. 045-671-3623

Upper limit management vote assistance paper (PDF: 29KB)

If you have already grasped the required style, please download and use it below.
However, what you need for application varies depending on the reason for application, so be sure to check the "How to apply" page.

◆Application form (PDF: 159KB) (PDF version)
◆Application form (Excel: 44KB) (Excel version)
◆Example of application form entry (PDF: 501KB)
※There have been reports of cases where the PDF version is rarely blacked when printing. In that case, please print out the Excel version.
※Please print out the income report page. If you are a tax-exempt household, you must also enter the income report column.
◆Medical certificate (Please select and print one of the forms depending on the printing environment.)
　☑　Medical certificate (for independence support medical application (for mental outpatient medical care)) Excel (Excel: 189KB) version
　☑　Medical certificate (for independence support medical application (for mental outpatient medical care)) PDF version / A3 / 1 sheet (PDF: 151KB)
　☑　Medical certificate (for independence support medical application (for mental outpatient medical care)) PDF version / A4.2 sheets (PDF: 334KB)
　※A4.2 sheets should be printed on two sides instead of double-sided printing.
◆Request book about offer of independence support medical certificate (copy) and consent form (PDF: 64KB) (documents necessary at the time of suburban transfer application)

※If you do not have a printing environment at home, you can send an application form or medical certificate.
Please follow the steps below.
[Billing Party]
〒231-0005 6-50-10, Honcho, Naka-ku, Yokohama-shi
City of Yokohama, Health and Social Welfare Bureau Mental Outpatient Medical Care and Notebook Processing Center
[Request method]
①　Write the name of the document you want to send in a note
Example: "Please send one copy of the application form for independence support medical care (psychiatric outpatient medical care)."
　　"Please send one copy of the medical certificate for independence support medical care (psychiatric outpatient medical care)."
　　"Please send a copy of the application form for the Mental Handicapped Health and Welfare Handbook."
　　"Please send me a copy of the medical certificate for the Mental Handicapped Health and Welfare Handbook."
②　I will prepare a stamp of 110 yen.
③　①Please send 2 and 2 to the processing center.

If you need a copy of your medical certificate, please ask the hospital or clinics first.
If you are unable to receive a copy of your medical certificate at a hospital or clinics, you can receive a copy by requesting the City of Yokohama to disclose it.
※The reception desk for disclosure requests is "Ward Administration Promotion Division Public Relations Section in your ward" or "Citizen Information Center".
※It takes about one month from the request to the delivery of the copy.
※The method of grant is either "window (window of mental health consultation center)" or "mail (mailing fee paid by the person)".
※At the time of request, it is necessary to specify the documents to be disclosed, such as "Medical certificate for independence support medical care (psychiatric outpatient medical care) submitted in 200", so please check with the submission address in advance when a medical certificate is required Please give me.
※Please note that Yokohama City will call the doctor who listed the medical certificate to confirm that the medical certificate may be disclosed.
※The preservation period of the medical certificate submitted to Yokohama City is 5 years. We can't handle anything older than that.
For more information, please refer to this page.