Skip to main content

Japanese
English

If you need various certificates

If you need a certificate for my qualification (for general insured persons only)
If you want a certificate of loss of eligibility as an insured person
If you want a certificate of loss of eligibility as a dependent
If you want to undergo examination or treatment at a medical care institution or other such facility when you do not have your health insurance card
If you want a certificate of benefits
If you want a certificate of payment of insurance premiums (for Voluntarily and Continuously Insured Persons and Special-Case Retired Insured Persons only)

If you need a certificate for my qualification (for general insured persons only)

Eligibility to join Please check the color and symbol of your health insurance card. Click here for an image of the health insurance card.	Insured person (employee) If the symbol starts with "1".
Application Form	Application support system 　Request for Certificate of Eligibility * These procedures can be completed entirely using this system. （Connect to Hitachi Group Intranet.）
Application Form	If you are unable to use the application support system Request for Certificate of Eligibility/Loss of Eligibility Example
Documents to attach	none
Deadline	none * Generally, it takes about one week from receipt of the request by the Hitachi Health Insurance Society until the certificate is delivered.
Submit documents to	Operations (Application) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063 * If you use the application support system, you can complete the procedures on the Web. You do not need to mail a printed application form.
Others	The certificate will indicate the name of your establishment (company). Items shown on the Certificate of Eligibility You cannot use this certificate to undergo examination or treatment at a medical care institution or other such facility. * If you want to undergo examination or treatment at a medical care institution or other such facility when you do not have your health insurance card
Address inquiries to	Operations (Application) Hitachi health insurance society　 TEL 03-4554-3020

If you want a certificate of loss of eligibility as an insured person

Eligibility to join Please check the color and symbol of your health insurance card. Click here for an image of the health insurance card.	Insured person (employee) If the symbol starts with "1".	Voluntarily and Continuously Insured Person If the symbol starts with "2".	Special-Case Retired Insured Person If the symbol starts with "3".
Application Form	Application support system 　Prior Request for Issuance of Certificate of Loss of Eligibility * These procedures can be completed entirely using this system. （Connect to Hitachi Group Intranet.）	Request for Certificate of Eligibility/Loss of Eligibility Example
Application Form	If you are unable to use the application support system If you have already left your employer Request for Certificate of Eligibility/Loss of Eligibility Example
Documents to attach	none	none
Deadline	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.
Submit documents to	Operations (Application) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063 * If you use the application support system, you can complete the procedures on the Web. You do not need to mail a printed application form.	Operations (Application) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063
Others	The certificate will be issued after the Hitachi Health Insurance Society receives a notification of loss of eligibility from your establishment (employer). This request can also be used to issue certificates for dependents who lost their eligibility at the same time as the insured person (persons subject to certification can be specified).	The certificate will be issued after the Hitachi Health Insurance Society has completed the procedures for the loss of eligibility. The certificate of membership expiration will be issued automatically by the Hitachi Health Insurance Society. There is no need to make an application.
Address inquiries to	Operations (Application) Hitachi health insurance society　 TEL 03-4554-3020	Operations (Application) Hitachi health insurance society　 TEL 03-4554-3020

If you want a certificate of loss of eligibility as a dependent

Eligibility to join Please check the color and symbol of your health insurance card. Click here for an image of the health insurance card.	Insured person (employee) If the symbol starts with "1".	Voluntarily and Continuously Insured Person If the symbol starts with "2".	Special-Case Retired Insured Person If the symbol starts with "3".
Application Form	Application support system Request for Certificate of Eligibility as a Dependent * These procedures can be completed entirely using this system. （Connect to Hitachi Group Intranet.）	Request for Certificate of Eligibility/Loss of Eligibility Example
Application Form	If you are unable to use the application support system Request for Certificate of Eligibility/Loss of Eligibility Example
Documents to attach	none	none
Deadline	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.
Submit documents to	Operations (Application) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063 * If you use the application support system, you can complete the procedures on the Web. You do not need to mail a printed application form.	Operations (Application) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063
Others	The certificate will be issued after the Hitachi Health Insurance Society has completed the dependent removal procedures. You can apply to have a certificate issued at the same time as when performing the dependent removal procedures on the Application Support System.	The certificate will be issued after the Hitachi Health Insurance Society has completed the dependent removal procedures. Certificates of membership expiration for insured persons as well as those for dependents will be issued automatically by the Hitachi Health Insurance Society. There is no need to make applications.
Address inquiries to	Operations (Application) Hitachi health insurance society　 TEL 03-4554-3020	Operations (Application) Hitachi health insurance society　 TEL 03-4554-3020

If you want to undergo examination or treatment at a medical care institution or other such facility when you do not have your health insurance card

Eligibility to join Please check the color and symbol of your health insurance card. Click here for an image of the health insurance card.	Insured person (employee) If the symbol starts with "1".	Voluntarily and Continuously Insured Person If the symbol starts with "2".	Special-Case Retired Insured Person If the symbol starts with "3".
Application Form	Application form for issuance of Certificate of Eligibility Example	Explain to the medical care institution why you do not have your health insurance card and undergo the examination or treatment. Even if you pay the entire amount of medical expenses yourself, you can apply to the Hitachi Health Insurance Society for a reimbursement of the amount paid covered by health insurance. * See here for procedures for obtaining reimbursements of medical expenses
Documents to attach	none
Deadline	none
Submit documents to	Your employer’s health insurance contact (e.g., General Affairs, Labor Management)
Others	Your establishment (employer) will issue a certificate of eligibility to use in place of the health insurance card. A certificate cannot be issued to someone who is not a member of the Hitachi Health Insurance Society (i.e., someone who has not completed membership procedures).
Address inquiries to	Your employer’s health insurance contact (e.g., General Affairs, Labor Management)

If you want a certificate of benefits

Eligibility to join Please check the color and symbol of your health insurance card. Click here for an image of the health insurance card.	Insured person (employee) If the symbol starts with "1".	Voluntarily and Continuously Insured Person If the symbol starts with "2".	Special-Case Retired Insured Person If the symbol starts with "3".
Application Form	Application for Certification of Benefits Example	Application for Certification of Benefits Example
Documents to attach	none	none
Deadline	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.
Submit documents to	Operations (Benefits) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063	Operations (Benefits) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063
Others	A benefits certificate will be issued three months or later after the month of examination or treatment. See the example of a completed form for details. Medical care cost information can be viewed on MY HEALTH WEB.	A benefits certificate will be issued three months or later after the month of examination or treatment. See the example of a completed form for details. Medical care cost information can be viewed on MY HEALTH WEB.
Address inquiries to	Operations (Benefits) Hitachi health insurance society　 TEL 03-4554-3030	Operations (Benefits) Hitachi health insurance society　 TEL 03-4554-3030

If you want a certificate of payment of insurance premiums (for Voluntarily and Continuously Insured Persons and Special-Case Retired Insured Persons only)

Eligibility to join Please check the color and symbol of your health insurance card. Click here for an image of the health insurance card.	Voluntarily and Continuously Insured Person If the symbol starts with "2".	Special-Case Retired Insured Person If the symbol starts with "3".
Application Form	Application for issuance of certificate of insurance premium payment Example
Documents to attach	none
Deadline	none * Generally, it takes about one week from receipt of the request form by the Hitachi Health Insurance Society until the certificate is delivered.
Submit documents to	Operations (Application) Hitachi Health Insurance Society Higashi-Ochanomizu Building, 2-29, Kanda Awaji-cho, Chiyoda-ku, Tokyo, 101-0063
Others	A certificate of payment of insurance premiums for those paid during the one-year period from January through December will be issued automatically by the Hitachi Health Insurance Society to all eligible persons in January of the following year. Use this application form to request a certificate as needed at other times.
Address inquiries to	Operations (Application) Hitachi health insurance society　 TEL 03-4554-3020