Regarding reissuance of medical certificates for the elderly: For those who have lost their certificates
Updated: December 2, 2024
If you lose your medical certificate for the Elderly, you can have it reissued by filling out an application form (Application for Reissue of Medical Certificate for the Elderly) and submitting it by mail or in person at the office.
If the insured person (the person) is coming to the city office, please bring the necessary items listed below and come to the Insurance and Pension Division/Medical Care Section for the Elderly at Counter 3 on the 1st floor of City Hall.
Items that can be reissued
Certificate of qualification, certificate of medical treatment for specific diseases
Regarding application by mail
If you wish to apply and receive your certificate by mail, please download and print out the form below, fill in the necessary information, and mail it. (Please contact us if you wish to have your application form mailed to you.) Once the application form arrives at the city hall, we will complete it and mail it to you.
About application at city hall
Reissuance of the Certificate of Eligibility
If you wish to apply and receive the insurance at the city hall, please wait for the insured person's identification card. (Identification documents such as driver's license, My Number Card, passport, long-term care insurance insurance card, late-stage elderly medical insurance premium decision notification, cash card, etc.) Note: If a photo is included, please check one item, if a photo is not included. In this case, two points will be confirmed.)
Note: If you are bringing a representative, please bring proof of identity.
In addition, if the procedure is being carried out by a representative who lives with the insured person (the person himself/herself), the eligibility confirmation certificate can be issued at the counter once the representative's identity has been verified.
If the insured person (the person himself/herself) and a representative who lives separately from them are carrying out the procedure, the representative can fill out and submit the application form, but the eligibility confirmation certificate will be sent by registered mail.
Reissuance of Specific Disease Treatment Certificate
If you wish to have your specific disease medical treatment certificate reissued at the city hall, please wait for the insured person's (self) identification. (Driver's license, My Number card, passport, late-stage elderly medical insurance certificate, late-stage elderly medical qualification confirmation, nursing care insurance certificate, late-stage elderly medical insurance premium determination notice, cash card, etc. Note: If there is a photo, one item will be checked, if there is no photo, two items will be checked.)
Note: If the procedure is being carried out by a representative who lives with the insured person (principal), a reissued card can be issued at the counter once the representative's identity can be verified.
In addition, if the insured person (self) and their representative who lives separately are carrying out the procedure, please bring the insured person's (self) insurance certificate or qualification confirmation document and something that can verify the representative's identity. If you bring these two documents, you can receive a reissued certificate at the counter.
About application at branch office
You can also fill out and submit the application for reissue of the certificate for medical care for the elderly at the Hirao and Wakabadai branch offices. Once the application arrives at the city hall, we will complete it and mail it to you.
Download form
Application for reissuance of medical insurance for the elderly (PDF: 67KB)
Adobe Acrobat Reader DC (formerly Adobe Reader) is required to open PDF files.
If you don't have it, you can download it for free from Adobe.
Download Adobe Acrobat Reader DC
Inquiries regarding this page
Inagi City Citizens Department Insurance and Pension Division
2111 Higashi-Naganuma, Inagi-shi, Tokyo
Phone: 042-378-2111 Fax: 042-377-4781