Application for National Health Insurance Injury and Sickness Allowance due to the new coronavirus infections (application period extended until March 31, 2023) 国民健康保険傷病手当金の支給申請（令和5年3月31日まで延長）

If a member of Nagahama City National Health Insurance is infected with the new coronavirus infections, or if the person is suspected of having symptoms such as fever, and he or she is unable to receive all or part of his or her salary from the employer because he or she is unable to take time off from work to recuperate, we pay sickness allowance.

People who meet all of the following conditions are eligible.

1. Be a member of the Nagahama City National Health Insurance and receive a salary, etc. (Individual business owners are not eligible)
 

2. Being unable to work due to medical treatment due to being infected with the new coronavirus infections or having symptoms such as fever and being suspected of being infected.

 

3. Four days or more, including three consecutive days (waiting period), during which you cannot work due to medical treatment.

 

4. Not receiving all or part of the salary while the person is unable to work due to medical treatment.

 

※Applicable only when the person has symptoms such as infection or fever.

[Cases that are not covered]

・ The person became a close contact and decided to take a break from work.

・ The family was infected and he or she had to take a break from work for nursing.

[Amount obtained by dividing the total amount of salary income for the most recent three consecutive months by the number of working days] × Two-thirds × Number of days subject to payment

The number of days eligible for payment refers to the number of days during which work was planned, out of the period during which work was not possible after three days had passed since the day on which work was not possible.

There is a maximum amount of payment per day.

Days when the person was unable to work between January 1, 2020 and March 31, 2023

However, if hospitalization continues, it can be extended up to 1 year and 6 months

 

[Note]

The applicable period was until December 31, 2022, but has been extended to March 31, 2023.　

 

Please submit the following four documents to the Insurance and Pension Division in person or by mail.

Please inquire about how to fill out the form at the Health Insurance and Pension Division in advance.

If the person cannot fill out the payment application form (for filling out at the medical institution) because he or she has stayed at the hotel or received medical treatment at home, please contact us.

 

• 1.国民健康保険傷病手当金支給申請書（世帯主記入用）National Health Insurance Injury and Sickness Allowance Payment Application Form (for entry by householder) (25.86KB)
• 2.国民健康保険傷病手当金支給申請書（被保険者記入用）National Health Insurance Injury and Sickness Allowance Payment Application Form (for entry by the insured person) (27.72KB)
• 3.国民健康保険傷病手当金支給申請書（事業主記入用）National Health Insurance Injury and Sickness Allowance Payment Application Form (for entry by business owner) (52.56KB)
• 4.国民健康保険傷病手当金支給申請書（医療機関記入用）National Health Insurance Injury and Sickness Allowance Payment Application Form (for entry by Medical institution) (24.81KB)

• 1.国民健康保険傷病手当金支給申請書（世帯主記入用　記入例）National Health Insurance Injury and Sickness Allowance Payment Application Form (for the head of the household; entry example) (29.21KB)
• 2.国民健康保険傷病手当金支給申請書（被保険者記入用　記入例）National Health Insurance Injury and Sickness Allowance Payment Application Form (for the insured person; entry example) (26.42KB)
• 3.国民健康保険傷病手当金支給申請書（事業主記入用　記入例）National Health Insurance Injury and Sickness Allowance Payment Application Form (for business 　owner; entry example) (50.40KB)
• 4.国民健康保険傷病手当金支給申請書（医療機関記入用　記入例）National Health Insurance Injury and Sickness Allowance Payment Application Form (for Medical institution; entry example) (27.33KB)