If you paid the entire medical care cost up front

Required documents:	Application Form for Medical Care Expenses Sample * In the case of an application for therapeutic eyeglasses or prosthetic equipment, it is not necessary to submit the second copy of the Application Form for Medical Care Expenses. * In the case of an application due to upfront payment of the entire medical care cost, the second copy of the Application Form for Medical Care Expenses must be submitted if the medical cost details and the pharmaceutical statement cannot be submitted.
Required documents:	[Documents to attach] See the table below
Deadline:	As soon as possible
Applies to:	Insured persons and dependents eligible for payment for the reasons shown below
Submit to:	Your employer's HR section * Submit directly to Pfizer Health Insurance Society if you are Pfizer employee.
Notes:	See the table below concerning reasons for eligibility for payment and required documents to attach.

Reason for eligibility for payment of medical care expenses	Documents to attach to application form
If you underwent treatment without your health insurance card due to sudden sickness	Receipt (original) Medical cost details or pharmaceutical statement [=rezept] (original) * Please ask the reception desk at the hospital or pharmacy to issue the medical cost details or pharmaceutical statement. The medical statement issued with the receipt cannot be used for the procedure.
If you received a live blood transfusion	Receipt (original) Blood transfusion certificate (original)
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) In the case of foot equipment, photographs of the equipment If the equipment made can be confirmed while wearing it: Three photographs of the equipment being worn: (1) front, (2) back (reverse side of front), and (3) logo of the equipment (only if applicable). If the equipment made cannot be confirmed while wearing it (e.g., insole placed inside the shoe): Three photographs of the equipment only: (1) front, (2) back (reverse side of front), and (3) logo of the equipment (only if applicable).
If you underwent acupuncture, moxibustion, massage, shiatsu, or similar treatment with an insurance doctor's approval:	Receipt (original) Written consent from an insurance doctor (original)
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) Lens prescription from an insurance doctor (original) Patient's checkup results (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) Written instructions or other document from an insurance doctor (original) (A original) of a prescription or other document noting the name of the illness that can be used to confirm that the contact lenses were prescribed for an illness eligible for benefits)

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
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
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:	(Excluding Dental) Application Form for Overseas Medical Care Expenses (Excluding Dental) Sample
	(Dental) Application Form for Overseas Medical Care Expenses (Dental) Sample
	[Documents to attach] "Attending physician's statement" issued by the overseas hospital "Itemized receipt" issued by the overseas hospital 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 society making detailed inquiries to the overseas medical care institution or other organization about your treatment
Deadline:	As soon as possible
Applies to:	Insured persons or dependents who have undergone examination or treatment at a medical care institution overseas
Submit to:	Your employer's HR section * Submit to HR Ops directly if you are Pfizer employee.
Notes:	The amount of the benefits will be based on the treatment costs as established under domestic health insurance.

If you cannot walk to or between hospitals

Required documents:	[For approval by the Health Insurance Society] Application Form for Approval of Transportation/Notification of Transportation" ** Submit this form, with a doctor's certification, to the Health Insurance Society in advance for approval.
	[To claim transportation expenses] Application Form for Transportation Expenses Application Form for Transportation Expenses Sample
	[Documents to attach] Receipt
Deadline:	As soon as possible
Applies to:	Insured persons or dependents transported to or between hospitals as instructed by a doctor because the sickness or injury makes movement difficult
Submit to:	Pfizer Health Insurance Society
Notes:	This benefit is paid if a doctor determines there is a need for temporary, emergency transportation and the Health Insurance Society 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.