保険証がないときに役に立つ「健康保険被保険者資格証明書」とは

健康保険証の発行には時間がかかる

就職したり転職すると、健康保険証が発行されます。 経験したことがある方も多いと思いますが、健康保険証の発行には結構な時間がかかります。 自営業の方などが加入する国民健康保険は即日発行なので、手続きをしたその日に健康保険証を受け取って帰ることができます しかし、サラリーマンの場合は会社が健康保険組合・協会けんぽとやりとりをするので、手続きに時間が必要になります。 早くて1~2週間で手元に届きますが、長い場合は1か月ほどかかることもあります。

健康保険証の代わりになる健康保険被保険者資格証明書

健康保険証がないと、定期的な通院や突然の体調不良で困りますよね。 「手続き中で保険証が手元にないけれど病院に行きたい」という時に使えるのが健康保険被保険者資格証明書です。 もちろん、健康保険証が届くまでの仮のものですが、健康保険証に記載されるのと同じ記号・番号・保険者番号が記載されています。

会社から健康保険被保険者資格証明書をもらえることも

大企業などの場合、入社後に健康保険被保険者資格証明書を渡してくれることもあります。 ただし、会社発行のものは独自の様式のものがほとんどです。 病院によっては、会社独自の様式ではなく公的な書類でないと認めてもらえないこともあります。 次で説明する、健康保険被保険者資格証明書は公的な書類になります。 健康保険証の代わりを果たすものなので、どうやって入手するのか確認しておきましょう。

健康保険被保険者資格証明書の取得方法

窓口は日本年金機構

健康保険被保険者資格証明書の取り寄せは、日本年金機構の管轄になります。 会社の健康保険組合や協会けんぽで加入する場合も、日本年金機構に申請をします。 どこにどんな風に申請するのか、方法を3種類お伝えします。

①事業所発行

会社に「病院に行きたいので健康保険被保険者資格証明書をください」と伝えて事業所発行してもらう方法です。 メリットは、自分は何もしなくてよい点です。 事務の方との距離が近い職場では有効な方法と言えます。 しかし、大規模の会社ではどの部署に言えばいいのかわからず言い出しにくいということも考えられます。 また、事業所発行の場合、事業主以外の人(例えば事務の人)などが申請に行くと委任状が必要になります。 この委任状は、本来であれば事業主が行う申請を、事務の人が代理で行うことに対するものです。 事業所発行の場合でも、すぐに入手することは難しい場合が多いと言えます。

②自分で取り寄せる(窓口)

自分で窓口へ足を運んで手続きをすることのメリットは、その場で受け取れる点です。 急な体調不良などの場合、窓口での申請が一番いいでしょう。 申請をする窓口は、事業所の所在地を管轄する年金事務所です。 わからなければ、事前に確認してから行くとベストです。 必要なものは申請書と本人確認書類です。 ・申請書…健康保険被保険者資格証明書交付申請書 →日本年金機構HPからダウンロードできます。 ・本人確認書類…個人番号カード、運転免許証、パスポートなど 以上2点を持って、平日の8:30~17:15の間で窓口へ行きましょう。

③自分で取り寄せる(郵送)

事業所発行・窓口での申請が難しい場合、郵送でも手続きが可能です。 郵送だと日数はかかりますが、受診日がわかっていて余裕がある方におすすめです。 郵送の場合、宛先は事業所の所在地を管轄する事務センターになります。 年金事務所に送らないよう気をつけましょう。 必要な書類は健康保険被保険者資格証明書交付申請書です。 日本年金機構HPからダウンロードして必要箇所を記入して送ります。

健康保険被保険者資格証明書交付申請書の書き方

フォーマットは日本年金機構HPよりダウンロードできます。 WordまたはExcelで出力し、必要事項を記入していきます。 ・事業所整理記号と事業所番号 ネットで調べることができないので空欄で持参するか、郵送の場合は電話で日本年金機構に確認しましょう。 被保険者と、扶養者のものも発行する場合は被扶養者の情報を書きます。 証明書発行理由は「健康保険証発行手続き中のため」などを記入し、最後に事業所所在地、事業所名称、名前を書いてハンコを押します。

健康保険証なしで病院に行くとどうなる?

保険証がないタイミングで病院に行ったらどうなるかご存知ですか? もちろん健康保険被保険者資格証明書の申請ができたらいいのですが、突然の体調不良などで病院へ行く場合、心配なのはお金ですよね。 もしも健康保険証なしで病院に行ったらどうなるか、2パターン紹介します。

①とりあえず10割負担で支払う

健康保険証があれば3割負担で治療を受けられますが、ない場合は原則10割負担です。 つまり、いつもであれば3000円ほどの負担でも、健康保険証がないと10000円です。 病院で10000円を超えることは通常であればあまりないので、お財布に大ダメージを与えることは間違いありません。 もちろん、後日窓口で健康保険証を提示することで7割分は戻ってきます。 ただ、次の予約があればいいのですが予約が無い場合、健康保険証の提示と精算のために行かなければなりません。 いつでもいいわけではなく、受診と同じ月の間でないといけません。 お金や手間を考えると、やはり面倒に感じてしまう方が多いでしょう。

②3割負担でもいいケース

少数ではありますが、保険証がなくても3割負担で精算してもらえる場合があります。 どういう場合かというと以下の2つが想定されます。 ・定期的に通院している場合 ・次回の予約が入っている場合 定期的に通院している場合は、次回の通院日に新しい健康保険証を見せてくださいと言われて、いつも通りの精算ということがあります。 また、初診で行っても同月内に次回の予約がある場合、とりあえず3割で精算してもらえる…ということもあります。 ただ、2つ目の場合でも、次回精算するのでとりあえず10割で精算という病院ももちろんあります。

健康保険被保険者資格証明書があれば安心

健康保険証がない場合でも、健康保険被保険者資格証明書があればいつものように病院にかかることができます。 事業所発行ができれば一番楽ですが、自分でも発行手続きは可能なので状況に応じて手続きをしましょう。 ただもしも準備ができなかった場合でも、事前に病院に問い合わせることで10割負担か3割負担かを知ることができます。 「体調が悪いけれど保険証がないから我慢しよう…」と考えがちですが、無理せず病院へ行きましょう。 就職や転職などで手元に健康保険証がないときに、健康保険被保険者資格証明書の存在を思い出してください。 この記事が日々の生活のプラスになれば嬉しいです。

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