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Article 67Co-payment

第六十七条(一部負担金)

A person who receives benefits for medical treatment from a medical institution providing services covered by health insurance, etc. pursuant to the provisions of Article 64, paragraph (3) must, when receiving those benefits, pay to that medical institution providing services covered by health insurance, etc., as a co-payment, the amount obtained by multiplying the amount calculated for those benefits in accordance with the standards for calculating the amount of expenses required for benefits for medical treatment under Article 70, paragraph (2) or Article 71, paragraph (1) by the ratio specified in the relevant item, in accordance with the category of cases listed in the following items.

第六十四条第三項の規定により保険医療機関等について療養の給付を受ける者は、その給付を受ける際、次の各号に掲げる場合の区分に応じ、当該給付につき第七十条第二項又は第七十一条第一項の療養の給付に要する費用の額の算定に関する基準により算定した額に当該各号に定める割合を乗じて得た額を、一部負担金として、当該保険医療機関等に支払わなければならない。

in cases other than the cases set forth in the following item and item (iii):ten percent;

次号及び第三号に掲げる場合以外の場合 百分の十

if the amount of income calculated pursuant to Cabinet Order for a person receiving benefits for medical treatment or for an insured or other person specified by Cabinet Order who is another Household Member of the household to which the person belongs is not less than the amount specified by Cabinet Order (other than in the case set forth in the following item):20 percent;

当該療養の給付を受ける者又はその属する世帯の他の世帯員である被保険者その他政令で定める者について政令で定めるところにより算定した所得の額が政令で定める額以上である場合(次号に掲げる場合を除く。) 百分の二十

in the case where the amount of income calculated as specified by Cabinet Order for a person receiving the relevant benefits for medical treatment, or for an insured or other person specified by Cabinet Order who is another Household Member of the household to which that person belongs, is not less than the amount specified by Cabinet Order that exceeds the amount specified by Cabinet Order in the preceding item: 30 percent.

当該療養の給付を受ける者又はその属する世帯の他の世帯員である被保険者その他政令で定める者について政令で定めるところにより算定した所得の額が前号の政令で定める額を超える政令で定める額以上である場合 百分の三十

A medical institution providing services covered by health insurance, etc. is to receive payment of the co-payment under the preceding paragraph (where a measure under Article 69, paragraph (1), item (i) has been taken, the reduced co-payment), and if, despite the medical institution providing services covered by health insurance, etc. having endeavored to receive that payment with the same care as a good administrator, the insured still fails to pay all or part of the co-payment, the Association of Medical Care Systems for the Elderly Aged 75 and older may, upon the request of that medical institution providing services covered by health insurance, etc., dispose of it in the same manner as money to be collected pursuant to the provisions of this Act.

保険医療機関等は、前項の一部負担金(第六十九条第一項第一号の措置が採られたときは、当該減額された一部負担金とする。)の支払を受けるべきものとし、保険医療機関等が善良な管理者と同一の注意をもつてその支払を受けることに努めたにもかかわらず、なお被保険者が当該一部負担金の全部又は一部を支払わないときは、後期高齢者医療広域連合は、当該保険医療機関等の請求に基づき、この法律の規定による徴収金の例によりこれを処分することができる。

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