Chapter V Insurance Benefits (Articles 43-4 to 44)
The law as Cabinet Order Partially Amending the Order for Enforcement of the Health Insurance Act, etc. (Cabinet Order No. 240 of 2026) leaves it, with the words it changes marked.
The main text is read a page at a time: a chapter to a page, and a long chapter in runs of articles. The whole main text, and the supplementary provisions and appended tables this amendment changes. Those it leaves untouched are on the page for the text in force.
Article 43-4第四十三条の四
Other Matters Concerning the Payment of Expenses for High-Cost Medical Treatment Combined with Long-Term Care（その他高額介護合算療養費の支給に関する事項）
Article 43-4, paragraph (1)
With regard to the payment of expenses for high-cost medical treatment combined with long-term care in the case where an insured person loses status as an insured person during the calculation period and does not become a person covered by medical insurance during that calculation period on or after the day on which the person lost that eligibility, or in any other case specified by Order of the Ministry of Health, Labour and Welfare, the provisions of the preceding two Articles apply by deeming the day before that day (or, in the case of that other case specified by Order of the Ministry of Health, Labour and Welfare, the day specified by Order of the Ministry of Health, Labour and Welfare) to be the reference date.
Matters necessary for procedures concerning the payment of expenses for high-cost medical treatment combined with long-term care are specified by Order of the Ministry of Health, Labour and Welfare.
The provisions of Article 41, Article 42 (excluding limited to the parts relating to paragraph (1), items (ii) through (iv)(ix) and (xiii), paragraph (2), items (ii) through (iv)(ix) and (xiii), paragraph (3), items (ii)(xii) through (iv)(xiv), paragraph (4), items (ii) through (iv), paragraph (7), item (i), (b) (xii) through (xiv), paragraph (5), items (ii) through (iv), paragraph (6), paragraph (7), item (i), (i) and (m), item (ii), (l) through (d)(n) and item (ii)(iii), (b) through (d), paragraph (9), item (ii), and paragraphs (10) through (12)(8) and paragraph (9), item (i)) and Article 43 (excluding the parts relating to paragraph (1), item (i), (b)(a) through (d)(h) and (j) through (l), item (ii), (b)(a) through (d)(k) and item (iii), (b)(a) through (d)(k)) apply mutatis mutandis to the payment of high-cost medical expenses for specially-insured day laborers. In this case, the phrase "an insured person whose standard monthly remuneration for the month in which the medical treatment was received is 280,000 yen or more and less than 360,000 yen, or a dependent of such a person (excluding those listed in item (xiii))" in Article 42, paragraph (1), item (ix) is deemed to be replaced with "a person other than those listed in item (xiii)", and the phrase "an insured person whose standard monthly remuneration for the month in which the medical treatment was received is less than 160,000 yen, or a dependent of such a person (excluding those listed in the following item or item (xiv))" in paragraph (3), item (xii) of that Article is deemed to be replaced with "a person other than those listed in the following item and item (xiv)".
The provisions of Article 41-2, paragraph (1) (excluding the parts relating to items (ii), (iv), (viii), (x), (xiv) and (xvi)), paragraph (2) of that Article (excluding the parts relating to items (ii), (iv), (viii), (x), (xiv) and (xvi) of paragraph (1)), paragraphs (8) through (10) of that Article, Article 41-3, Article 42, paragraph (10), paragraph (11) of that Article (excluding the parts relating to items (ii) and (iii)through (iv)) and paragraph (12) of that Article (excluding the parts relating to items (ii) and (iii)through (iv)) apply mutatis mutandis to the payment of high-cost medical expenses for persons who are, on the reference date, specially-insured day laborers and persons who are dependents thereof.
The provisions of Article 41-2, paragraphs (5) through (10) and Article 42, paragraph (10) apply mutatis mutandis to the payment of high-cost medical expenses for persons who were specially-insured day laborers and persons who were dependents thereof during the calculation period (limited to persons who, on the reference date, are persons listed in Article 7, paragraph (4), items (i) through (v) of the Act on Assurance of Medical Care for Elderly People or insured persons of the late-stage elderly medical care system).
With regard to the payment of high-cost medical expenses under Article 41-2 in the case where a specially-insured day laborer, during the calculation period, is approved under the proviso to Article 3, paragraph (2) of the Act or returns the specially-insured day laborer's insurance book pursuant to Article 126, paragraph (3) of the Act, and does not become a person covered by medical insurance in the calculation period on or after the day on which the person received that approval or returned that insurance book, and in other cases specified by Order of the Ministry of Health, Labour and Welfare, the provisions of the preceding two paragraphs and the provisions applied mutatis mutandis therein apply by deeming the day preceding the day on which the person received that approval or the day preceding the day on which the person returned that insurance book (in a case specified by that Order, the day specified by Order of the Ministry of Health, Labour and Welfare) to be the reference date.
With regard to the payment of high-cost medical expenses under Article 41-3 in the case where a specially-insured day laborer (excluding a person who is a specially-insured day laborer on the reference date) is approved under the proviso to Article 3, paragraph (2) of the Act or returns the specially-insured day laborer's insurance book pursuant to Article 126, paragraph (3) of the Act during the calculation period, the provisions of paragraph (2) and the provisions applied mutatis mutandis therein apply by deeming the day preceding the day on which the person received that approval or returned that insurance book (if there are multiple days on which the person received that approval or returned that insurance book in the calculation period, the latest of those days) to be the reference date.
The provisions of Article 43-2, paragraphs (1) through (3) (excluding the portions relating to paragraph (1), items (ii) and (iv)), Article 43-3, paragraphs (1) through (3) (excluding the portions relating to paragraph (1), items (ii) through (iv) and paragraph (2), items (ii) through (iv)) and paragraph (2) of the preceding Article apply mutatis mutandis to the payment of expenses for high-cost medical treatment combined with long-term care to a person who is a specially-insured day laborer on the reference date and a person who is a dependent thereof.
The provisions of Article 43-2, paragraphs (5) through (7), Article 43-3, paragraphs (5) and (6) and paragraph (2) of the preceding Article apply mutatis mutandis to the payment of expenses for high-cost medical treatment combined with long-term care to a person who was a specially-insured day laborer and a person who was a dependent thereof during the calculation period (limited to a person who, on the reference date, is a person listed in Article 7, paragraph (4), items (i) through (v) of the Act on Assurance of Medical Care for Elderly People or an insured person of the late-stage elderly medical care system).
With regard to the payment of expenses for high-cost medical treatment combined with long-term care in the case where a specially-insured day laborer, during the calculation period, is approved under the proviso to Article 3, paragraph (2) of the Act or returns the specially-insured day laborer's insurance book pursuant to Article 126, paragraph (3) of the Act, and does not become a person covered by medical insurance in the calculation period on or after the day on which the person received that approval or returned that insurance book, and in other cases specified by Order of the Ministry of Health, Labour and Welfare, the provisions of the preceding two paragraphs and the provisions applied mutatis mutandis therein apply by deeming the day preceding the day on which the person received that approval or the day preceding the day on which the person returned that insurance book (in a case specified by that Order, the day specified by Order of the Ministry of Health, Labour and Welfare) to be the reference date.
The day a law or an amendment starts to apply. It is often months or years after promulgation, so that people have time to prepare. The Ministry of Justice's English usually says a law "comes into force" or "comes into effect", and sometimes calls the day its "enforcement date". Its "enforcement" more often means the word's other sense, carrying a law out, as in an Order for Enforcement (施行令), the Cabinet Order (政令) that sets out the details for carrying out an Act.