Article 41Requirements for Payment and Amount of Monthly High-Cost Medical Expenses
第四十一条（月間の高額療養費の支給要件及び支給額）
High-cost medical expenses are to be paid when the amount (hereinafter in this paragraph referred to as the "household total of co-payments, etc.") obtained by deducting the amount of high-cost medical expenses paid under the provisions of the following paragraph through paragraph (5) from the total of the following amounts exceeds the base amount for calculating high-cost medical expenses, and the amount of the high-cost medical expenses is the amount obtained by deducting the base amount for calculating high-cost medical expenses from the household total of co-payments, etc.:
高額療養費は、次に掲げる額を合算した額から次項から第五項までの規定により支給される高額療養費の額を控除した額（以下この項において「一部負担金等世帯合算額」という。）が高額療養費算定基準額を超える場合に支給するものとし、その額は、一部負担金等世帯合算額から高額療養費算定基準額を控除した額とする。
the total of the amounts listed in (a) through (f) below (for those relating to medical treatment received in or before the month that includes the day on which the person reaches the age of 70, limited to those of 21,000 yen or more (10,500 yen or more for those relating to medical treatment under the special rule on reaching age 75 prescribed in Article 41-3, paragraph (1), item (i))) that relate to medical treatment (excluding dietary treatment prescribed in Article 63, paragraph (2), item (i) of the Act (hereinafter referred to simply as "dietary treatment" in this Article), living support prescribed in item (ii) of that paragraph (hereinafter referred to simply as "living support" in this Article), and the treatment prescribed in paragraph (8) where the insured person or the insured person's dependent falls under that paragraph; the same applies hereinafter from this paragraph through paragraph (5), in Article 41-3, in Article 43, paragraphs (1) and (3), and in Article 43-2), other than the treatment subject to specified benefits prescribed in the following item, that an insured person (including a person who receives benefits for medical treatment, or medical expenses combined with treatment outside insurance coverage or medical expenses for home-nursing, under Article 98, paragraph (1) of the Act, and excluding a specially-insured day laborer; the same applies hereinafter in this Article, Article 42 and Article 43) or the insured person's dependent (including a person receiving treatment for which dependent's medical expenses are paid under Article 98, paragraph (1) of the Act as applied mutatis mutandis pursuant to Article 110, paragraph (7) of the Act, and a person receiving treatment for which dependent's medical expenses for home-nursing are paid under Article 98, paragraph (1) of the Act as applied mutatis mutandis pursuant to Article 111, paragraph (3) of the Act; the same applies hereinafter in this Article, Article 42 and Article 43) received in the same month from each single hospital, clinic, pharmacy or other person (hereinafter referred to as a "hospital, etc.");
被保険者（法第九十八条第一項の規定により療養の給付又は保険外併用療養費若しくは訪問看護療養費の支給を受けている者を含み、日雇特例被保険者を除く。以下この条、第四十二条及び第四十三条において同じ。）又はその被扶養者（法第百十条第七項において準用する法第九十八条第一項の規定により支給される家族療養費に係る療養を受けている者又は法第百十一条第三項において準用する法第九十八条第一項の規定により支給される家族訪問看護療養費に係る療養を受けている者を含む。以下この条、第四十二条及び第四十三条において同じ。）が同一の月にそれぞれ一の病院、診療所、薬局その他の者（以下「病院等」という。）から受けた療養（法第六十三条第二項第一号に規定する食事療養（以下この条において単に「食事療養」という。）、同項第二号に規定する生活療養（以下この条において単に「生活療養」という。）及び当該被保険者又はその被扶養者が第八項の規定に該当する場合における同項に規定する療養を除く。以下この項から第五項まで、第四十一条の三、第四十三条第一項及び第三項並びに第四十三条の二において同じ。）であって次号に規定する特定給付対象療養以外のものに係る次のイからヘまでに掲げる額（七十歳に達する日の属する月以前の療養に係るものにあっては、二万千円（第四十一条の三第一項第一号に規定する七十五歳到達時特例対象療養に係るものにあっては、一万五百円）以上のものに限る。）を合算した額
the amount of the co-payment;
一部負担金の額
where the treatment includes evaluation treatment prescribed in Article 63, paragraph (2), item (iii) of the Act, patient-requested treatment prescribed in item (iv) of that paragraph or selective treatment prescribed in item (v) of that paragraph, the amount obtained by adding to the amount of the co-payment the amount obtained by deducting, from the amount of expenses calculated as specified by the Minister of Health, Labour and Welfare as referred to in Article 86, paragraph (2), item (i) of the Act (or, where that amount exceeds the amount of expenses actually required for the treatment, the amount of expenses actually required for the treatment), the amount equivalent to the amount paid as medical expenses combined with treatment outside insurance coverage for the expenses required for the treatment;
当該療養が法第六十三条第二項第三号に規定する評価療養、同項第四号に規定する患者申出療養又は同項第五号に規定する選定療養を含む場合における一部負担金の額に法第八十六条第二項第一号に規定する厚生労働大臣が定めるところにより算定した費用の額（その額が現に当該療養に要した費用の額を超えるときは、現に当該療養に要した費用の額）から当該療養に要した費用につき保険外併用療養費として支給される額に相当する額を控除した額を加えた額
the amount obtained by deducting, from the amount of expenses calculated for the treatment (or, where that amount exceeds the amount of expenses actually required for the treatment, the amount of expenses actually required for the treatment), the amount equivalent to the amount paid as medical expenses for the expenses required for the treatment;
当該療養につき算定した費用の額（その額が現に当該療養に要した費用の額を超えるときは、現に当該療養に要した費用の額）から当該療養に要した費用につき療養費として支給される額に相当する額を控除した額
the amount obtained by deducting, from the amount of expenses calculated as specified by the Minister of Health, Labour and Welfare prescribed in Article 88, paragraph (4) of the Act, an amount equivalent to the amount paid as medical expenses for home-nursing for the expenses required for the relevant designated home nursing;
法第八十八条第四項に規定する厚生労働大臣が定めるところにより算定した費用の額からその指定訪問看護に要した費用につき訪問看護療養費として支給される額に相当する額を控除した額
the amount obtained by deducting, from the amount of expenses calculated for the relevant medical treatment (if that amount exceeds the amount of expenses actually required for the relevant medical treatment, the amount of expenses actually required for the relevant medical treatment), an amount equivalent to the amount paid as dependent's medical expenses (including medical expenses paid in lieu of dependent's medical expenses pursuant to Article 87, paragraph (1) of the Act as applied mutatis mutandis pursuant to Article 110, paragraph (7) of the Act) for the expenses required for the relevant medical treatment;
the amount obtained by deducting, from the amount of expenses calculated pursuant to Article 111, paragraph (2) of the Act, an amount equivalent to the amount paid as dependent's medical expenses for home-nursing for the expenses required for the relevant designated home nursing;
法第百十一条第二項の規定により算定した費用の額からその指定訪問看護に要した費用につき家族訪問看護療養費として支給される額に相当する額を控除した額
the total sum of the amounts that the insured person or a dependent thereof still has to bear for treatment subject to specified benefits (meaning medical treatment for which payment of general medical expenses for atomic bomb survivors under the Atomic Bomb Survivors' Assistance Act (Act No. 117 of 1994) (referred to as "general medical expenses for atomic bomb survivors" in Article 43, paragraph (5)) or other benefits for medical care specified by Order of the Ministry of Health, Labour and Welfare are to be provided, and the treatment prescribed in paragraph (9) in the case where the insured person or a dependent thereof has received certification by the insurer under that paragraph; the same applies hereinafter) that the insured person or a dependent thereof received in the same month as in the preceding item from each single hospital, etc. (for those relating to treatment subject to specified benefits on or before the month that includes the day on which the person reaches the age of 70, limited to those for which the amounts listed in (a) through (f) of the preceding item relating to that treatment subject to specified benefits are 21,000 yen or more (10,500 yen or more for those relating to medical treatment under the special rule on reaching age 75 prescribed in Article 41-3, paragraph (1), item (i))).
被保険者又はその被扶養者が前号と同一の月にそれぞれ一の病院等から受けた特定給付対象療養（原子爆弾被爆者に対する援護に関する法律（平成六年法律第百十七号）による一般疾病医療費（第四十三条第五項において「原爆一般疾病医療費」という。）の支給その他厚生労働省令で定める医療に関する給付が行われるべき療養及び当該被保険者又はその被扶養者が第九項の規定による保険者の認定を受けた場合における同項に規定する療養をいう。以下同じ。）について、当該被保険者又はその被扶養者がなお負担すべき額（七十歳に達する日の属する月以前の特定給付対象療養に係るものにあっては、当該特定給付対象療養に係る前号イからヘまでに掲げる額が二万千円（第四十一条の三第一項第一号に規定する七十五歳到達時特例対象療養に係るものにあっては、一万五百円）以上のものに限る。）を合算した額
If a dependent of an insured person receives medical treatment (limited to medical treatment under the special rule on reaching age 75 prescribed in Article 41-3, paragraph (1), item (i) that was received on or before the month that includes the day on which the person reaches the age of 70), and the amount obtained by totaling, for each dependent, the amounts listed in the following items relating to that medical treatment that the dependent received in the same month from each single hospital, etc. exceeds the base amount for calculating high-cost medical expenses, the total sum of the amounts obtained by deducting the base amount for calculating high-cost medical expenses from the respective totals is paid as high-cost medical expenses.
被保険者の被扶養者が療養（第四十一条の三第一項第一号に規定する七十五歳到達時特例対象療養であって、七十歳に達する日の属する月以前のものに限る。）を受けた場合において、当該被扶養者が同一の月にそれぞれ一の病院等から受けた当該療養に係る次に掲げる額を当該被扶養者ごとにそれぞれ合算した額が高額療養費算定基準額を超えるときは、当該それぞれ合算した額から高額療養費算定基準額を控除した額の合算額を高額療養費として支給する。
the total sum of the amounts listed in item (i), (a) through (f) of the preceding paragraph relating to that medical treatment received by the dependent (excluding treatment subject to specified benefits) (limited to those of 10,500 yen or more);
the total sum of the amounts that the dependent still has to bear for that medical treatment received by the dependent (limited to treatment subject to specified benefits) (limited to those for which the amounts listed in item (i), (a) through (f) of the preceding paragraph relating to that treatment subject to specified benefits are 10,500 yen or more).
If an insured person or a dependent thereof receives medical treatment (limited to medical treatment on or after the month following the month that includes the day on which the person reaches the age of 70; the same applies in paragraph (5)), and the amount obtained by deducting the amount of high-cost medical expenses paid pursuant to the following paragraph or paragraph (5) from the total sum of the following amounts relating to that medical treatment that the insured person or a dependent thereof received in the same month from each single hospital, etc. (hereinafter in this paragraph referred to as the "household total of co-payments, etc. for persons aged 70 or over") exceeds the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the household total of co-payments, etc. for persons aged 70 or over is paid as high-cost medical expenses.
the total sum of the amounts listed in paragraph (1), item (i), (a) through (f) relating to that medical treatment received by the insured person or a dependent thereof (excluding treatment subject to specified benefits);
the total sum of the amounts that the insured person or a dependent thereof still has to bear for that medical treatment received by the insured person or a dependent thereof (limited to treatment subject to specified benefits).
被保険者又はその被扶養者が受けた当該療養（特定給付対象療養に限る。）について、当該被保険者又はその被扶養者がなお負担すべき額を合算した額
If an insured person receives the medical treatment listed in item (i), or a dependent thereof receives the medical treatment listed in item (ii) or the medical treatment listed in item (iii) (limited to medical treatment on or after the month following the month that includes the day on which the person reaches the age of 70), and the amount obtained by deducting, from the amount obtained by totaling, for each insured person or dependent thereof, the amounts listed in the items of the preceding paragraph relating to that medical treatment that the insured person or dependent received in the same month from each single hospital, etc., the portion of the amount of high-cost medical expenses paid pursuant to the following paragraph that relates to that insured person or dependent exceeds the base amount for calculating high-cost medical expenses, the total sum of the amounts obtained by deducting the base amount for calculating high-cost medical expenses from the respective amounts so deducted is paid as high-cost medical expenses.
the medical treatment received by a person who falls under Article 52, item (i) of the Act on Assurance of Medical Care for Elderly People and has lost status as an insured person of health insurance by acquiring, on a day other than the first day of a month, status as an insured person under Article 50 of that Act (hereinafter referred to as an "insured person of the late-stage elderly medical care system") (referred to as a "former insured person before reaching age 75" in item (iii)), in the month that includes the day preceding that day (limited to the period on or before that day; referred to as the "month in which the former insured person reaches age 75" in item (iii));
高齢者の医療の確保に関する法律第五十二条第一号に該当し、月の初日以外の日において同法第五十条の規定による被保険者（以下「後期高齢者医療の被保険者」という。）の資格を取得したことにより健康保険の被保険者の資格を喪失した者（第三号において「七十五歳到達前旧被保険者」という。）が、同日の前日の属する月（同日以前の期間に限る。第三号において「旧被保険者七十五歳到達月」という。）に受けた療養
the medical treatment received by a person who falls under Article 52, item (i) of the Act on Assurance of Medical Care for Elderly People and has ceased to be a dependent by acquiring, on a day other than the first day of a month, status as an insured person of the late-stage elderly medical care system, in the month that includes the day preceding that day (limited to the period on or before that day);
高齢者の医療の確保に関する法律第五十二条第一号に該当し、月の初日以外の日において後期高齢者医療の被保険者の資格を取得したことにより被扶養者でなくなった者が、同日の前日の属する月（同日以前の期間に限る。）に受けた療養
the medical treatment received, in the month in which the former insured person reaches age 75 for the relevant former insured person before reaching age 75, by a person who was a dependent of a former insured person before reaching age 75 (limited to a person who ceased to be a dependent of that former insured person before reaching age 75 by reason of that former insured person before reaching age 75 acquiring status as an insured person of the late-stage elderly medical care system).
七十五歳到達前旧被保険者の被扶養者であった者（当該七十五歳到達前旧被保険者が後期高齢者医療の被保険者の資格を取得したことによりその被扶養者でなくなった者に限る。）が、当該七十五歳到達前旧被保険者に係る旧被保険者七十五歳到達月に受けた療養
If an insured person (excluding a case where the person is one to whom the provisions of Article 74, paragraph (1), item (iii) of the Act apply) or a dependent thereof receives medical treatment (limited to outpatient treatment (meaning the medical treatment listed in Article 63, paragraph (1), items (i) through (iv) of the Act (excluding that accompanying the medical treatment listed in item (v) of that paragraph); the same applies in the following Article and in Article 42, paragraph (6), item (iii), paragraph (7), item (iii) and paragraph (8), item (iii))), and the amount obtained by totaling, for each insured person or dependent thereof, the amounts listed in the items of paragraph (3) relating to that medical treatment that the insured person or dependent received in the same month from each single hospital, etc. exceeds the base amount for calculating high-cost medical expenses, the total sum of the amounts obtained by deducting the base amount for calculating high-cost medical expenses from the respective totals is paid as high-cost medical expenses.
被保険者（法第七十四条第一項第三号の規定が適用される者である場合を除く。）又はその被扶養者が療養（外来療養（法第六十三条第一項第一号から第四号までに掲げる療養（同項第五号に掲げる療養に伴うものを除く。）をいう。次条並びに第四十二条第六項第三号、第七項第三号及び第八項第三号において同じ。）に限る。）を受けた場合において、当該被保険者又はその被扶養者が同一の月にそれぞれ一の病院等から受けた当該療養に係る第三項各号に掲げる額を当該被保険者又はその被扶養者ごとにそれぞれ合算した額が高額療養費算定基準額を超えるときは、当該それぞれ合算した額から高額療養費算定基準額を控除した額の合算額を高額療養費として支給する。
If an insured person or a dependent thereof receives treatment subject to specified benefits (excluding treatment subject to specified disease benefits prescribed in the following paragraph in the case where the insured person or a dependent thereof has received certification by the insurer under that paragraph, and the treatment prescribed in paragraph (9) in the case where the insured person or a dependent thereof has received certification by the insurer under that paragraph), and the amounts listed in paragraph (1), item (i), (a) through (f) relating to that treatment subject to specified benefits that the insured person or dependent received in the same month from each single hospital, etc. exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (f) of that item is paid as high-cost medical expenses.
If an insured person or a dependent thereof receives treatment subject to specified disease benefits (meaning, among treatment subject to specified benefits (excluding the treatment prescribed in paragraph (9) in the case where the insured person or a dependent thereof has received certification by the insurer under that paragraph), treatment for which benefits for medical care specified by the Minister of Health, Labour and Welfare as benefits for reducing the burden of the costs necessary for the treatment of a disease for which a treatment method has not been established or another disease that, by being contracted, requires treatment over a long period are to be provided; the same applies in Article 42, paragraph (7)), the insured person or dependent who received that treatment subject to specified disease benefits has received certification by the insurer as provided by Order of the Ministry of Health, Labour and Welfare, and the amounts listed in paragraph (1), item (i), (a) through (f) relating to that treatment subject to specified disease benefits that the insured person or dependent received in the same month from each single hospital, etc. exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (f) of that item is paid as high-cost medical expenses.
被保険者又はその被扶養者が特定疾病給付対象療養（特定給付対象療養（当該被保険者又はその被扶養者が第九項の規定による保険者の認定を受けた場合における同項に規定する療養を除く。）のうち、治療方法が確立していない疾病その他の疾病であって、当該疾病にかかることにより長期にわたり療養を必要とすることとなるものの当該療養に必要な費用の負担を軽減するための医療に関する給付として厚生労働大臣が定めるものが行われるべきものをいう。第四十二条第七項において同じ。）を受けた場合において、当該特定疾病給付対象療養を受けた被保険者又はその被扶養者が厚生労働省令で定めるところにより保険者の認定を受けたものであり、かつ、当該被保険者又はその被扶養者が同一の月にそれぞれ一の病院等から受けた当該特定疾病給付対象療養に係る第一項第一号イからヘまでに掲げる額が高額療養費算定基準額を超えるときは、当該同号イからヘまでに掲げる額から高額療養費算定基準額を控除した額を高額療養費として支給する。
If an insured person or a dependent thereof is a public assistance recipient prescribed in Article 6, paragraph (1) of the Public Assistance Act (Act No. 144 of 1950), and the amounts listed in paragraph (1), item (i), (a) through (f) relating to medical treatment (excluding dietary treatment, living support and treatment subject to specified benefits) that the insured person or dependent received in the same month from each single hospital, etc. exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (f) of that item is paid as high-cost medical expenses.
If an insured person or a dependent thereof receives medical treatment (excluding dietary treatment and living support) for a disease specified by the Minister of Health, Labour and Welfare that falls under all of the following items, the insured person or dependent who received that treatment has received certification by the insurer as provided by Order of the Ministry of Health, Labour and Welfare, and the amounts listed in paragraph (1), item (i), (a) through (f) relating to that treatment that the insured person or dependent received in the same month from each single hospital, etc. exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (f) of that item is paid as high-cost medical expenses.
that the disease requires treatment specified by the Minister of Health, Labour and Welfare as a certain treatment the cost of which is extremely high;
費用が著しく高額な一定の治療として厚生労働大臣が定める治療を要すること。
that the treatment prescribed in the preceding item must be continued over an extremely long period.
前号に規定する治療を著しく長期間にわたり継続しなければならないこと。
Read this with the articles around it
household total of co-payments, etc.machine translation
「一部負担金等世帯合算額」
In Article 41, paragraph (1), the total of the co-payments (一部負担金) and other costs an insured person (被保険者) and their dependents (被扶養者) were left to bear for medical treatment received in one month from each hospital, clinic, pharmacy or other provider, together with what they still bear for treatment covered by other public medical benefits (特定給付対象療養) — for treatment up to the month they turn 70, counting only amounts of 21,000 yen or more (10,500 yen for treatment under the special rule on reaching age 75) — less the high-cost medical expenses (高額療養費) paid under paragraphs (2) to (5); where it exceeds the base amount for calculating high-cost medical expenses (高額療養費算定基準額), the excess is paid as high-cost medical expenses.
Short name set inArticle 41, paragraph (1)· applies only in this paragraph
living supportmachine translation
「生活療養」
In Article 41, living support as defined in Article 63, paragraph (2), item (ii) of the Health Insurance Act: meals, and a suitable care environment as to temperature, lighting and water supply, given together with inpatient care to an insured person undergoing special long-term hospitalization (特定長期入院被保険者).
Short name set inArticle 41, paragraph (1), item (i)· applies only in this article
hospital, etc.machine translation
「病院等」
A hospital, clinic, pharmacy or other provider from which a person receives medical treatment.
Short name set inArticle 41, paragraph (1), item (i)
dietary treatmentmachine translation
「食事療養」
In Article 41, dietary treatment as defined in Article 63, paragraph (2), item (i) of the Health Insurance Act: meals provided as treatment together with inpatient care in a hospital or clinic, other than those given to an insured person undergoing special long-term hospitalization (特定長期入院被保険者).
Short name set inArticle 41, paragraph (1), item (i)· applies only in this article
general medical expenses for atomic bomb survivorsmachine translation
「原爆一般疾病医療費」
In Article 41, paragraph (1), item (ii) and Article 43, paragraph (5), the general medical expenses (一般疾病医療費) paid under the Atomic Bomb Survivors' Assistance Act.
Short name set inArticle 41, paragraph (1), item (ii)· applies only in this provision and in Article 43, paragraph (5)
treatment subject to specified benefitsmachine translation
「特定給付対象療養」
Treatment for which the general medical expenses for atomic bomb survivors (原爆一般疾病医療費) under the Atomic Bomb Survivors' Assistance Act or another medical benefit a Ministry of Health, Labour and Welfare Order (厚生労働省令) names is to be given, and treatment for a disease needing very costly treatment over a very long period that the Minister of Health, Labour and Welfare designates, received by an insured person or dependent the insurer has certified under Article 41, paragraph (9).
Defined inArticle 41, paragraph (1), item (ii)
household total of co-payments, etc. for persons aged 70 or overmachine translation
「七十歳以上一部負担金等世帯合算額」
In Article 41, paragraph (3), the total of the co-payments (一部負担金) and other costs an insured person (被保険者) and their dependents (被扶養者) bore for medical treatment received in one month from each hospital, clinic, pharmacy or other provider, from the month after the month they turn 70, together with what they still bear for treatment covered by other public medical benefits (特定給付対象療養), less the high-cost medical expenses (高額療養費) paid under paragraph (4) or (5); where it exceeds the base amount for calculating high-cost medical expenses (高額療養費算定基準額), the excess is paid as high-cost medical expenses.
Short name set inArticle 41, paragraph (3)· applies only in this paragraph
former insured person before reaching age 75machine translation
「七十五歳到達前旧被保険者」
In Article 41, paragraph (4), a person who lost their status as an insured person under health insurance because, on reaching age 75 (Article 52, item (i) of the Act on Assurance of Medical Care for Elderly People), they became an insured person of the late-stage elderly medical care system (後期高齢者医療) on a day other than the first of a month.
Short name set inArticle 41, paragraph (4), item (i)· applies only in this provision and in Article 41, paragraph (4), item (iii)
insured person of the late-stage elderly medical care systemmachine translation
「後期高齢者医療の被保険者」
An insured person of the late-stage elderly medical care system (後期高齢者医療) under Article 50 of the Act on Assurance of Medical Care for Elderly People.
Short name set inArticle 41, paragraph (4), item (i)
month in which the former insured person reaches age 75machine translation
「旧被保険者七十五歳到達月」
In Article 41, paragraph (4), items (i) and (iii), the month in which a former insured person before reaching age 75 (七十五歳到達前旧被保険者) became an insured person of the late-stage elderly medical care system (後期高齢者医療), counting only the days of it up to the day that happened.
Short name set inArticle 41, paragraph (4), item (i)· applies only in this provision and in Article 41, paragraph (4), item (iii)
outpatient treatmentmachine translation
「外来療養」
In Article 41, paragraph (5), Article 41-2 and Article 42, paragraphs (6) to (8), the treatment in Article 63, paragraph (1), items (i) to (iv) of the Health Insurance Act — examinations, medicines or materials, procedures, operations or other treatment, and management of treatment at home with the care that goes with it — other than treatment given with admission to a hospital or clinic.
Defined inArticle 41, paragraph (5)· applies only in this provision and in Article 41-2; Article 42, paragraph (6), item (iii); Article 42, paragraph (7), item (iii); and Article 42, paragraph (8), item (iii)
treatment subject to specified disease benefitsmachine translation
「特定疾病給付対象療養」
In Article 41, paragraph (7) and Article 42, paragraph (7), treatment subject to specified benefits (特定給付対象療養) — other than treatment under the insurer's certification under Article 41, paragraph (9) — for which a medical benefit the Minister of Health, Labour and Welfare designates is to be given to lighten the cost of treating a disease with no established cure, or another disease, that requires treatment over a long period.
Defined inArticle 41, paragraph (7)· applies only in this provision and in Article 42, paragraph (7)
medical treatment under the special rule on reaching age 75machine translation
「七十五歳到達時特例対象療養」
The medical treatment listed in the items of Article 41, paragraph (4): treatment received, in the month in which they joined the late-stage elderly medical care system (後期高齢者医療) on reaching age 75 on a day other than the first of the month (up to that day), by a person who thereby lost their health insurance coverage as an insured person (被保険者) or as a dependent (被扶養者), and by the former dependents of such an insured person who ceased to be dependents for that reason; for it, the thresholds this Order sets are halved, from 21,000 yen to 10,500 yen.
Short name set inArticle 41-3, paragraph (1), item (i)