Changes on (Cabinet Order No. 240 of 2026)
The provisions of Article 41, Article 42 (excluding the parts relating to paragraph (1), items (ii) through (iv), paragraph (2), items (ii) through (iv), paragraph (3), items (ii) through (iv), paragraph (4), items (ii) through (iv), paragraph (7), item (i), (b) through (d) and item (ii), (b) through (d), paragraph (9), item (ii), and paragraphs (10) through (12)) and Article 43 (excluding the parts relating to paragraph (1), item (i), (b) through (d), item (ii), (b) through (d) and item (iii), (b) through (d)) apply mutatis mutandis to the payment of high-cost medical expenses for specially-insured day laborers.
第四十一条、第四十二条(第一項第二号から第四号まで、第二項第二号から第四号まで、第三項第二号から第四号まで、第四項第二号から第四号まで、第七項第一号ロからニまで及び第二号ロからニまで、第九項第二号並びに第十項から第十二項までに係る部分を除く。)及び第四十三条(第一項第一号ロからニまで、第二号ロからニまで及び第三号ロからニまでに係る部分を除く。)の規定は、日雇特例被保険者に係る高額療養費の支給について準用する。
Changes on (Cabinet Order No. 240 of 2026)
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)) and paragraph (12) of that Article (excluding the parts relating to items (ii) and (iii)) 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).
第四十一条の二第五項から第十項まで及び第四十二条第十項の規定は、計算期間において日雇特例被保険者であった者及びその被扶養者であった者(基準日において高齢者の医療の確保に関する法律第七条第四項第一号から第五号までに掲げる者又は後期高齢者医療の被保険者である者に限る。)に係る高額療養費の支給について準用する。
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.
第四十三条の二第一項から第三項まで(第一項第二号及び第四号に係る部分を除く。)、第四十三条の三第一項から第三項まで(第一項第二号から第四号まで及び第二項第二号から第四号までに係る部分を除く。)及び前条第二項の規定は、基準日において日雇特例被保険者である者及びその被扶養者である者に係る高額介護合算療養費の支給について準用する。
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).
第四十三条の二第五項から第七項まで、第四十三条の三第五項及び第六項並びに前条第二項の規定は、計算期間において日雇特例被保険者であった者及びその被扶養者であった者(基準日において高齢者の医療の確保に関する法律第七条第四項第一号から第五号までに掲げる者又は後期高齢者医療の被保険者である者に限る。)に係る高額介護合算療養費の支給について準用する。
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.
Read this with the articles around it
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)
reference datemachine translation
「基準日」
The last day of the calculation period (計算期間), the period from 1 August each year to the following 31 July, on which high-cost medical expenses (高額療養費) and similar amounts for the whole period are worked out.
Defined inArticle 41-2, paragraph (1)
calculation periodmachine translation
「計算期間」
The period from 1 August each year to the following 31 July, over which annual amounts such as high-cost medical expenses (高額療養費) for outpatient treatment are worked out.
Defined inArticle 41-2, paragraph (4)
person covered by medical insurancemachine translation
「医療保険加入者」
In Article 43, paragraph (11), Article 43-4, paragraph (1) and Article 44, paragraphs (4) and (8), a person covered by one of the medical insurance schemes — a member (加入者) as defined in Article 7, paragraph (4) of the Act on Assurance of Medical Care for Elderly People — or an insured person of the late-stage elderly medical care system (後期高齢者医療).
Defined inArticle 43, paragraph (11)· applies only in this provision and in Article 43-4, paragraph (1); and Article 44, paragraphs (4) and (8)