Order for Enforcement of the Health Insurance Act
Article 42, paragraph (3), item (iv)
第四十二条第三項第四号
Each amendment that changed this provision, and each that will, oldest first. Each is shown against the wording just before it; where an amendment gives the provision another number, it is followed under the new one. Read it as it stands today
In force today
a person to whom the provisions of Article 74, paragraph (1), item (iii) of the Act apply who is an insured person whose standard monthly remuneration for the month in which the medical treatment was received is less than 530,000 yen, or a dependent of such a person: the total sum of 85,800 yen and the amount obtained by multiplying by 1% the amount obtained by deducting 286,000 yen from the cost of the medical treatment, calculated as provided by Order of the Ministry of Health, Labour and Welfare, relating to the total sum of the amounts listed in the items of Article 41, paragraph (3) (or 286,000 yen, if that cost is less than 286,000 yen) (where that amount includes a fractional amount of less than 1 yen, the amount obtained by rounding down that fractional amount if it is less than 50 sen, or by rounding it up to 1 yen if it is 50 sen or more); provided, however, that in the case of repeated high-cost medical expenses, the amount is 44,400 yen.
法第七十四条第一項第三号の規定が適用される者であって療養のあった月の標準報酬月額が五十三万円未満の被保険者又はその被扶養者 八万五千八百円と、第四十一条第三項各号に掲げる額を合算した額に係る療養につき厚生労働省令で定めるところにより算定した当該療養に要した費用の額（その額が二十八万六千円に満たないときは、二十八万六千円）から二十八万六千円を控除した額に百分の一を乗じて得た額（この額に一円未満の端数がある場合において、その端数金額が五十銭未満であるときは、これを切り捨て、その端数金額が五十銭以上であるときは、これを一円に切り上げた額）との合算額。ただし、高額療養費多数回該当の場合にあっては、四万四千四百円とする。
a person to whom the provisions of Article 74, paragraph (1), item (iii) of the Act apply who is an insured person whose standard monthly remuneration for the month in which the medical treatment was received is 710,000 yen or more and less than
530,000830,000 yen, or a dependent of such a person: the total sum of85,800209,400 yen and the amount obtained by multiplying by 1% the amount obtained by deducting286,000698,000 yen from the cost of the medical treatment, calculated as provided by Order of the Ministry of Health, Labour and Welfare, relating to the total sum of the amounts listed in the items of Article 41, paragraph (3) (or286,000698,000 yen, if that cost is less than286,000698,000 yen) (where that amount includes a fractional amount of less than 1 yen, the amount obtained by rounding down that fractional amount if it is less than 50 sen, or by rounding it up to 1 yen if it is 50 sen or more); provided, however, that in the case of repeated high-cost medical expenses, the amount is44,40093,000 yen.法第七十四条第一項第三号の規定が適用される者であって療養のあった月の標準報酬月額が
五十三万円七十一万円以上八十三万円未満の被保険者又はその被扶養者八万五千八百二十万九千四百円と、第四十一条第三項各号に掲げる額を合算した額に係る療養につき厚生労働省令で定めるところにより算定した当該療養に要した費用の額（その額が二十八万六千六十九万八千円に満たないときは、二十八万六千円）から二十八万六千六十九万八千円）から六十九万八千円を控除した額に百分の一を乗じて得た額（この額に一円未満の端数がある場合において、その端数金額が五十銭未満であるときは、これを切り捨て、その端数金額が五十銭以上であるときは、これを一円に切り上げた額）との合算額。ただし、高額療養費多数回該当の場合にあっては、四万四千四百九万三千円とする。