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Order for Enforcement of the Health Insurance Act

Article 42, paragraph (3), item (v)

第四十二条第三項第五号

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

How the changes are shown

Underlined: words the amendment adds. A bar: where it removes words.Underlined: words the amendment adds. Struck through: the words it removes.Underlined: words the amendment adds. Struck through: the words it removes.

  1. In force today

    an insured person who is a person exempt from municipal inhabitant tax or a dependent thereof, or an insured person or a dependent thereof who falls under a person specified by Order of the Ministry of Health, Labour and Welfare among persons who, in the month in which the medical treatment was received, are persons requiring public assistance (excluding those listed in the preceding three items or the following item): 25,700 yen; provided, however, that in the case of repeated high-cost medical expenses, the amount is 24,600 yen.

    市町村民税非課税者である被保険者若しくはその被扶養者又は療養のあった月において要保護者である者であって厚生労働省令で定めるものに該当する被保険者若しくはその被扶養者(前三号又は次号に掲げる者を除く。) 二万五千七百円。ただし、高額療養費多数回該当の場合にあっては、二万四千六百円とする。

  2. Not yet in force Cabinet Order No. 240 of 2026 Moved to item (xiii) and reworded

    an insured person who is a person exempt from municipal inhabitant tax or a dependent thereof, or an insured person or a dependent thereof who falls under a person specified by Order of the Ministry of Health, Labour and Welfare among persons who, in the month in which the medical treatment was received, are persons requiring public assistance (excluding those listed in the preceding three itemsitems (i) through (ix) or the following item): 25,700 yen; provided, however, that in the case of repeated high-cost medical expenses, the amount is 24,600 yen.

    市町村民税非課税者である被保険者若しくはその被扶養者又は療養のあった月において要保護者である者であって厚生労働省令で定めるものに該当する被保険者若しくはその被扶養者(前三号第一号から第九号まで又は次号に掲げる者を除く。) 二万五千七百円。ただし、高額療養費多数回該当の場合にあっては、二万四千六百円とする。

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