This Cabinet Order comes into effect on April 1, 2008.

①The provisions of Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act apply to the case where the date on which medical care is received is on or after the day of enforcement of this Cabinet Order (hereinafter referred to as the "Effective Date"), and for the case where the date on which medical care is received is before the Effective Date, the provisions then in force continue to govern.

②With regard to an insured person prescribed in Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act and the insured person's dependents, in the case where the month in which benefits for medical treatment or the medical care of such a dependent is received is from April through August 2008, that paragraph is applied by deeming the phrase "and the insured person's dependents (limited to those falling under the case of being on or after the month following the month that includes the day on which they reach the age of 70)" in that paragraph to be replaced with "as well as the insured person's dependents (limited to those falling under the case of being on or after the month following the month that includes the day on which they reach the age of 70) and persons who were the insured person's dependents (meaning persons who have ceased to be dependents by coming to fall under the proviso to Article 3, paragraph (7) of the Act; the same applies hereinafter in this paragraph)", and the phrase "has no such dependent" in that paragraph to be replaced with "has no such dependent or person who was such a dependent".

With regard to the payment of dependent's medical expenses and dependent's medical expenses for home-nursing under the provisions of the Health Insurance Act (Act No. 70 of 1922) for medical care received before the Effective Date, the provisions then in force continue to govern.

With regard to the payment of high-cost medical expenses under the provisions of the Health Insurance Act for medical care received before the Effective Date, the provisions then in force continue to govern.

①Among the persons listed in Article 42, paragraph (2), item (ii) of the Order for Enforcement of the Health Insurance Act, for those who fall under any of the following items (hereinafter referred to in this Article as "insured persons with specified income"), the base amount for calculating high-cost medical expenses under Article 41, paragraph (2) of the Order for Enforcement of the Health Insurance Act is, notwithstanding Article 42, paragraph (2) of the Order for Enforcement of the Health Insurance Act, the amount specified in Article 42, paragraph (2), item (i) of the Order for Enforcement of the Health Insurance Act before the amendment by the provisions of Article 1 (hereinafter referred to in this Article as the "Former Health Insurance Order").

②The base amount for calculating high-cost medical expenses under Article 41, paragraph (3) of the Order for Enforcement of the Health Insurance Act for an insured person with specified income is, notwithstanding Article 42, paragraph (3) of the Order for Enforcement of the Health Insurance Act, the amount specified in Article 42, paragraph (3), item (i) of the Former Health Insurance Order.

③Where an insured person with specified income has received medical care listed in the following items, and the co-payment payable under the provisions of the Health Insurance Act has not been paid, the limit of the amount that the insurer pays, pursuant to Article 43, paragraph (1) of the Order for Enforcement of the Health Insurance Act, to the medical institution providing services covered by health insurance, etc. prescribed in that paragraph in respect of the insured person with specified income is, notwithstanding the items of that paragraph, the amount obtained by deducting, from the amount of the co-payment concerned, the amount specified in each of the following items in accordance with the category of medical care listed in that item.

④With regard to the payment of high-cost medical expenses relating to medical expenses combined with treatment outside insurance coverage or dependent's medical expenses (limited to those relating to a person who falls under paragraph (1), item (i)) for an insured person with specified income, Article 43, paragraph (3) of the Order for Enforcement of the Health Insurance Act is applied by deeming the phrase "the amount specified in each of those items" in that paragraph to be replaced with "the amount specified in sub-item (a) of each of those items before the amendment by the provisions of Article 1 of the Cabinet Order Partially Amending the Order for Enforcement of the Health Insurance Act, etc. (Cabinet Order No. 116 of 2008)".

①Among insured persons to whom Article 74, paragraph (1), item (ii) of the Health Insurance Act applies or dependents to whom Article 110, paragraph (2), item (i), (c) of that Act applies, with regard to the payment of high-cost medical expenses under Article 41, paragraph (4) of the Order for Enforcement of the Health Insurance Act for those who have received, during the period from April through December 2008, treatment subject to specified benefits (meaning treatment subject to specified benefits prescribed in Article 41, paragraph (1), item (ii) of the Order for Enforcement of the Health Insurance Act, limited to medical care for which benefits relating to medical care for those persons specified by the Minister of Health, Labour and Welfare are to be provided) (hereinafter referred to in this Article as an "insured person, etc. under the 2008 special measure"), the phrase "excluding treatment subject to specified disease benefits" in Article 41, paragraph (4) of the Order for Enforcement of the Health Insurance Act is deemed to be replaced with "excluding medical care for which benefits specified by the Minister of Health, Labour and Welfare prescribed in Article 32, paragraph (1) of the Supplementary Provisions of the Cabinet Order Partially Amending the Order for Enforcement of the Health Insurance Act, etc. (Cabinet Order No. 116 of 2008) are to be provided, and treatment subject to specified disease benefits".

②With regard to the base amount for calculating high-cost medical expenses under Article 41, paragraph (2) of the Order for Enforcement of the Health Insurance Act for an insured person, etc. under the 2008 special measure, the provisions then in force continue to govern, notwithstanding Article 42, paragraph (2), item (i) of the Order for Enforcement of the Health Insurance Act.

③With regard to the base amount for calculating high-cost medical expenses under Article 41, paragraph (3) of the Order for Enforcement of the Health Insurance Act for an insured person, etc. under the 2008 special measure, notwithstanding the provisions of Article 42, paragraph (3), item (i) of that Order, the provisions then in force continue to govern.

④With regard to the limit of the amount that an insurer pays to a medical institution providing services covered by health insurance, etc. prescribed in Article 43, paragraph (1) of the Order for Enforcement of the Health Insurance Act for an insured person, etc. under the 2008 special measure pursuant to the provisions of that paragraph, notwithstanding the provisions of item (ii), (a) and item (iii), (a) of that paragraph, the provisions then in force continue to govern. In this case, the provisions of Article 43, paragraph (3) of that Order are applied by deeming the phrase "each of those items" in that paragraph to be replaced with "each of those items prior to amendment by Article 1 of the Cabinet Order Partially Amending the Order for Enforcement of the Health Insurance Act, etc. (Cabinet Order No. 116 of 2008)".

⑤The provisions of Article 43, paragraphs (4) and (5) of the Order for Enforcement of the Health Insurance Act apply mutatis mutandis to the payment of high-cost medical expenses under Article 41, paragraph (3) of that Order in the case where an insured person, etc. under the 2008 special measure has received outpatient treatment (meaning outpatient treatment prescribed in Article 41, paragraph (3) of that Order) and the amount of co-payment, etc. to be paid under the provisions of the Health Insurance Act (meaning the amount of co-payment, etc. prescribed in Article 115, paragraph (1) of that Act) has not been paid. In this case, the phrase "the amount equivalent to the amount to be paid to the insured person as high-cost medical expenses under the provisions of paragraphs (4) through (6) of that Article, out of the expenses required for that treatment" in Article 43, paragraph (4) of that Order is deemed to be replaced with "with regard to the high-cost medical expenses under the provisions of paragraph (3) of that Article, within the limit of the amount obtained by deducting from the amount of that co-payment, etc. the base amount for calculating high-cost medical expenses under Article 41, paragraph (3), as to which the provisions then in force continue to govern pursuant to the provisions of Article 32, paragraph (3) of the Supplementary Provisions of the Cabinet Order Partially Amending the Order for Enforcement of the Health Insurance Act, etc. (Cabinet Order No. 116 of 2008) (or, where the amount obtained by multiplying the amount of expenses calculated for that outpatient treatment by 10% exceeds that base amount for calculating high-cost medical expenses, the amount so obtained),", and the phrase "Article 41, paragraphs (4) through (6)" in Article 43, paragraph (5) of that Order with "Article 41, paragraph (3)".

⑥The provisions of the preceding paragraphs apply mutatis mutandis to the payment of high-cost medical expenses for a specially-insured day laborer prescribed in Article 37 of the Order for Enforcement of the Health Insurance Act who, where the provisions of paragraph (1) are applied by deeming that specially-insured day laborer to be an insured person, would come to fall under an insured person, etc. under the 2008 special measure.