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Read the text in force →健康保険法
Chapter I General Provisions (Article 3)
The law as Act Partially Amending the Health Insurance Act, etc. (Act No. 31 of 2026) leaves it, with the words it changes marked.
The main text is read a page at a time: a chapter to a page, and a long chapter in runs of articles. The whole main text, and the supplementary provisions and appended tables this amendment changes. Those it leaves untouched are on the page for the text in force.
The term "insured person" as used in this Act means a worker employed at an applicable place of business or an insured person with optional and continued coverage; however, a person who falls under any of the following items is ineligible to be an insured person except in the case of becoming a specially-insured day laborer:
この法律において「被保険者」とは、適用事業所に使用される者及び任意継続被保険者をいう。ただし、次の各号のいずれかに該当する者は、日雇特例被保険者となる場合を除き、被保険者となることができない。
an insured person covered by Seamen's Insurance (excluding insured persons with optional and continued disease coverage prescribed in the provisions of Article 2, paragraph (2) of the Seamen's Insurance Act (Act No. 73 of 1939));
船員保険の被保険者（船員保険法（昭和十四年法律第七十三号）第二条第二項に規定する疾病任意継続被保険者を除く。）
a worker employed temporarily and listed below (excluding when continuous employment has exceeded one month if the worker falls under (a) and exceeded the fixed period listed in (b) if the worker falls under (b)):
臨時に使用される者であって、次に掲げるもの（イに掲げる者にあっては一月を超え、ロに掲げる者にあってはロに掲げる定めた期間を超え、引き続き使用されるに至った場合を除く。）
a worker hired on a daily basis;
日々雇い入れられる者
a worker employed for a fixed period of two months or less, who is not expected to be employed beyond that fixed period;
二月以内の期間を定めて使用される者であって、当該定めた期間を超えて使用されることが見込まれないもの
a worker employed at a place of business or office (hereinafter referred to simply as "place of business" except in Article 88, paragraph (1) and Article 89, paragraph (1)) the location of which is not fixed;
事業所又は事務所（第八十八条第一項及び第八十九条第一項を除き、以下単に「事業所」という。）で所在地が一定しないものに使用される者
a worker employed in seasonal work (excluding continuous employment exceeding four months);
季節的業務に使用される者（継続して四月を超えて使用されるべき場合を除く。）
a worker employed at a place of temporary business (excluding continuous employment exceeding six months);
臨時的事業の事業所に使用される者（継続して六月を超えて使用されるべき場合を除く。）
a worker employed at a place of business of a national health insurance society;
国民健康保険組合の事業所に使用される者
a person eligible for insurance under the late-stage elderly medical care system (meaning an insured person pursuant to the provisions of Article 50 of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982)) or a person who falls under any of the items in Article 50 of the Act on Assurance of Medical Care for Elderly People but is not eligible for that insurance pursuant to the provisions of Article 51 of the same Act (hereinafter referred to as "persons with late-stage elderly medical care insurance");
後期高齢者医療の被保険者（高齢者の医療の確保に関する法律（昭和五十七年法律第八十号）第五十条の規定による被保険者をいう。）及び同条各号のいずれかに該当する者で同法第五十一条の規定により後期高齢者医療の被保険者とならないもの（以下「後期高齢者医療の被保険者等」という。）
a person who has made a request to the Minister of Health, Labour and Welfare, a health insurance society or a mutual aid association to the effect that the person will become an insured person of National Health Insurance by not becoming an insured person of health insurance (limited to the period in which the person should be covered by National Health Insurance due to not being covered by other health insurance); or
厚生労働大臣、健康保険組合又は共済組合に対し、健康保険の被保険者とならないことにより国民健康保険の被保険者となる旨の申出をした者（健康保険の被保険者でないことにより国民健康保険の被保険者であるべき期間に限る。）
a person employed at a place of business who is a part-time worker whose weekly prescribed working hours are less than three-quarters of the weekly prescribed working hours of an ordinary worker employed at the same place of business (for a person employed at that place of business who engages in the same type of work as an ordinary worker employed at that place of business, the ordinary worker who engages in the same type of work as that person, except in cases specified by Order of the Ministry of Health, Labour and Welfare; hereinafter simply referred to as "ordinary worker" in this item) ("part-time worker" meaning a person whose weekly prescribed working hours are shorter than the weekly prescribed working hours of an ordinary worker employed at the same place of business; the same applies hereinafter in this item), or a part-time worker whose monthly prescribed working days are less than three-quarters of the monthly prescribed working days of an ordinary worker employed at the same place of business, and who meets the requirements of either (a) or (b):
事業所に使用される者であって、その一週間の所定労働時間が同一の事業所に使用される通常の労働者（当該事業所に使用される通常の労働者と同種の業務に従事する当該事業所に使用される者にあっては、厚生労働省令で定める場合を除き、当該者と同種の業務に従事する当該通常の労働者。以下この号において単に「通常の労働者」という。）の一週間の所定労働時間の四分の三未満である短時間労働者（一週間の所定労働時間が同一の事業所に使用される通常の労働者の一週間の所定労働時間に比し短い者をいう。以下この号において同じ。）又はその一月間の所定労働日数が同一の事業所に使用される通常の労働者の一月間の所定労働日数の四分の三未満である短時間労働者に該当し、かつ、イ又はロのいずれかの要件に該当するもの
the prescribed weekly scheduled working hours are shorter than 20 hours;
一週間の所定労働時間が二十時間未満であること。
a high school student prescribed by Article 50 of the School Education Act (Act No. 26 of 1947), a student at a university prescribed by Article 83 of the same Act, or another person specified by Order of the Ministry of Health, Labour and Welfare.
学校教育法（昭和二十二年法律第二十六号）第五十条に規定する高等学校の生徒、同法第八十三条に規定する大学の学生その他の厚生労働省令で定める者であること。
The term "specially-insured day laborer" as used in this Act means a day worker who is employed at an applicable place of business; however, this does not apply to persons with late-stage elderly medical care insurance or those approved by the Minister of Health, Labour and Welfare as a person who falls under any of the following items:
この法律において「日雇特例被保険者」とは、適用事業所に使用される日雇労働者をいう。ただし、後期高齢者医療の被保険者等である者又は次の各号のいずれかに該当する者として厚生労働大臣の承認を受けたものは、この限りでない。
it is clear that the person will not be employed at the applicable place of business for 26 days or longer in total during the following two months;
適用事業所において、引き続く二月間に通算して二十六日以上使用される見込みのないことが明らかであるとき。
the person is insured with optional and continued coverage; or
任意継続被保険者であるとき。
there is another special reason.
その他特別の理由があるとき。
The term "applicable place of business" as used in this Act means a place of business which falls under any of the following items:
この法律において「適用事業所」とは、次の各号のいずれかに該当する事業所をいう。
a place of business for any of the businesses listed below and at which five or more employees work regularly:
次に掲げる事業の事業所であって、常時五人以上の従業員を使用するもの
businesses of manufacturing, processing, selection, packaging, repair, or demolition of structures;
物の製造、加工、選別、包装、修理又は解体の事業
civil engineering businesses or business that builds or otherwise constructs, remodels, preserves, repairs, changes, destroys, or dismantles structures, or prepares therefor;
土木、建築その他工作物の建設、改造、保存、修理、変更、破壊、解体又はその準備の事業
business of mining or collecting minerals;
鉱物の採掘又は採取の事業
business that generates, conducts, or transmits electricity or other power sources;
電気又は動力の発生、伝導又は供給の事業
business that transports freight or passengers;
貨物又は旅客の運送の事業
business that loads and unloads freight;
貨物積卸しの事業
business of incineration or cleaning, or slaughterhouse business;
焼却、清掃又はと殺の事業
business that sells or supplies articles;
物の販売又は配給の事業
financial or insurance business;
金融又は保険の事業
business that retains or leases articles;
物の保管又は賃貸の事業
intermediary or brokerage business;
媒介周旋の事業
money-collecting, guiding, or advertising business;
集金、案内又は広告の事業
educational, research, or survey business;
教育、研究又は調査の事業
business that treats or nurses sick or injured people, or midwife or other medical services;
疾病の治療、助産その他医療の事業
communication or reporting business;
通信又は報道の事業
social welfare services prescribed by the Social Welfare Act (Act No. 45 of 1951) and offenders rehabilitation services prescribed by the Offenders Rehabilitation Services Act (Act No. 86 of 1995); or
社会福祉法（昭和二十六年法律第四十五号）に定める社会福祉事業及び更生保護事業法（平成七年法律第八十六号）に定める更生保護事業
a business that performs work relating to law or accounting which attorneys, certified public accountants, or other persons specified by Cabinet Order are to perform pursuant to the provisions of laws and regulations;
弁護士、公認会計士その他政令で定める者が法令の規定に基づき行うこととされている法律又は会計に係る業務を行う事業
beyond what is listed in the preceding item, any place of business that is operated by the government, a local government, or a juridical person and employs employees regularly;
前号に掲げるもののほか、国、地方公共団体又は法人の事業所であって、常時従業員を使用するもの
The term "insured person with optional and continued coverage" as used in this Act means a worker who lost eligibility to be insured (excluding a specially-insured day laborer) due to no longer being employed at an applicable place of business or falling under the proviso to paragraph (1), had been continuously insured for two months or longer by the day immediately before the day on which the person lost eligibility (excluding a specially-insured day laborer or an insured person who is a member of a mutual aid association), and, by submitting a request to the insurer, continues to be insured by the insurer; however, this does not apply to an insured person covered by Seamen's Insurance or a person with late-stage elderly medical care insurance.
この法律において「任意継続被保険者」とは、適用事業所に使用されなくなったため、又は第一項ただし書に該当するに至ったため被保険者（日雇特例被保険者を除く。）の資格を喪失した者であって、喪失の日の前日まで継続して二月以上被保険者（日雇特例被保険者、任意継続被保険者又は共済組合の組合員である被保険者を除く。）であったもののうち、保険者に申し出て、継続して当該保険者の被保険者となった者をいう。ただし、船員保険の被保険者又は後期高齢者医療の被保険者等である者は、この限りでない。
The term "remuneration" as used in this Act means the wage, salary, pay, allowance, bonus, and all other payments which the worker receives as compensation for labor under whatever name the compensation is known; however, this does not apply to extraordinary wages and wages received periodically for a period exceeding three months.
この法律において「報酬」とは、賃金、給料、俸給、手当、賞与その他いかなる名称であるかを問わず、労働者が、労働の対償として受けるすべてのものをいう。ただし、臨時に受けるもの及び三月を超える期間ごとに受けるものは、この限りでない。
The term "bonus" as used in this Act means the wage, salary, pay, allowance, bonus, and all other payments which the worker receives as compensation for labor periodically for a period exceeding three months under whatever name the compensation is known.
この法律において「賞与」とは、賃金、給料、俸給、手当、賞与その他いかなる名称であるかを問わず、労働者が、労働の対償として受けるすべてのもののうち、三月を超える期間ごとに受けるものをいう。
The term "dependent" as used in this Act means a person listed below who has a domicile in Japan, or who does not have a domicile in Japan but is specified by Order of the Ministry of Health, Labour and Welfare as a person, such as a student studying abroad, who is found to have a basis of living in Japan in consideration of the purpose of travel and other circumstances; provided, however, that this does not apply to a person who is a person with late-stage elderly medical care insurance or any other person specified by Order of the Ministry of Health, Labour and Welfare as having a special reason to be excluded from the application of this Act.
この法律において「被扶養者」とは、次に掲げる者で、日本国内に住所を有するもの又は外国において留学をする学生その他の日本国内に住所を有しないが渡航目的その他の事情を考慮して日本国内に生活の基礎があると認められるものとして厚生労働省令で定めるものをいう。ただし、後期高齢者医療の被保険者等である者その他この法律の適用を除外すべき特別の理由がある者として厚生労働省令で定める者は、この限りでない。
a relative of the insured person (including a former specially-insured day laborer; hereinafter in this paragraph) that is the insured person's parent, spouse (including a person who has not made a notification of marriage but is in a de facto marital relationship with the insured person; the same applies hereinafter in this paragraph), child, grandchild or sibling who is financially supported mainly by the insured person;
被保険者（日雇特例被保険者であった者を含む。以下この項において同じ。）の直系尊属、配偶者（届出をしていないが、事実上婚姻関係と同様の事情にある者を含む。以下この項において同じ。）、子、孫及び兄弟姉妹であって、主としてその被保険者により生計を維持するもの
any other relative of the insured person within the third degree of kinship who belongs to the same household as the insured person and who is financially supported mainly by the insured person;
被保険者の三親等内の親族で前号に掲げる者以外のものであって、その被保険者と同一の世帯に属し、主としてその被保険者により生計を維持するもの
if the insured person's spouse has not made a notification of marriage but is in a de facto marital relationship with the insured person, the spouse's father, mother, or child who belongs to the same household as the insured person and who is financially supported mainly by the insured person; or
被保険者の配偶者で届出をしていないが事実上婚姻関係と同様の事情にあるものの父母及び子であって、その被保険者と同一の世帯に属し、主としてその被保険者により生計を維持するもの
if the spouse referred to in the preceding item has died, the spouse's father, mother, or child who continues to belong to the same household as the insured person and who is financially supported mainly by the insured person.
前号の配偶者の死亡後におけるその父母及び子であって、引き続きその被保険者と同一の世帯に属し、主としてその被保険者により生計を維持するもの
The term "day worker" as used in this Act means a person who falls under any of the following items:
この法律において「日雇労働者」とは、次の各号のいずれかに該当する者をいう。
a worker employed temporarily and listed below (in the same place of business, excluding cases of continuous employment which has exceeded one month if the person is listed in (a) or exceeded the fixed period listed in (b) if the person is listed in (b) (except for cases of continuous employment at a place of business whose location is not fixed));
臨時に使用される者であって、次に掲げるもの（同一の事業所において、イに掲げる者にあっては一月を超え、ロに掲げる者にあってはロに掲げる定めた期間を超え、引き続き使用されるに至った場合（所在地の一定しない事業所において引き続き使用されるに至った場合を除く。）を除く。）
a worker hired on a daily basis;
日々雇い入れられる者
a worker employed for a fixed period of two months or less, who is not expected to be employed beyond that fixed period;
二月以内の期間を定めて使用される者であって、当該定めた期間を超えて使用されることが見込まれないもの
a worker employed in seasonal work (excluding cases of continuous employment exceeding four months); or
季節的業務に使用される者（継続して四月を超えて使用されるべき場合を除く。）
a worker employed at a place of temporary business (excluding cases of continuous employment exceeding six months).
臨時的事業の事業所に使用される者（継続して六月を超えて使用されるべき場合を除く。）
The term "wage" as used in this Act means the wage, salary, allowance, bonus, and all other payments which a day worker receives as compensation for labor under whatever name the compensation is known; however, this does not apply to wages received periodically for a period exceeding three months.
この法律において「賃金」とは、賃金、給料、手当、賞与その他いかなる名称であるかを問わず、日雇労働者が、労働の対償として受けるすべてのものをいう。ただし、三月を超える期間ごとに受けるものは、この限りでない。
The term "mutual aid association" as used in this Act means a mutual aid association organized pursuant to law.
この法律において「共済組合」とは、法律によって組織された共済組合をいう。
The term "insurer number" as used in this Act means a number that the Minister of Health, Labour and Welfare determines for each insurer as a number for identifying the insurer in health insurance services.
この法律において「保険者番号」とは、厚生労働大臣が健康保険事業において保険者を識別するための番号として、保険者ごとに定めるものをいう。
The term "insured person's symbol and number" as used in this Act means a symbol, number, or other code that an insurer determines for each insured person or dependent for managing the eligibility of an insured person or dependent.
この法律において「被保険者等記号・番号」とは、保険者が被保険者又は被扶養者の資格を管理するための記号、番号その他の符号として、被保険者又は被扶養者ごとに定めるものをいう。
The term "electronic eligibility confirmation" as used in this Act means that a person who intends to receive medical treatment from a medical institution providing services covered by health insurance, etc. (meaning a hospital, clinic, or pharmacy listed in the items of Article 63, paragraph (3); the same applies hereinafter) or, a person who intends to receive designated home nursing prescribed in Article 88, paragraph (1) from a designated home-nursing provider prescribed in that paragraph , or a person who intends to receive delivery care from a hospital or clinic listed in the items of Article 63, paragraph (3) (limited to those that handle deliveries; hereinafter referred to as a "delivery-handling medical institution providing services covered by health insurance, etc.") or a designated birthing center, etc. prescribed in Article 98-2, paragraph (1) makes an inquiry to the insurer about information relating to the eligibility of an insured person or dependent (including information necessary for claims for expenses relating to insurance benefits), by a method such as transmitting the electronic certificate for user verification (meaning the electronic certificate for user verification prescribed in Article 22, paragraph (1) of the Act on Certification Business of the Japan Agency for Local Authority Information Systems in Relation to Electronic Signatures, etc. (Act No. 153 of 2002)) recorded on an Individual Number Card (meaning an Individual Number Card prescribed in Article 2, paragraph (7) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (Act No. 27 of 2013)) or by another method specified by Order of the Ministry of Health, Labour and Welfare, receives a response from the insurer by a method using an electronic data processing system or another method using information and communications technology and provides that information to the medical institution providing services covered by health insurance, etc. or, the designated home-nursing provider, or the delivery-handling medical institution providing services covered by health insurance, etc. or designated birthing center, etc., and receives confirmation from that medical institution providing services covered by health insurance, etc. or, designated home-nursing provider, or delivery-handling medical institution providing services covered by health insurance, etc. or designated birthing center, etc. that the person is an insured person or dependent.
この法律において「電子資格確認」とは、保険医療機関等（第六十三条第三項各号に掲げる病院若しくは診療所又は薬局をいう。以下同じ。）から療養を受けようとする者又は、第八十八条第一項に規定する指定訪問看護事業者から同項に規定する指定訪問看護を受けようとする者又は第六十三条第三項各号に掲げる病院若しくは診療所（分娩を取り扱うものに限る。以下「分娩取扱保険医療機関等」という。）若しくは第九十八条の二第一項に規定する指定助産所等から分娩の手当を受けようとする者が、保険者に対し、個人番号カード（行政手続における特定の個人を識別するための番号の利用等に関する法律（平成二十五年法律第二十七号）第二条第七項に規定する個人番号カードをいう。）に記録された利用者証明用電子証明書（電子署名等に係る地方公共団体情報システム機構の認証業務に関する法律（平成十四年法律第百五十三号）第二十二条第一項に規定する利用者証明用電子証明書をいう。）を送信する方法その他の厚生労働省令で定める方法により、被保険者又は被扶養者の資格に係る情報（保険給付に係る費用の請求に必要な情報を含む。）の照会を行い、電子情報処理組織を使用する方法その他の情報通信の技術を利用する方法により、保険者から回答を受けて当該情報を当該保険医療機関等又は、指定訪問看護事業者又は分娩取扱保険医療機関等若しくは指定助産所等に提供し、当該保険医療機関等又は、指定訪問看護事業者又は分娩取扱保険医療機関等若しくは指定助産所等から被保険者又は被扶養者であることの確認を受けることをいう。