Article 115-2Expenses for High-Cost Medical Treatment Combined with Long-Term Care
第百十五条の二(高額介護合算療養費)
When the amount of co-payment, etc. (if high-cost medical expenses referred to in paragraph (1) of the preceding Article is to be paid, the amount obtained by deducting the amount so paid from the amount of co-payment, etc.), or the sum of the amount to be borne by a user of long-term care service prescribed in Article 51, paragraph (1) of the Long-Term Care Insurance Act (if expenses for high-cost long-term care service referred to in the same paragraph are paid, the amount obtained by deducting the amount so paid from the amount to be borne by the user of long-term care service), and the amount to be borne by a user of a service to prevent long-term care prescribed in Article 61, paragraph (1) of the same Act (if expenses for high-cost service to prevent long-term care referred to in the same paragraph are to be paid, the amount obtained by deducting the amount so paid from the amount to be borne by the user of the service to prevent long-term care) is extremely large, expenses for high-cost medical treatment combined with long-term care are paid to the person who received benefits for medical treatment to which the amount of the co-payment pertained, or payment of medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, dependent's medical expenses, or dependent's medical expenses for home-nursing.
一部負担金等の額(前条第一項の高額療養費が支給される場合にあっては、当該支給額に相当する額を控除して得た額)並びに介護保険法第五十一条第一項に規定する介護サービス利用者負担額(同項の高額介護サービス費が支給される場合にあっては、当該支給額を控除して得た額)及び同法第六十一条第一項に規定する介護予防サービス利用者負担額(同項の高額介護予防サービス費が支給される場合にあっては、当該支給額を控除して得た額)の合計額が著しく高額であるときは、当該一部負担金等の額に係る療養の給付又は保険外併用療養費、療養費、訪問看護療養費、家族療養費若しくは家族訪問看護療養費の支給を受けた者に対し、高額介護合算療養費を支給する。
The provisions of paragraph (2) of the preceding Article apply mutatis mutandis to the payment of expenses for high-cost medical treatment combined with long-term care.
前条第二項の規定は、高額介護合算療養費の支給について準用する。