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Article 132Medical Expenses

第百三十二条(療養費)

When an insurer finds it difficult to pay benefits for medical treatment or expenses for dietary treatment for inpatients, living support expenses for inpatients, or medical expenses combined with treatment outside insurance coverage (hereinafter referred to as a "benefits for medical treatment, etc." in this paragraph) or finds it unavoidable in cases where a specially-insured day laborer has received any medical care, medication or treatment from a hospital, clinic, pharmacy or other person not listed in Article 63, paragraph (3), items (i) and (ii), it may pay medical expenses in lieu of benefits for medical treatment, etc.

保険者は、療養の給付若しくは入院時食事療養費、入院時生活療養費若しくは保険外併用療養費の支給(以下この項において「療養の給付等」という。)を行うことが困難であると認めるとき、又は日雇特例被保険者が第六十三条第三項第一号若しくは第二号に掲げる病院若しくは診療所若しくは薬局以外の病院、診療所、薬局その他の者から診療、薬剤の支給若しくは手当を受けた場合において、保険者がやむを得ないものと認めるときは、療養の給付等に代えて、療養費を支給することができる。

The provisions of the preceding paragraph apply when a specially-insured day laborer receives medical care or medication from a hospital, clinic or pharmacy listed in Article 63, paragraph (3), item (i) or (ii) without the confirmation prescribed in Article 129, paragraph (3) and the insurer finds that the lack of confirmation was due to urgent and unavoidable reasons.

日雇特例被保険者が、第百二十九条第三項に規定する確認を受けないで、第六十三条第三項第一号又は第二号に掲げる病院若しくは診療所又は薬局から診療又は薬剤の支給を受けた場合において、保険者が、その確認を受けなかったことを緊急やむを得ない理由によるものと認めるときも、前項と同様とする。

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