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Article 147High-Cost Medical Expenses

第百四十七条(高額療養費)

When the amount of co-payment made in relation to the payment of benefits for medical treatment or the amount calculated by deducting, from the amount of expenses incurred in medical treatment (excluding dietary treatment and living support), an amount equivalent to the amount paid as medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, dependent's medical expenses, dependent's medical expenses for home-nursing, or special medical expenses (in the following Article referred to as the "amount of co-payment pertaining to specially-insured day laborer") pertaining to a specially-insured day laborer is extremely large, high-cost medical expenses are paid to the specially-insured day laborer who received benefits for that medical treatment, or the payment of the medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing expenses, dependent's medical expenses, or dependent's medical expenses for home-nursing, or special medical expenses.

日雇特例被保険者に係る療養の給付について支払われた一部負担金の額又は日雇特例被保険者若しくはその被扶養者の療養(食事療養及び生活療養を除く。)に要した費用の額からその療養に要した費用につき保険外併用療養費、療養費、訪問看護療養費、家族療養費、家族訪問看護療養費若しくは特別療養費として支給される額に相当する額を控除した額(次条において「日雇特例被保険者に係る一部負担金等の額」という。)が著しく高額であるときは、その療養の給付又はその保険外併用療養費、療養費、訪問看護療養費、家族療養費、家族訪問看護療養費若しくは特別療養費の支給を受けた日雇特例被保険者に対し、高額療養費を支給する。

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