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Article 40-3Scope of Medical Expenses

第四十条の三(医療費の範囲)

The circumstances specified by Ministry of Finance Order as prescribed in are the following circumstances:

(医療費の範囲)に規定する財務省令で定める状況は、次に掲げる状況とする。

The circumstances of provision of the things listed in the items of at designated facilities covered by public aid providing long-term care to the elderly (meaning designated facilities covered by public aid providing long-term care to the elderly prescribed in Article 48, paragraph (1), item (i) (Payment of an Allowance for Long-Term Care Facility Service) of the Long-Term Care Insurance Act (Act No. 123 of 1997); the same applies in the following paragraph) and designated community-based facilities covered by public aid providing long-term care to the elderly (meaning community-based facilities covered by public aid providing long-term care to the elderly prescribed in Article 8, paragraph (22) (Definitions) of that Act that conduct the business of daily life care for Residents of community-based facilities covered by public aid providing long-term care to the elderly prescribed in that paragraph, which business falls under the designated community-based services prescribed in Article 42-2, paragraph (1) (Payment of an Allowance for Community-Based Long-Term Care Service) of that Act; the same applies in the following paragraph);

指定介護老人福祉施設(介護保険法(平成九年法律第百二十三号)第四十八条第一項第一号(施設介護サービス費の支給)に規定する指定介護老人福祉施設をいう。次項において同じ。)及び指定地域密着型介護老人福祉施設(同法第四十二条の二第一項(地域密着型介護サービス費の支給)に規定する指定地域密着型サービスに該当する同法第八条第二十二項(定義)に規定する地域密着型介護老人福祉施設入所者生活介護の事業を行う同項に規定する地域密着型介護老人福祉施設をいう。次項において同じ。)における各号に掲げるものの提供の状況

The condition of a person who receives, based on the results of the specific health checkup prescribed in Article 18, paragraph (1) (Basic Guidelines for Special health examinations) of the Act on Assurance of Medical Care for Elderly People (Act No. 80 of 1982), the specific health guidance prescribed in that paragraph (limited to that provided through intensive support (meaning intensive support prescribed in (Intensive Support) of the Standards for Implementation of Specific Health Checkups and Specific Health Guidance (Ministry of Health, Labour and Welfare Order No. 157 of 2007; hereinafter referred to as the "Implementation Standards" in this item)) based on the instructions of the physician who conducted that specific health checkup), and whose results fall under any of the following criteria:

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)第十八条第一項(特定健康診査等基本指針)に規定する特定健康診査の結果に基づき同項に規定する特定保健指導(当該特定健康診査を行つた医師の指示に基づき積極的支援((積極的支援)に規定する積極的支援をいう。)により行われるものに限る。)を受ける者のうちその結果が次のいずれかの基準に該当する者のその状態

The criterion under which the result of the blood pressure measurement listed in (Items of Specific Health Checkups) of the Implementation Standards is found to indicate a condition equivalent to hypertension;

実施基準(特定健康診査の項目)に掲げる血圧の測定の結果が高血圧症と同等の状態であると認められる基準

The criterion under which the result of the blood lipid test prescribed in of the Implementation Standards is found to indicate a condition equivalent to dyslipidemia;

実施基準に規定する血中脂質検査の結果が脂質異常症と同等の状態であると認められる基準

The criterion under which the result of the blood glucose test listed in of the Implementation Standards is found to indicate a condition equivalent to diabetes.

実施基準に掲げる血糖検査の結果が糖尿病と同等の状態であると認められる基準

に規定する財務省令で定めるものは、指定介護老人福祉施設及び指定地域密着型介護老人福祉施設とする。

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