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Read the text in force →介護保険法
Chapter IV Insurance Benefits (Articles 59 to 61-2)
The law as Act Partially Amending the Social Welfare Act, etc. (Act No. 51 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.
A Municipality, in the following cases, pay an Exceptional Allowance for Preventive Long-Term Care Service Plan to an Insured In-Home Person Requiring Support:
市町村は、次に掲げる場合には、居宅要支援被保険者に対し、特例介護予防サービス計画費を支給する。
when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support receives Preventive Long-Term Care Support other than Designated Preventive Long-Term Care Support, or equivalentany service (limited to services equivalent thereto, that is provided by a provider that performsBusiness Office conducting a business that is found to satisfy those, among the standards determined by Municipal Ordinance as set forth in Article 115-24, paragraph (1) pertaining to the business of Designated Preventive Long-Term Care Support and the number of employees determined by Municipal Ordinance as set forth in the same paragraph, and the standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Preventive Long-Term Care Support as prescribed in paragraph (2) of the same Article and the standards concerning the management of the business of Designated Preventive Long-Term Care Support, that are determined by the Municipal Ordinance (referred to as "Standards for the Business of said Municipality; herein Designated Preventive Long-Term Care Support" in the following item), those determined by Municipal Ordinance (hereinafter referred to as "Preventive Long-Term Care Support Applicable to Standards" in the following item and the following paragraphthis Article);
居宅要支援被保険者が、指定介護予防支援以外の介護予防支援又はこれに相当するサービス（であって、指定介護予防支援の事業に係る第百十五条の二十四第一項の市町村の条例で定める基準及び同項の市町村の条例で定める員数並びに同条第二項に規定する指定介護予防支援に係る介護予防のための効果的な支援の方法に関する基準及び指定介護予防支援の事業の運営に関する基準のうち、当該（次号において「指定介護予防支援の事業に係る基準」という。）のうち市町村の条例で定めるものを満たすと認められる事業を行う事業者所により行われるものに限る。次号及び次項（以下この条において「基準該当介護予防支援」という。）を受けた場合において、必要があると認めるとき。
when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support that is domiciled on an isolated island orreceives Preventive Long-Term Care Support other location where it is significantly difficult to securethan Designated Support for Prevention ofPreventive Long-Term Care, Support and Preventive Long-Term Care Support Applicable to Standards, and where it or any service equivalent thereto, that is definedprovided by standards as determined by the Minister of Health, Labour, and Welfare, receives Preventive Long-Term Care Support or equivalent service other than Designated Supporta Business Office conducting a business that is located in a Specified Area and is found to satisfy those of the Standards for Prevention the Business of Designated Preventive Long-Term Care or Support that are specified by Municipal Ordinance (hereinafter referred to as "Preventive Long-Term Care Support Applicable to Standardsin a Specified Area" in this Article);
指定介護予防支援及び基準該当介護予防支援の確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要支援被保険者が、指定介護予防支援及び基準該当介護予防支援以外の介護予防支援又はこれに相当するサービスであって、特定地域に所在し、かつ、指定介護予防支援の事業に係る基準のうち市町村の条例で定めるものを満たすと認められる事業を行う事業所により行われるもの（以下この条において「特定地域介護予防支援」という。）を受けた場合において、必要があると認めるとき。
when provided a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support who is domiciled on an isolated island or other location where it is significantly difficult to secure Designated Preventive Long-Term Care Support, Preventive Long-Term Care Support Applicable to Standards and Preventive Long-Term Care Support in a Specified Area, and which falls under the standards as determined by a Cabinet Order.the Minister of Health, Labour and Welfare, receives Preventive Long-Term Care Support other than Designated Preventive Long-Term Care Support, Preventive Long-Term Care Support Applicable to Standards and Preventive Long-Term Care Support in a Specified Area, or service equivalent thereto;
指定介護予防支援、基準該当介護予防支援及び特定地域介護予防支援の確保が著しく困難である離島その他政令で定の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要支援被保険者が、指定介護予防支援、基準該当介護予防支援及び特定地域介護予防支援以外の介護予防支援又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
when otherwise provided by a Cabinet Order.
その他政令で定めるとき。
A Municipality, in establishing the Municipal Ordinance set forth inpursuant to the provisions of item (i) of the preceding paragraph, is to establish the following matters in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards determined by Order of the Ministry of Health, Labour and Welfare for other matters:
市町村が前項第一号の規定により条例を定めるに当たっては、次に掲げる事項については厚生労働省令で定める基準に従い定めるものとし、その他の事項については厚生労働省令で定める基準を参酌するものとする。
the standards concerning the employees that engage in Preventive Long-Term Care Support Applicable to Standards and the number of said employees;
基準該当介護予防支援に従事する従業者に係る基準及び当該従業者の員数
matters concerning the management of the business of Preventive Long-Term Care Support Applicable to Standards that are determined by Order of the Ministry of Health, Labour and Welfare as being closely related to the appropriate use of services by Persons Requiring Support who use them, appropriate treatment, ensuring of safety, and maintenance of confidentiality, etc.
基準該当介護予防支援の事業の運営に関する事項であって、利用する要支援者のサービスの適切な利用、適切な処遇及び安全の確保並びに秘密の保持等に密接に関連するものとして厚生労働省令で定めるもの
The amount of Exceptional Allowance for Preventive Long-Term Care Service Plan A Municipality, in establishing a Municipal Ordinance pursuant to the provisions of paragraph (1), item (ii), is to be establish the matters listed in item (i) in accordance with the standards specified by a Municipality based on Order of the Ministry of Health, Labour and Welfare, taking into consideration the expenses calculated by status of population decline in areas that fall under the standards determinedspecified by Order of the MinisterMinistry of Health, Labour, and Welfare as set forth inprescribed in Article 42, paragraph (2) of 1), item (iii), the preceding Article for said status of employees engaging in Preventive Long-Term Care Support or equivalent service (in a case said calculated amount exceeds the amount of actual expenses of said Preventive Long-Term Care Support or equivalent service, the base amount and other circumstances; is to establish the matters listed in item (ii) in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare; and is to be take into consideration the actual expenses required for said Preventive Long-Term Care Support or equivalent service)standards specified by Order of the Ministry of Health, Labour and Welfare for other matters.
特例介護予防サービス計画費の額は、当該介護予防支援又はこれに相当するサービス市町村が第一項第二号の規定により条例を定めるに当たっては、第一号に掲げる事項について前条第二項のは第四十二条第一項第三号に規定する厚生労働大臣が省令で定める基準により算定した費用の額（その額が現に当該介護予防支援又はこれに相該当するサービスに要した費用の額を超えるときは、当該現に地域における人口の減少の状況、介護予防支援又はこれに相当するサービスに要した費用の額とする。）を基準として、市町村が定めに従事する従業者の状況その他の事情を勘案して厚生労働省令で定める基準に従い定めるものとし、第二号に掲げる事項については厚生労働省令で定める基準に従い定めるものとし、その他の事項については厚生労働省令で定める基準を参酌するものとする。
standards pertaining to employees engaging in Preventive Long-Term Care Support in a Specified Area and the number of such employees;
特定地域介護予防支援に従事する従業者に係る基準及び当該従業者の員数
matters concerning the operation of the business of Preventive Long-Term Care Support in a Specified Area that are closely related to ensuring the appropriate use of services, appropriate treatment and safety of Persons Requiring Support who use them, and maintaining confidentiality, etc., and that are specified by Order of the Ministry of Health, Labour and Welfare.
特定地域介護予防支援の事業の運営に関する事項であって、利用する要支援者のサービスの適切な利用、適切な処遇及び安全の確保並びに秘密の保持等に密接に関連するものとして厚生労働省令で定めるもの
The mayor of a Municipality, when he or she determines the necessity for the paymentamount of an Exceptional Allowance for Preventive Long-Term Care Service Plan, may order a person that is or was in charge of the Preventive Long-Term Care Support pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge in the cases listed in paragraph (1), item (i), item (iii) or item (iv) is to be specified by a Municipality based on the expenses calculated by standards determined by the Minister of Preventive Long-Term Care Support, etc." in this Health, Labour and Welfare as set forth in paragraph") to report, submit or present record books and documents, appear, (2) of the preceding Article for said Preventive Long-Term Care Support or direct its personnel to question the relevant Person or enterequivalent service (in a case said calculated amount exceeds the Business Officeamount of the provideractual expenses of said Person, etc., in Charge of Preventive Long-Term Care Support, etc., pertaining or equivalent service, the base amount is to said payment in order to inspectbe the actual expenses required for said record books and documents, and other itemsPreventive Long-Term Care Support or equivalent service).
市町村長は、第一項第一号、第三号又は第四号に掲げる場合における特例介護予防サービス計画費の支給に関して必要があると認めるとき額は、当該支給に係る介護予防支援若しく又はこれに相当するサービスを担当する者若しくは担当した者（以下この項において「について前条第二項の厚生労働大臣が定める基準により算定した費用の額（その額が現に当該介護予防支援等を担又はこれに相当する者等」という。）に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該サービスに要した費用の額を超えるときは、当該現に介護予防支援等を担又はこれに相当する者等の当該支給に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができサービスに要した費用の額とする。）を基準として、市町村が定める。
The provisionsamount of Article 24, Exceptional Allowance for Preventive Long-Term Care Service Plan in the case listed in paragraph (3) apply mutatis mutandis 1), item (ii) is specified by a Municipality based on the amount of expenses calculated according to questions or inspections as prescribed the standards determined by the Minister of Health, Labour and Welfare after taking into consideration the average expenses required for Preventive Long-Term Care Support in a Specified Area, calculated by taking into consideration the preceding paragraph, andarea, etc., where the provisions of paragraph (4) Business Offices conducting the business of the same Article apply mutatis mutandis to Preventive Long-Term Care Support in a Specified Area are located (if that amount exceeds the authority granted as prescribed actual expenses required for said Preventive Long-Term Care Support in a Specified Area, the preceding paragraphamount of those actual expenses).
第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用す一項第二号に掲げる場合における特例介護予防サービス計画費の額は、特定地域介護予防支援の事業を行う事業所の所在する地域等を勘案して算定される特定地域介護予防支援に要する平均的な費用の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該特定地域介護予防支援に要した費用の額を超えるときは、当該現に特定地域介護予防支援に要した費用の額とする。）を基準として、市町村が定める。
The Minister of Health, Labour and Welfare, when intending to determine the standards referred to in the preceding paragraph, must hear the opinion of the Social Security Council in advance.
厚生労働大臣は、前項の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
The mayor of a Municipality, when he or she determines it necessary for the payment of an Exceptional Allowance for Preventive Long-Term Care Service Plan, may order a person that is or has been in charge of the Preventive Long-Term Care Support or equivalent service pertaining to said payment (herein referred to as "Person, etc., in Charge of Preventive Long-Term Care Support, etc." in this paragraph) to report, to submit or present record books and documents, or to appear, or may direct its personnel to question the relevant persons or to enter the Business Office of said Person, etc., in Charge of Preventive Long-Term Care Support, etc., pertaining to said payment and inspect the record books and documents, and other items.
市町村長は、特例介護予防サービス計画費の支給に関して必要があると認めるときは、当該支給に係る介護予防支援若しくはこれに相当するサービスを担当する者若しくは担当した者（以下この項において「介護予防支援等を担当する者等」という。）に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該介護予防支援等を担当する者等の当該支給に係る事業所に立ち入り、その帳簿書類その他の物件を検査させることができる。
The provisions of Article 24, paragraph (3) apply mutatis mutandis to questions or inspections as prescribed in the preceding paragraph, and the provisions of paragraph (4) of the same Article apply mutatis mutandis to the authority granted as prescribed in the preceding paragraph.
第二十四条第三項の規定は前項の規定による質問又は検査について、同条第四項の規定は前項の規定による権限について準用する。
In the case of applying the provisions determined in each of the following items to the Prevention Benefit listed in those items that is received by an Insured In-Home Person Requiring Support who is a Primary Insured Person and whose amount of income calculated as determined by Cabinet Order is equal to or more than the amount determined by Cabinet Order (excluding an Insured In-Home Person Requiring Support prescribed in the following paragraph), the phrase "90 percent" in these provisions is to be deemed to be replaced with "80 percent":
第一号被保険者であって政令で定めるところにより算定した所得の額が政令で定める額以上である居宅要支援被保険者（次項に規定する居宅要支援被保険者を除く。）が受ける次の各号に掲げる予防給付について当該各号に定める規定を適用する場合においては、これらの規定中「百分の九十」とあるのは、「百分の八十」とする。
payment of an Allowance for Preventive Long-Term Care Service:Article 53, paragraph (2), item (i) and item (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
介護予防サービス費の支給 第五十三条第二項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
payment of an Exceptional Allowance for Preventive Long-Term Care Service:Article 54, paragraph (3)4) and paragraph (5), items (i) and (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
特例介護予防サービス費の支給 第五十四条第三項四項並びに第五項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
payment of an Allowance for Community-Based Preventive Long-Term Care Service:Article 54-2, paragraph (2), item (i) and item (ii), and Article 55, paragraph (1), paragraph (4), and paragraph (6);
地域密着型介護予防サービス費の支給 第五十四条の二第二項第一号及び第二号並びに第五十五条第一項、第四項及び第六項
payment of an Exceptional Allowance for Community-Based Preventive Long-Term Care Service:Article 54-3, paragraph (2) and Article 55, paragraph (1), paragraph (4), and paragraph (6);
特例地域密着型介護予防サービス費の支給 第五十四条の三第二項並びに第五十五条第一項、第四項及び第六項
payment of an Allowance for Purchasing Equipment for Preventive Long-Term Care Covered by Public Aid:Article 56, paragraph (3), paragraph (45), and paragraph (78);
介護予防福祉用具購入費の支給 第五十六条第三項、第四五項及び第七八項
payment of an Allowance for Preventive Long-Term Care Home Modification:Article 57, paragraph (3), paragraph (4) and paragraph (7).
介護予防住宅改修費の支給 第五十七条第三項、第四項及び第七項
In the case of applying the provisions determined in each of the items of the preceding paragraph to the Prevention Benefit listed in those items that is received by an Insured In-Home Person Requiring Support who is a Primary Insured Person and whose amount of income calculated as determined by Cabinet Order is equal to or more than the amount determined by Cabinet Order that exceeds the amount determined by Cabinet Order in that paragraph, the phrase "90 percent" in these provisions is to be deemed to be replaced with "70 percent".
第一号被保険者であって政令で定めるところにより算定した所得の額が前項の政令で定める額を超える政令で定める額以上である居宅要支援被保険者が受ける同項各号に掲げる予防給付について当該各号に定める規定を適用する場合においては、これらの規定中「百分の九十」とあるのは、「百分の七十」とする。
In a case when a Municipality applies the provisions determined in each item of paragraph (1) of the preceding Article to a Prevention Benefit listed in those items that an Insured In-Home Person Requiring Support receives, for whom it is deemed to be difficult to pay necessary expenses for Preventive Long-Term Care Service (including equivalent services; the same applies hereinafter in this Article), Community-Based Service for Preventive Long-Term Care (including equivalent services; the same applies hereinafter in this Article), or Home Modification due to a disaster or other special reasons as determined by Order of the Ministry of Health, Labour and Welfare (excluding a case when they are applied with the terms replaced pursuant to the provisions of that Article), the term "90 percent" in these provisions is to be deemed to be replaced with "the percentage provided by a Municipality within the range exceeding 90 percent and 100 percent or less".
市町村が、災害その他の厚生労働省令で定める特別の事情があることにより、介護予防サービス（これに相当するサービスを含む。以下この条において同じ。）、地域密着型介護予防サービス（これに相当するサービスを含む。以下この条において同じ。）又は住宅改修に必要な費用を負担することが困難であると認めた居宅要支援被保険者が受ける前条第一項各号に掲げる予防給付について当該各号に定める規定を適用する場合（同条の規定により読み替えて適用する場合を除く。）においては、これらの規定中「百分の九十」とあるのは、「百分の九十を超え百分の百以下の範囲内において市町村が定めた割合」とする。
In a case when a Municipality applies the provisions determined in each item of paragraph (1) of the preceding Article to a Prevention Benefit listed in those items that an Insured In-Home Person Requiring Support receives, for whom it is deemed to be difficult to pay necessary expenses for Preventive Long-Term Care Service, Community-Based Service for Preventive Long-Term Care, or Home Modification due to a disaster or other special circumstance as determined by Order of the Ministry of Health, Labour and Welfare (limited to a case when they are applied with the terms replaced pursuant to the provisions of that paragraph), the phrase "80 percent" in these provisions applied with the terms replaced pursuant to the provisions of that paragraph is to be deemed to be replaced with "the percentage provided by a Municipality within the range exceeding 80 percent and 100 percent or less".
市町村が、災害その他の厚生労働省令で定める特別の事情があることにより、介護予防サービス、地域密着型介護予防サービス又は住宅改修に必要な費用を負担することが困難であると認めた居宅要支援被保険者が受ける前条第一項各号に掲げる予防給付について当該各号に定める規定を適用する場合（同項の規定により読み替えて適用する場合に限る。）においては、同項の規定により読み替えて適用するこれらの規定中「百分の八十」とあるのは、「百分の八十を超え百分の百以下の範囲内において市町村が定めた割合」とする。
In a case when a Municipality applies the provisions determined in each item of paragraph (1) of the preceding Article to a Prevention Benefit listed in those items that an Insured In-Home Person Requiring Support receives, for whom it is deemed to be difficult to pay necessary expenses for Preventive Long-Term Care Service, Community-Based Service for Preventive Long-Term Care, or Home Modification due to a disaster or other special circumstance as determined by Order of the Ministry of Health, Labour and Welfare (limited to a case when they are applied with the terms replaced pursuant to the provisions of paragraph (2) of that Article), the phrase "70 percent" in these provisions applied with the terms replaced pursuant to the provisions of paragraph (2) of that Article is to be deemed to be replaced with "the percentage provided by a Municipality within the range exceeding 70 percent and 100 percent or less".
市町村が、災害その他の厚生労働省令で定める特別の事情があることにより、介護予防サービス、地域密着型介護予防サービス又は住宅改修に必要な費用を負担することが困難であると認めた居宅要支援被保険者が受ける前条第一項各号に掲げる予防給付について当該各号に定める規定を適用する場合（同条第二項の規定により読み替えて適用する場合に限る。）においては、同条第二項の規定により読み替えて適用するこれらの規定中「百分の七十」とあるのは、「百分の七十を超え百分の百以下の範囲内において市町村が定めた割合」とする。
When the amount that is obtained by deducting from the amount calculated pursuant to the provisions of a Cabinet Order as the total amount of each expense required for Preventive Long-Term Care Service (including equivalent service) or Community-Based Service for Preventive Long-Term Care (including equivalent service) that an Insured In-Home Person Requiring Support receives, the total amount of Allowance for Preventive Long-Term Care Service, Exceptional Allowance for Preventive Long-Term Care Service, Allowance for Community-Based Preventive Long-Term Care Service, and Exceptional Allowance for Community-Based Preventive Long-Term Care Service that are actually paid for said expenses (herein referred to as "User Charge for Preventive Long-Term Care Service" in paragraph (1) of the following Article) is significantly large, a Municipality pays an Allowance for High-Cost Preventive Long-Term Care Service to said Insured In-Home Person Requiring Support.
市町村は、居宅要支援被保険者が受けた介護予防サービス（これに相当するサービスを含む。）又は地域密着型介護予防サービス（これに相当するサービスを含む。）に要した費用の合計額として政令で定めるところにより算定した額から、当該費用につき支給された介護予防サービス費、特例介護予防サービス費、地域密着型介護予防サービス費及び特例地域密着型介護予防サービス費の合計額を控除して得た額（次条第一項において「介護予防サービス利用者負担額」という。）が、著しく高額であるときは、当該居宅要支援被保険者に対し、高額介護予防サービス費を支給する。
In addition to the provisions as set forth in the preceding paragraph, requirements for payment of an Allowance for High-Cost Preventive Long-Term Care Service, the amount of said allowance, and other matters necessary for payment of an Allowance for High-Cost Preventive Long-Term Care Service are prescribed by a Cabinet Order after considering the impact on the household budget from the burden of the expenses necessary for Preventive Long-Term Care Service or Community-Based Service for Preventive Long-Term Care.
前項に規定するもののほか、高額介護予防サービス費の支給要件、支給額その他高額介護予防サービス費の支給に関して必要な事項は、介護予防サービス又は地域密着型介護予防サービスに必要な費用の負担の家計に与える影響を考慮して、政令で定める。
A Municipality, when the total of the User Charge for Preventive Long-Term Care Service of an Insured In-Home Person Requiring Support (in a case when an Allowance for High-Cost Preventive Long-Term Care Service under paragraph (1) of the preceding Article is paid, the amount obtained by deducting the amount equivalent to the amount of said allowance paid), the amount of the co-payment, etc. prescribed in Article 115, paragraph (1) of the Health Insurance Act pertaining to said Insured In-Home Person Requiring Support (in a case when high-cost medical expenses under that paragraph are paid, the amount obtained by deducting the amount equivalent to the amount of said payment), and other amounts determined by Cabinet Order as amounts equivalent to these as prescribed in the Medical Insurance Acts or the Act on Assurance of Medical Care for Elderly People, is significantly large, pays an Allowance for High-Cost Medical and Preventive Long-Term Care Service Combined to said Insured In-Home Person Requiring Support.
市町村は、居宅要支援被保険者の介護予防サービス利用者負担額（前条第一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、当該支給額に相当する額を控除して得た額）及び当該居宅要支援被保険者に係る健康保険法第百十五条第一項に規定する一部負担金等の額（同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）その他の医療保険各法又は高齢者の医療の確保に関する法律に規定するこれに相当する額として政令で定める額の合計額が、著しく高額であるときは、当該居宅要支援被保険者に対し、高額医療合算介護予防サービス費を支給する。
The provisions of paragraph (2) of the preceding Article apply mutatis mutandis to payment of an Allowance for High-Cost Medical and Preventive Long-Term Care Service Combined.
前条第二項の規定は、高額医療合算介護予防サービス費の支給について準用する。