When the total sum of the amount of co-payment, etc. (or, where high-cost medical expenses set forth in paragraph (1) of the preceding Article are paid, the amount obtained by deducting the amount equivalent to the amount so paid), the amount to be borne by a user of Long-Term Care Service pursuant to the provisions of Article 51, paragraph (1) of the Long-Term Care Insurance Act (or, where expenses for High-Cost Long-Term Care Service set forth in the same paragraph are paid, the amount obtained by deducting the amount so paid) and the amount to be borne by a user of Preventive Long-Term Care Service pursuant to the provisions of Article 61, paragraph (1) of the same Act (or, where expenses for High-Cost Preventive Long-Term Care Service set forth in the same paragraph are paid, the amount obtained by deducting the amount so paid) is extremely large, Municipalities and Societies shall pay expenses for high-cost medical treatment combined with long-term care to the relevant Householder or Society member; provided, however, that this shall not apply if no benefit for medical treatment, medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing or special medical expenses were paid and no difference was paid pursuant to the provisions of Article 56, paragraph (2) with respect to the medical treatment relevant to such amount of co-payment, etc.
市町村及び組合は、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つては、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つては、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つては、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、世帯主又は組合員に対し、高額介護合算療養費を支給する。ただし、当該一部負担金等の額に係る療養の給付、保険外併用療養費の支給、療養費の支給、訪問看護療養費の支給若しくは特別療養費の支給又は第五十六条第二項の規定による差額の支給を受けなかつたときは、この限りでない。
The provisions of paragraph (2) of the preceding Article shall apply mutatis mutandis to the payment of medical expenses combined with high-cost 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。
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