Article 43-4Other Matters Concerning the Payment of Expenses for High-Cost Medical Treatment Combined with Long-Term Care
第四十三条の四（その他高額介護合算療養費の支給に関する事項）
With regard to the payment of expenses for high-cost medical treatment combined with long-term care in the case where an insured person loses status as an insured person during the calculation period and does not become a person covered by medical insurance during that calculation period on or after the day on which the person lost that eligibility, or in any other case specified by Order of the Ministry of Health, Labour and Welfare, the provisions of the preceding two Articles apply by deeming the day before that day (or, in the case of that other case specified by Order of the Ministry of Health, Labour and Welfare, the day specified by Order of the Ministry of Health, Labour and Welfare) to be the reference date.
Matters necessary for procedures concerning the payment of expenses for high-cost medical treatment combined with long-term care are specified by Order of the Ministry of Health, Labour and Welfare.
高額介護合算療養費の支給に関する手続に関して必要な事項は、厚生労働省令で定める。
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reference datemachine translation
「基準日」
The last day of the calculation period (計算期間), the period from 1 August each year to the following 31 July, on which high-cost medical expenses (高額療養費) and similar amounts for the whole period are worked out.
Defined inArticle 41-2, paragraph (1)
calculation periodmachine translation
「計算期間」
The period from 1 August each year to the following 31 July, over which annual amounts such as high-cost medical expenses (高額療養費) for outpatient treatment are worked out.
Defined inArticle 41-2, paragraph (4)
person covered by medical insurancemachine translation
「医療保険加入者」
In Article 43, paragraph (11), Article 43-4, paragraph (1) and Article 44, paragraphs (4) and (8), a person covered by one of the medical insurance schemes — a member (加入者) as defined in Article 7, paragraph (4) of the Act on Assurance of Medical Care for Elderly People — or an insured person of the late-stage elderly medical care system (後期高齢者医療).
Defined inArticle 43, paragraph (11)· applies only in this provision and in Article 43-4, paragraph (1); and Article 44, paragraphs (4) and (8)