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Article 42Co-payment in Cases Where Benefits for Medical Treatment Are Received

第四十二条(療養の給付を受ける場合の一部負担金)

A person who receives benefit for medical treatment in relation to an Health Insurance-Covered Medical Institution, etc. pursuant to the provisions of Article 36, paragraph (3) shall pay, in accordance with the categories listed in the following items, an amount obtained by multiplying the amount calculated pursuant to the provisions of Article 45, paragraph (2) or (3) with respect to such benefit by the ratio listed in the relevant item below, as said person's co-payment to such Health Insurance-Covered Medical Institution, etc. when receiving such benefit:

第三十六条第三項の規定により保険医療機関等について療養の給付を受ける者は、その給付を受ける際、次の各号の区分に従い、当該給付につき第四十五条第二項又は第三項の規定により算定した額に当該各号に掲げる割合を乗じて得た額を、一部負担金として、当該保険医療機関等に支払わなければならない。

in cases where the first March 31 after said person's 6th birthday has passed and the month in which said person's 70th birthday is has not yet started:0.3;

六歳に達する日以後の最初の三月三十一日の翌日以後であつて七十歳に達する日の属する月以前である場合 十分の三

in cases where the first March 31 after said person's 6th birthday has not yet passed:0.2;

六歳に達する日以後の最初の三月三十一日以前である場合 十分の二

in cases where the month in which said person's 70th birthday is has elapsed (excluding the case listed in the following item):0.2;

七十歳に達する日の属する月の翌月以後である場合(次号に掲げる場合を除く。) 十分の二

in cases where the month in which said person's 70th birthday is has elapsed and where the amount of income calculated pursuant to Cabinet Order provisions with respect to the insured persons (limited to persons whose 70th birthday is in any month before the current month and other persons specified by Cabinet Order) who belong to the household to which the person who receives such benefit for medical treatment belongs is not less than the amount specified by Cabinet Order:0.3.

七十歳に達する日の属する月の翌月以後である場合であつて、当該療養の給付を受ける者の属する世帯に属する被保険者(七十歳に達する日の属する月の翌月以後である場合に該当する者その他政令で定める者に限る。)について政令の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とき 十分の三

A health insurance-covered medical institution, etc. shall receive the co-payment set forth in the preceding paragraph (or, when the ratio of co-payment is reduced pursuant to the provisions of Article 43, paragraph (1), the co-payment calculated in accordance with the ratio after such reduction in the case of a health insurance-covered medical institution, etc. set forth in paragraph (2) of the same Article or, when the measure set forth in Article 44, paragraph (1), item (i) is taken, the co-payment after the relevant reduction) and, when an insured person fails to make all or part of such co-payment despite efforts of the health insurance-covered medical institution, etc. to receive such payment with the same care as due care of a prudent manager, Municipalities and Societies may impose a disposition on such insured person pursuant to the same rules as those for the monies to be collected pursuant to the provisions of this Act, at the request of such health insurance-covered medical institution, etc.

保険医療機関等は、前項の一部負担金(第四十三条第一項の規定により一部負担金の割合が減ぜられたときは、同条第二項に規定する保険医療機関等にあつては、当該減ぜられた割合による一部負担金とし、第四十四条第一項第一号の措置が採られたときは、当該減額された一部負担金とする。)の支払を受けるべきものとし、保険医療機関等が善良な管理者と同一の注意をもつてその支払を受けることに努めたにもかかわらず、なお被保険者が当該一部負担金の全部又は一部を支払わないときは、市町村及び組合は、当該保険医療機関等の請求に基づき、この法律の規定による徴収金の例によりこれを処分することができる。

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