# 高齢者の医療の確保に関する法律 / Act on Assurance of Medical Care for Elderly People — 第七十四条 (Article 74) - Law: 高齢者の医療の確保に関する法律 (Act on Assurance of Medical Care for Elderly People), 昭和五十七年法律第八十号 - English title "Act on Assurance of Medical Care for Elderly People": Ministry of Justice translation - Kind: Act — the distinction between 法律 (Act), 政令 (Cabinet Order), 省令 (Ministerial Order) and 条例 (local ordinance) decides who may issue it and what it may say. - Provision: 第七十四条 (Article 74)（入院時食事療養費） — address `art-74` - Text in force since: 2026-10-01 - URL (the page that opens at this provision): https://japanlaw.org/en/elderly-medical-care-act/art-74 - Permanent URL (e-Gov law ID, never renamed): https://japanlaw.org/l/357AC0000000080/art-74 - Every provision below carries its address and both URLs on the line under it. - Japanese text: e-Gov 法令検索, Digital Agency (デジタル庁). English: as marked on each line below. Only the Japanese as published by the government has legal effect; the text below is a copy of it. Every English rendering below is a translation and says which kind: the Ministry of Justice's translation, or this site's machine translation, whose model and date the Sources list names. They are never merged and never substituted for one another. --- ### 第七十四条（入院時食事療養費） — (Dietary Treatment Expenses for Inpatients) caption: Ministry of Justice translation — Japanese Law Translation Database System art-74 · https://japanlaw.org/en/elderly-medical-care-act/art-74 · https://japanlaw.org/l/357AC0000000080/art-74 **第一項** 後期高齢者医療広域連合は、被保険者（長期入院療養を受ける被保険者（次条第一項において「長期入院被保険者」という。）を除く。以下この条において同じ。）が、保険医療機関等（保険薬局を除く。以下この条及び次条において同じ。）のうち自己の選定するものについて第六十四条第一項第五号に掲げる療養の給付と併せて受けた食事療養に要した費用について、当該被保険者に対し、入院時食事療養費を支給する。ただし、当該被保険者が第八十二条第一項又は第二項本文の規定の適用を受けている間は、この限りでない。 art-74/par-1 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-1 · https://japanlaw.org/l/357AC0000000080/art-74/par-1 The Association of Medical Care Systems for the Elderly Aged 75 and older pays dietary treatment expenses for inpatients to an insured (excluding an insured who receives long-term hospitalization and medical treatment (referred to as a "long-term inpatient insured" in paragraph (1) of the following Article); the same applies hereinafter in this Article) for the expenses required for dietary treatment received together with the benefits for medical treatment listed in Article 64, paragraph (1), item (v) at a medical institution providing services covered by health insurance, etc. (excluding pharmacies providing services covered by health insurance; the same applies hereinafter in this Article and the following Article) of the insured's own choosing; provided, however, that this does not apply while the insured is subject to the provisions of Article 82, paragraph (1) or the main clause of paragraph (2). machine translation, not official **第二項** 入院時食事療養費の額は、当該食事療養につき食事療養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（その額が現に当該食事療養に要した費用の額を超えるときは、当該現に食事療養に要した費用の額）から、平均的な家計における食費の状況及び特定介護保険施設等（介護保険法第五十一条の三第一項に規定する特定介護保険施設等をいう。）における食事の提供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額（所得の状況その他の事情をしん酌して厚生労働省令で定める者については、別に定める額。以下「食事療養標準負担額」という。）を控除した額とする。 art-74/par-2 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-2 · https://japanlaw.org/l/357AC0000000080/art-74/par-2 The amount of dietary treatment expenses for inpatients is the amount calculated by deducting the amount specified by the Minister of Health, Labour and Welfare in consideration of the status of food expenses for an average household budget and the average amount of expenses required to provide meals at a specified nursing care insurance facilities, etc. (meaning a specified facility, etc. for insured long-term care prescribed in Article 51-3, paragraph (1) of Long-Term Care Insurance Act) (for a person specified by Order of the Ministry of Health, Labour and Welfare in consideration of income status and other circumstances, a separately determined amount; hereinafter referred to as the "standard co-payment for dietary treatment") from the amount of expenses calculated based on the standards specified by the Minister of Health, Labour and Welfare in consideration of the average amount of expenses required for the dietary treatment (when the calculated amount exceeds the amount of expenses actually incurred in the dietary treatment, the amount of expenses actually incurred). Ministry of Justice translation — Japanese Law Translation Database System **第三項** 厚生労働大臣は、食事療養標準負担額を定めた後に勘案又はしん酌すべき事項に係る事情が著しく変動したときは、速やかにその額を改定しなければならない。 art-74/par-3 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-3 · https://japanlaw.org/l/357AC0000000080/art-74/par-3 If the circumstances pertaining to the matters to be taken into consideration have significantly changed after the Minister of Health, Labour and Welfare has determined the standard co-payment amount for dietary treatment, the Minister must promptly revise the amount. Ministry of Justice translation — Japanese Law Translation Database System **第四項** 保険医療機関等及び保険医等（保険薬剤師を除く。次条第四項において同じ。）は、厚生労働大臣が定める入院時食事療養費に係る療養の取扱い及び担当に関する基準に従い、入院時食事療養費に係る療養を取り扱い、又は担当しなければならない。 art-74/par-4 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-4 · https://japanlaw.org/l/357AC0000000080/art-74/par-4 A medical institution providing services covered by health insurance, etc. and a physician providing health insurance treatment, etc. (excluding pharmacists filling health insurance prescriptions; the same applies in paragraph (4) of the following Article) must handle or take charge of medical treatment pertaining to dietary treatment expenses for inpatients in accordance with the standards for the handling and taking charge of medical treatment pertaining to dietary treatment expenses for inpatients specified by the Minister of Health, Labour and Welfare. machine translation, not official **第五項** 被保険者が保険医療機関等について食事療養を受けたときは、後期高齢者医療広域連合は、その被保険者が当該保険医療機関等に支払うべき食事療養に要した費用について、入院時食事療養費として被保険者に対し支給すべき額の限度において、被保険者に代わり、当該保険医療機関等に支払うことができる。 art-74/par-5 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-5 · https://japanlaw.org/l/357AC0000000080/art-74/par-5 When an insured has received dietary treatment at or from a medical institution providing services covered by health insurance, etc., the Association of Medical Care Systems for the Elderly Aged 75 and older may, on behalf of the insured, pay to the medical institution providing services covered by health insurance, etc. expenses incurred for the dietary treatment payable by the insured to the medical institution providing services covered by health insurance, etc., within the limit of the amount payable to the insured as expenses for dietary treatment for inpatients. Ministry of Justice translation with a slip corrected by this site — not the Ministry's text; the Ministry printed: "When a insured has received dietary treatment at or from a medical institution providing services covered by health insurance, etc., the Association of Medical Care Systems for the Elderly Aged 75 and older may, on behalf of the insured, pay to the medical institution providing services covered by health insurance, etc. expenses incurred for the dietary treatment payable by the insured to the medical institution providing services covered by health insurance, etc., within the limit of the amount payable to the insured as expenses for dietary treatment for inpatients." — https://www.japaneselawtranslation.go.jp/en/laws/view/4903/tb **第六項** 前項の規定による支払があつたときは、被保険者に対し入院時食事療養費の支給があつたものとみなす。 art-74/par-6 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-6 · https://japanlaw.org/l/357AC0000000080/art-74/par-6 If a payment under the provisions of the preceding paragraph is made, it is deemed that dietary treatment expenses for inpatients are paid to the insured. Ministry of Justice translation — Japanese Law Translation Database System **第七項** 保険医療機関等は、食事療養に要した費用につき、その支払を受ける際、当該支払をした被保険者に対し、厚生労働省令で定めるところにより、領収書を交付しなければならない。 art-74/par-7 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-7 · https://japanlaw.org/l/357AC0000000080/art-74/par-7 A medical institution providing services covered by health insurance, etc. must, when receiving payment of the expenses required for dietary treatment, issue a receipt to the insured who made the payment, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare. machine translation, not official **第八項** 厚生労働大臣は、第二項の規定による基準及び第四項に規定する入院時食事療養費に係る療養の取扱い及び担当に関する基準を定めようとするときは、あらかじめ中央社会保険医療協議会の意見を聴かなければならない。 art-74/par-8 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-8 · https://japanlaw.org/l/357AC0000000080/art-74/par-8 The Minister of Health, Labour and Welfare must hear the opinions of the Central Social Insurance Medical Council in advance, when the Minister intends to establish standards under the provisions of paragraph (2) and standards concerning the treatment and taking charge of medical treatment pertaining to dietary treatment expenses for inpatients prescribed in paragraph (4). Ministry of Justice translation — Japanese Law Translation Database System **第九項** 第七十一条第二項の規定は、前項に規定する事項に関する中央社会保険医療協議会の権限について準用する。 art-74/par-9 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-9 · https://japanlaw.org/l/357AC0000000080/art-74/par-9 The provisions of Article 71, paragraph (2) apply mutatis mutandis to the authority of the Central Social Insurance Medical Council concerning the particulars prescribed in the preceding paragraph. Ministry of Justice translation — Japanese Law Translation Database System **第十項** 健康保険法第六十四条並びに本法第六十四条第三項、第六十六条、第七十条第二項から第七項まで及び第七十二条の規定は、保険医療機関等について受けた食事療養及びこれに伴う入院時食事療養費の支給について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。 art-74/par-10 · https://japanlaw.org/en/elderly-medical-care-act/art-74/par-10 · https://japanlaw.org/l/357AC0000000080/art-74/par-10 The provisions of Article 64 of the Health Insurance Act and Article 64, paragraph (3), Article 66, Article 70, paragraphs (2) through (7), and Article 72 of this Act apply mutatis mutandis to dietary treatment received at or from a medical institution providing services covered by health insurance and to the payment of dietary treatment expenses for inpatients associated with that treatment. In such a case, Cabinet Order provides for the necessary technical replacement of terms in connection with these provisions. Ministry of Justice translation — Japanese Law Translation Database System --- ## Cites - art-74/par-1: 次条第一項 → 高齢者の医療の確保に関する法律 第七十五条第一項 (Article 75, paragraph (1)), art-75/par-1 — https://japanlaw.org/en/elderly-medical-care-act/art-75/par-1 · https://japanlaw.org/l/357AC0000000080/art-75/par-1 - art-74/par-1: この条 → 高齢者の医療の確保に関する法律 第七十四条 (Article 74), art-74 — https://japanlaw.org/en/elderly-medical-care-act/art-74 · https://japanlaw.org/l/357AC0000000080/art-74 - art-74/par-1: 次条 → 高齢者の医療の確保に関する法律 第七十五条 (Article 75), art-75 — https://japanlaw.org/en/elderly-medical-care-act/art-75 · https://japanlaw.org/l/357AC0000000080/art-75 - art-74/par-1: 第六十四条第一項第五号 → 高齢者の医療の確保に関する法律 第六十四条第一項第五号 (Article 64, paragraph (1), item (v)), art-64/par-1/item-5 — https://japanlaw.org/en/elderly-medical-care-act/art-64/par-1/item-5 · https://japanlaw.org/l/357AC0000000080/art-64/par-1/item-5 - art-74/par-1: 第八十二条第一項 → 高齢者の医療の確保に関する法律 第八十二条第一項 (Article 82, paragraph (1)), art-82/par-1 — https://japanlaw.org/en/elderly-medical-care-act/art-82/par-1 · https://japanlaw.org/l/357AC0000000080/art-82/par-1 - art-74/par-1: 第二項 → 高齢者の医療の確保に関する法律 第八十二条第二項 (Article 82, paragraph (2)), art-82/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-82/par-2 · https://japanlaw.org/l/357AC0000000080/art-82/par-2 - art-74/par-2: 介護保険法第五十一条の三第一項 → 介護保険法 第五十一条の三第一項 (Article 51-3, paragraph (1)), art-51-3/par-1 — https://japanlaw.org/en/long-term-care-insurance-act/art-51-3/par-1 · https://japanlaw.org/l/409AC0000000123/art-51-3/par-1 - art-74/par-4: 次条第四項 → 高齢者の医療の確保に関する法律 第七十五条第四項 (Article 75, paragraph (4)), art-75/par-4 — https://japanlaw.org/en/elderly-medical-care-act/art-75/par-4 · https://japanlaw.org/l/357AC0000000080/art-75/par-4 - art-74/par-6: 前項 → 高齢者の医療の確保に関する法律 第七十四条第五項 (Article 74, paragraph (5)), art-74/par-5 — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-5 · https://japanlaw.org/l/357AC0000000080/art-74/par-5 - art-74/par-8: 第二項 → 高齢者の医療の確保に関する法律 第七十四条第二項 (Article 74, paragraph (2)), art-74/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-2 · https://japanlaw.org/l/357AC0000000080/art-74/par-2 - art-74/par-8: 第四項 → 高齢者の医療の確保に関する法律 第七十四条第四項 (Article 74, paragraph (4)), art-74/par-4 — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-4 · https://japanlaw.org/l/357AC0000000080/art-74/par-4 - art-74/par-9: 第七十一条第二項 → 高齢者の医療の確保に関する法律 第七十一条第二項 (Article 71, paragraph (2)), art-71/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-71/par-2 · https://japanlaw.org/l/357AC0000000080/art-71/par-2 - art-74/par-9: 前項 → 高齢者の医療の確保に関する法律 第七十四条第八項 (Article 74, paragraph (8)), art-74/par-8 — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-8 · https://japanlaw.org/l/357AC0000000080/art-74/par-8 - art-74/par-10: 健康保険法第六十四条 → 健康保険法 第六十四条 (Article 64), art-64 — https://japanlaw.org/en/health-insurance-act/art-64 · https://japanlaw.org/l/211AC0000000070/art-64 - art-74/par-10: 第六十四条第三項 → 高齢者の医療の確保に関する法律 第六十四条第三項 (Article 64, paragraph (3)), art-64/par-3 — https://japanlaw.org/en/elderly-medical-care-act/art-64/par-3 · https://japanlaw.org/l/357AC0000000080/art-64/par-3 - art-74/par-10: 第六十六条 → 高齢者の医療の確保に関する法律 第六十六条 (Article 66), art-66 — https://japanlaw.org/en/elderly-medical-care-act/art-66 · https://japanlaw.org/l/357AC0000000080/art-66 - art-74/par-10: 第七十条第二項から第七項まで → 高齢者の医療の確保に関する法律 第七十条第二項 (Article 70, paragraph (2)), art-70/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-70/par-2 · https://japanlaw.org/l/357AC0000000080/art-70/par-2 - art-74/par-10: 第七十条第二項から第七項まで → 高齢者の医療の確保に関する法律 第七十条第三項 (Article 70, paragraph (3)), art-70/par-3 — https://japanlaw.org/en/elderly-medical-care-act/art-70/par-3 · https://japanlaw.org/l/357AC0000000080/art-70/par-3 - art-74/par-10: 第七十条第二項から第七項まで → 高齢者の医療の確保に関する法律 第七十条第四項 (Article 70, paragraph (4)), art-70/par-4 — https://japanlaw.org/en/elderly-medical-care-act/art-70/par-4 · https://japanlaw.org/l/357AC0000000080/art-70/par-4 - art-74/par-10: 第七十条第二項から第七項まで → 高齢者の医療の確保に関する法律 第七十条第五項 (Article 70, paragraph (5)), art-70/par-5 — https://japanlaw.org/en/elderly-medical-care-act/art-70/par-5 · https://japanlaw.org/l/357AC0000000080/art-70/par-5 - art-74/par-10: 第七十条第二項から第七項まで → 高齢者の医療の確保に関する法律 第七十条第六項 (Article 70, paragraph (6)), art-70/par-6 — https://japanlaw.org/en/elderly-medical-care-act/art-70/par-6 · https://japanlaw.org/l/357AC0000000080/art-70/par-6 - art-74/par-10: 第七十条第二項から第七項まで → 高齢者の医療の確保に関する法律 第七十条第七項 (Article 70, paragraph (7)), art-70/par-7 — https://japanlaw.org/en/elderly-medical-care-act/art-70/par-7 · https://japanlaw.org/l/357AC0000000080/art-70/par-7 - art-74/par-10: 第七十二条 → 高齢者の医療の確保に関する法律 第七十二条 (Article 72), art-72 — https://japanlaw.org/en/elderly-medical-care-act/art-72 · https://japanlaw.org/l/357AC0000000080/art-72 ## Cited by 20 provisions cite this one. No official source publishes this direction. - 高齢者の医療の確保に関する法律 第五十四条第四項（届出等） — https://japanlaw.org/en/elderly-medical-care-act/art-54/par-4 · https://japanlaw.org/l/357AC0000000080/art-54/par-4 - 高齢者の医療の確保に関する法律 第五十九条第三項（不正利得の徴収等） — https://japanlaw.org/en/elderly-medical-care-act/art-59/par-3 · https://japanlaw.org/l/357AC0000000080/art-59/par-3 - 高齢者の医療の確保に関する法律 第七十四条第一項（入院時食事療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-1 · https://japanlaw.org/l/357AC0000000080/art-74/par-1 - 高齢者の医療の確保に関する法律 第七十四条第六項（入院時食事療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-6 · https://japanlaw.org/l/357AC0000000080/art-74/par-6 - 高齢者の医療の確保に関する法律 第七十四条第八項（入院時食事療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-8 · https://japanlaw.org/l/357AC0000000080/art-74/par-8 - 高齢者の医療の確保に関する法律 第七十四条第九項（入院時食事療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-74/par-9 · https://japanlaw.org/l/357AC0000000080/art-74/par-9 - 高齢者の医療の確保に関する法律 第七十五条第七項（入院時生活療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-75/par-7 · https://japanlaw.org/l/357AC0000000080/art-75/par-7 - 高齢者の医療の確保に関する法律 第七十六条第二項第二号（保険外併用療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-76/par-2/item-2 · https://japanlaw.org/l/357AC0000000080/art-76/par-2/item-2 - 高齢者の医療の確保に関する法律 第七十六条第六項（保険外併用療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-76/par-6 · https://japanlaw.org/l/357AC0000000080/art-76/par-6 - 高齢者の医療の確保に関する法律 第七十六条第七項（保険外併用療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-76/par-7 · https://japanlaw.org/l/357AC0000000080/art-76/par-7 - 高齢者の医療の確保に関する法律 第七十七条第四項（療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-77/par-4 · https://japanlaw.org/l/357AC0000000080/art-77/par-4 - 高齢者の医療の確保に関する法律 第七十八条第八項（訪問看護療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-78/par-8 · https://japanlaw.org/l/357AC0000000080/art-78/par-8 - 高齢者の医療の確保に関する法律 第七十八条第九項（訪問看護療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-78/par-9 · https://japanlaw.org/l/357AC0000000080/art-78/par-9 - 高齢者の医療の確保に関する法律 第八十二条第六項 — https://japanlaw.org/en/elderly-medical-care-act/art-82/par-6 · https://japanlaw.org/l/357AC0000000080/art-82/par-6 - 高齢者の医療の確保に関する法律 第百五十五条第一項（国保連合会の業務） — https://japanlaw.org/en/elderly-medical-care-act/art-155/par-1 · https://japanlaw.org/l/357AC0000000080/art-155/par-1 - 高齢者の医療の確保に関する法律 第百六十五条第一項（事務の区分） — https://japanlaw.org/en/elderly-medical-care-act/art-165/par-1 · https://japanlaw.org/l/357AC0000000080/art-165/par-1 - 高齢者の医療の確保に関する法律 第百六十五条の二第一項（機構等への事務の委託） — https://japanlaw.org/en/elderly-medical-care-act/art-165-2/par-1 · https://japanlaw.org/l/357AC0000000080/art-165-2/par-1 - 高齢者の医療の確保に関する法律 第百六十七条第二項第三号 — https://japanlaw.org/en/elderly-medical-care-act/art-167/par-2/item-3 · https://japanlaw.org/l/357AC0000000080/art-167/par-2/item-3 - 高齢者の医療の確保に関する法律 第百六十七条第二項第四号 — https://japanlaw.org/en/elderly-medical-care-act/art-167/par-2/item-4 · https://japanlaw.org/l/357AC0000000080/art-167/par-2/item-4 - 高齢者の医療の確保に関する法律 附則第三十三条第二項 — https://japanlaw.org/en/elderly-medical-care-act/suppl-4181-83/art-33/par-2 · https://japanlaw.org/l/357AC0000000080/suppl-4181-83/art-33/par-2 --- ## Sources - claude-opus-5-5 — Corrections to the Ministry of Justice's English of 高齢者の医療の確保に関する法律, written 2026-10-19 - e-Gov 法令検索, Digital Agency (デジタル庁) — 高齢者の医療の確保に関する法律 — the text in force from 2026-10-01 (https://laws.e-gov.go.jp/law/357AC0000000080/20261001_507AC0000000087), retrieved 2026-10-19 - Japanese Law Translation Database System, Ministry of Justice (法務省) — Act on Assurance of Medical Care for Elderly People — Ministry of Justice translation (https://www.japaneselawtranslation.go.jp/en/laws/view/4903/tb), retrieved 2026-10-19 - Japanese Law Translation Database System, Ministry of Justice (法務省) — Act on Assurance of Medical Care for Elderly People (高齢者の医療の確保に関する法律), Article 74, paragraph (5) — the Ministry of Justice's English as printed (https://www.japaneselawtranslation.go.jp/en/laws/view/4903/tb), retrieved 2026-10-19 - claude-sonnet-5-5 — Machine translation, batch elderly-medical-care-act-20261019T112331-003, translated 2026-10-20 - This site's parser, version 209 — 高齢者の医療の確保に関する法律 — structure, counts, cross-references and defined terms, computed 2026-10-19