# 高齢者の医療の確保に関する法律 / Act on Assurance of Medical Care for Elderly People — 第七十七条 (Article 77) - 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: 第七十七条 (Article 77)（療養費） — address `art-77` - Text in force since: 2026-10-01 - URL (the page that opens at this provision): https://japanlaw.org/en/elderly-medical-care-act/art-77 - Permanent URL (e-Gov law ID, never renamed): https://japanlaw.org/l/357AC0000000080/art-77 - 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. --- ### 第七十七条（療養費） — (Medical Expenses) caption: Ministry of Justice translation — Japanese Law Translation Database System art-77 · https://japanlaw.org/en/elderly-medical-care-act/art-77 · https://japanlaw.org/l/357AC0000000080/art-77 **第一項** 後期高齢者医療広域連合は、療養の給付若しくは入院時食事療養費、入院時生活療養費若しくは保険外併用療養費の支給（以下この項及び次項において「療養の給付等」という。）を行うことが困難であると認めるとき、又は被保険者が保険医療機関等以外の病院、診療所若しくは薬局その他の者について診療、薬剤の支給若しくは手当を受けた場合において、後期高齢者医療広域連合がやむを得ないものと認めるときは、療養の給付等に代えて、療養費を支給することができる。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-77/par-1 · https://japanlaw.org/en/elderly-medical-care-act/art-77/par-1 · https://japanlaw.org/l/357AC0000000080/art-77/par-1 When a Association of Medical Care Systems for the Elderly Aged 75 and older finds it difficult to pay benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, or medical expenses combined with treatment outside insurance coverage (hereinafter referred to as "benefits for medical treatment, etc." in this paragraph and the following paragraph), or when an insured has received any medical care, medication or treatment at or from hospitals, clinics, pharmacies or any other persons other than medical institutions providing services covered by health insurance, etc. and the Association of Medical Care Systems for the Elderly Aged 75 and older finds it unavoidable, it may pay medical expenses in lieu of benefits for medical treatment, etc.;provided, however, that this does not apply during any period for which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article are applied to the insured. Ministry of Justice translation with a slip corrected by this site — not the Ministry's text; the Ministry printed: "When a Association of Medical Care Systems for the Elderly Aged 75 and older finds it difficult to pay benefits for medical treatment, or expenses for dietary treatment for inpatients, living support expenses for inpatients, or medical expenses combined with treatment outside insurance coverage (hereinafter referred to as "benefits for medical treatment, etc." in this paragraph and the following paragraph), or when a insured has received any medical care, medication or treatment at or from hospitals, clinics, pharmacies or any other persons other than medical institutions providing services covered by health insurance, etc. and the Association of Medical Care Systems for the Elderly Aged 75 and older finds it unavoidable, it may pay medical expenses in lieu of benefits for medical treatment, etc.;provided, however, that this does not apply during any period for which the provisions of Article 82, paragraph (1) or the main clause of paragraph (2) of the same Article are applied to the insured." — https://www.japaneselawtranslation.go.jp/en/laws/view/4903/tb **第二項** 後期高齢者医療広域連合は、被保険者が電子資格確認等により被保険者であることの確認を受けないで保険医療機関等について診療又は薬剤の支給を受けた場合において、当該確認を受けなかつたことが、緊急その他やむを得ない理由によるものと認めるときは、療養の給付等に代えて、療養費を支給するものとする。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-77/par-2 · https://japanlaw.org/en/elderly-medical-care-act/art-77/par-2 · https://japanlaw.org/l/357AC0000000080/art-77/par-2 When an insured has received medical care or medication from a medical institution providing services covered by health insurance, etc. without receiving confirmation of being an insured by electronic eligibility confirmation, etc., and the Association of Medical Care Systems for the Elderly Aged 75 and older finds that the failure to receive that confirmation was due to an emergency or other unavoidable reason, it is to pay medical expenses in lieu of benefits for medical treatment, etc.; 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 **第三項** 療養費の額は、当該療養（食事療養及び生活療養を除く。）について算定した費用の額から、その額に第六十七条第一項各号に掲げる場合の区分に応じ、同項各号に定める割合を乗じて得た額を控除した額及び当該食事療養又は生活療養について算定した費用の額から食事療養標準負担額又は生活療養標準負担額を控除した額を基準として、後期高齢者医療広域連合が定める。 art-77/par-3 · https://japanlaw.org/en/elderly-medical-care-act/art-77/par-3 · https://japanlaw.org/l/357AC0000000080/art-77/par-3 The amount of medical expenses is determined by the Association of Medical Care Systems for the Elderly Aged 75 and older based on: (a) the amount calculated by deducting, from the amount calculated for the medical treatment (excluding dietary treatment and living support), the amount obtained by multiplying that amount by the applicable ratio specified in the items of Article 67, paragraph (1) in accordance with the categories of cases listed in the items of the same paragraph; and (b) the amount calculated by deducting, from the amount calculated for the dietary treatment or living support, the amount of standard co-payment for dietary treatment or standard co-payment for living support. Ministry of Justice translation — Japanese Law Translation Database System **第四項** 前項の費用の額の算定については、療養の給付を受けるべき場合においては第七十一条第一項の規定を、入院時食事療養費の支給を受けるべき場合においては第七十四条第二項の規定を、入院時生活療養費の支給を受けるべき場合においては第七十五条第二項の規定を、保険外併用療養費の支給を受けるべき場合においては前条第二項の規定を準用する。ただし、その額は、現に療養に要した費用の額を超えることができない。 art-77/par-4 · https://japanlaw.org/en/elderly-medical-care-act/art-77/par-4 · https://japanlaw.org/l/357AC0000000080/art-77/par-4 With regard to the calculation of the amount of expenses referred to in the preceding paragraph, the provisions of Article 71, paragraph (1) apply mutatis mutandis if benefits for medical treatment are to be received, the provisions of Article 74, paragraph (2) apply mutatis mutandis if dietary treatment expenses for inpatients are to be received, the provisions of Article 75, paragraph (2) apply mutatis mutandis if living support expenses for inpatients are to be received, and the provisions of paragraph (2) of the preceding Article apply mutatis mutandis if medical expenses combined with treatment outside insurance coverage are to be received; provided, however, that the amount may not exceed the amount of expenses actually incurred in the medical treatment. Ministry of Justice translation — Japanese Law Translation Database System --- ## Cites - art-77/par-1: この項 → 高齢者の医療の確保に関する法律 第七十七条第一項 (Article 77, paragraph (1)), art-77/par-1 — https://japanlaw.org/en/elderly-medical-care-act/art-77/par-1 · https://japanlaw.org/l/357AC0000000080/art-77/par-1 - art-77/par-1: 次項 → 高齢者の医療の確保に関する法律 第七十七条第二項 (Article 77, paragraph (2)), art-77/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-77/par-2 · https://japanlaw.org/l/357AC0000000080/art-77/par-2 - art-77/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-77/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-77/par-2: 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-77/par-2: 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-77/par-3: 第六十七条第一項 → 高齢者の医療の確保に関する法律 第六十七条第一項 (Article 67, paragraph (1)), art-67/par-1 — https://japanlaw.org/en/elderly-medical-care-act/art-67/par-1 · https://japanlaw.org/l/357AC0000000080/art-67/par-1 - art-77/par-4: 前項 → 高齢者の医療の確保に関する法律 第七十七条第三項 (Article 77, paragraph (3)), art-77/par-3 — https://japanlaw.org/en/elderly-medical-care-act/art-77/par-3 · https://japanlaw.org/l/357AC0000000080/art-77/par-3 - art-77/par-4: 第七十一条第一項 → 高齢者の医療の確保に関する法律 第七十一条第一項 (Article 71, paragraph (1)), art-71/par-1 — https://japanlaw.org/en/elderly-medical-care-act/art-71/par-1 · https://japanlaw.org/l/357AC0000000080/art-71/par-1 - art-77/par-4: 第七十四条第二項 → 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-77/par-4: 第七十五条第二項 → 高齢者の医療の確保に関する法律 第七十五条第二項 (Article 75, paragraph (2)), art-75/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-75/par-2 · https://japanlaw.org/l/357AC0000000080/art-75/par-2 - art-77/par-4: 前条第二項 → 高齢者の医療の確保に関する法律 第七十六条第二項 (Article 76, paragraph (2)), art-76/par-2 — https://japanlaw.org/en/elderly-medical-care-act/art-76/par-2 · https://japanlaw.org/l/357AC0000000080/art-76/par-2 ## Cited by 4 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 第七十七条第一項（療養費） — https://japanlaw.org/en/elderly-medical-care-act/art-77/par-1 · https://japanlaw.org/l/357AC0000000080/art-77/par-1 - 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 第八十二条第七項 — https://japanlaw.org/en/elderly-medical-care-act/art-82/par-7 · https://japanlaw.org/l/357AC0000000080/art-82/par-7 - 高齢者の医療の確保に関する法律 第八十二条第九項 — https://japanlaw.org/en/elderly-medical-care-act/art-82/par-9 · https://japanlaw.org/l/357AC0000000080/art-82/par-9 --- ## 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 77, paragraph (1) — 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