# Article 42, paragraph (3), item (iv), its wordings — Order for Enforcement of the Health Insurance Act This is the Markdown twin of https://japanlaw.org/en/health-insurance-act-enforcement-order/history/art-42/par-3/item-4. Every law, and how to address a provision: https://japanlaw.org/llms.txt. The same laws as MCP tools (no sign-in): https://japanlaw.org/mcp. How the wording of Article 42, paragraph (3), item (iv) (第四十二条第三項第四号) changed with each amendment, and how it will change. - Law: Order for Enforcement of the Health Insurance Act (健康保険法施行令) — https://japanlaw.org/en/health-insurance-act-enforcement-order - Provision: Article 42, paragraph (3), item (iv) (第四十二条第三項第四号) — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-3/item-4 (as Markdown: https://japanlaw.org/md/en/health-insurance-act-enforcement-order/art-42/par-3/item-4) - The law's amendments: https://japanlaw.org/en/health-insurance-act-enforcement-order/amendments - 2 wordings, oldest first. ## 1. Before Cabinet Order No. 240 of 2026 - State: In force Japanese: > 法第七十四条第一項第三号の規定が適用される者であって療養のあった月の標準報酬月額が五十三万円未満の被保険者又はその被扶養者　八万五千八百円と、第四十一条第三項各号に掲げる額を合算した額に係る療養につき厚生労働省令で定めるところにより算定した当該療養に要した費用の額（その額が二十八万六千円に満たないときは、二十八万六千円）から二十八万六千円を控除した額に百分の一を乗じて得た額（この額に一円未満の端数がある場合において、その端数金額が五十銭未満であるときは、これを切り捨て、その端数金額が五十銭以上であるときは、これを一円に切り上げた額）との合算額。ただし、高額療養費多数回該当の場合にあっては、四万四千四百円とする。 English (Machine translation, not official): > a person to whom the provisions of Article 74, paragraph (1), item (iii) of the Act apply who is an insured person whose standard monthly remuneration for the month in which the medical treatment was received is less than 530,000 yen, or a dependent of such a person: the total sum of 85,800 yen and the amount obtained by multiplying by 1% the amount obtained by deducting 286,000 yen from the cost of the medical treatment, calculated as provided by Order of the Ministry of Health, Labour and Welfare, relating to the total sum of the amounts listed in the items of Article 41, paragraph (3) (or 286,000 yen, if that cost is less than 286,000 yen) (where that amount includes a fractional amount of less than 1 yen, the amount obtained by rounding down that fractional amount if it is less than 50 sen, or by rounding it up to 1 yen if it is 50 sen or more); provided, however, that in the case of repeated high-cost medical expenses, the amount is 44,400 yen. ## 2. 1 August 2027 — Cabinet Order No. 240 of 2026 - State: Not yet in force - Takes effect: 1 August 2027 - The amendment: Reworded (Cabinet Order No. 240 of 2026) — https://japanlaw.org/en/health-insurance-act-enforcement-order/amendments/20270801_508CO0000000240 Japanese: > 法第七十四条第一項第三号の規定が適用される者であって療養のあった月の標準報酬月額が七十一万円以上八十三万円未満の被保険者又はその被扶養者　二十万九千四百円と、第四十一条第三項各号に掲げる額を合算した額に係る療養につき厚生労働省令で定めるところにより算定した当該療養に要した費用の額（その額が六十九万八千円に満たないときは、六十九万八千円）から六十九万八千円を控除した額に百分の一を乗じて得た額（この額に一円未満の端数がある場合において、その端数金額が五十銭未満であるときは、これを切り捨て、その端数金額が五十銭以上であるときは、これを一円に切り上げた額）との合算額。ただし、高額療養費多数回該当の場合にあっては、九万三千円とする。 English (Machine translation, not official): > a person to whom the provisions of Article 74, paragraph (1), item (iii) of the Act apply who is an insured person whose standard monthly remuneration for the month in which the medical treatment was received is 710,000 yen or more and less than 830,000 yen, or a dependent of such a person: the total sum of 209,400 yen and the amount obtained by multiplying by 1% the amount obtained by deducting 698,000 yen from the cost of the medical treatment, calculated as provided by Order of the Ministry of Health, Labour and Welfare, relating to the total sum of the amounts listed in the items of Article 41, paragraph (3) (or 698,000 yen, if that cost is less than 698,000 yen) (where that amount includes a fractional amount of less than 1 yen, the amount obtained by rounding down that fractional amount if it is less than 50 sen, or by rounding it up to 1 yen if it is 50 sen or more); provided, however, that in the case of repeated high-cost medical expenses, the amount is 93,000 yen. --- ## Sources - The dates and the amending laws: e-Gov (Digital Agency) (https://laws.e-gov.go.jp/law/215IO0000000243) - English name of the law: Written for this site with AI - English titles of the amending laws: Written for this site with AI - The Japanese text before: e-Gov (Digital Agency) (https://laws.e-gov.go.jp/law/215IO0000000243/20261001_508CO0000000276) - The Japanese text after: e-Gov (Digital Agency) (https://laws.e-gov.go.jp/law/215IO0000000243/20270801_508CO0000000240)