# Article 42, paragraph (4), item (iii), 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-4/item-3. 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 (4), item (iii) (第四十二条第四項第三号) 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 (4), item (iii) (第四十二条第四項第三号) — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-4/item-3 (as Markdown: https://japanlaw.org/md/en/health-insurance-act-enforcement-order/art-42/par-4/item-3)
- 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:

> 前項第三号に掲げる者　八万九千五百五十円と、第四十一条第四項に規定する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（その額が二十九万八千五百円に満たないときは、二十九万八千五百円）から二十九万八千五百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、四万六千五百円とする。

English (Machine translation, not official):

> a person listed in item (iii) of the preceding paragraph: the total sum of 89,550 yen and the amount obtained by multiplying by 1% the amount obtained by deducting 298,500 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 amount prescribed in Article 41, paragraph (4) (or 298,500 yen, if that cost is less than 298,500 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 46,500 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:

> 前項第三号に掲げる者　十三万五千百五十円と、第四十一条第四項に規定する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（その額が四十五万五百円に満たないときは、四十五万五百円）から四十五万五百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、七万五十円とする。

English (Machine translation, not official):

> a person listed in item (iii) of the preceding paragraph: the total sum of 135,150 yen and the amount obtained by multiplying by 1% the amount obtained by deducting 450,500 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 amount prescribed in Article 41, paragraph (4) (or 450,500 yen, if that cost is less than 450,500 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 70,050 yen.

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## 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)