# 健康保険法施行令 / Order for Enforcement of the Health Insurance Act — 第三十一条 (Supplementary Provisions, Article 31)

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- Law: 健康保険法施行令 (Order for Enforcement of the Health Insurance Act), 大正十五年勅令第二百四十三号
- English title "Order for Enforcement of the Health Insurance Act": claude-opus-5-5
- Kind: ImperialOrder — 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: 第三十一条 (Supplementary Provisions, Article 31) — address `suppl-4202-116/art-31`
- Text in force since: 2026-10-01
- URL (the page that opens at this provision): https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31
- e-Gov law ID: 215IO0000000243 — never renamed. A permanent link, `/l/{lawId}/{address}` on this site, redirects to the page.
- Every provision below carries its address and its URL 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.

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### 第三十一条
<sup>suppl-4202-116/art-31 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31</sup>

**第一項**  健康保険法施行令第四十二条第二項第二号に掲げる者のうち、次の各号のいずれかに該当するもの（以下この条において「特定収入被保険者」という。）に係る同令第四十一条第二項の高額療養費算定基準額は、同令第四十二条第二項の規定にかかわらず、第一条の規定による改正前の健康保険法施行令（以下この条において「旧健保令」という。）第四十二条第二項第一号に定める額とする。
<sup>suppl-4202-116/art-31/par-1 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1</sup>
Among the persons listed in Article 42, paragraph (2), item (ii) of the Order for Enforcement of the Health Insurance Act, for those who fall under any of the following items (hereinafter referred to in this Article as "insured persons with specified income"), the base amount for calculating high-cost medical expenses under Article 41, paragraph (2) of the Order for Enforcement of the Health Insurance Act is, notwithstanding Article 42, paragraph (2) of the Order for Enforcement of the Health Insurance Act, the amount specified in Article 42, paragraph (2), item (i) of the Order for Enforcement of the Health Insurance Act before the amendment by the provisions of Article 1 (hereinafter referred to in this Article as the "Former Health Insurance Order").
<sup>machine translation, not official</sup>

  **一**  療養の給付又はその被扶養者（健康保険法施行令第三十四条第二項に規定する被扶養者をいう。以下この号において同じ。）の療養を受ける月が平成二十年四月から八月までの場合における附則第二十八条第二項の規定により読み替えて適用する健康保険法施行令第三十四条第二項の収入の額が六百二十一万円未満である者（被扶養者及び附則第二十八条第二項の規定により読み替えて適用する健康保険法施行令第三十四条第二項に規定する被扶養者であった者がいない者にあっては、四百八十四万円未満である者）
  <sup>suppl-4202-116/art-31/par-1/item-1 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-1</sup>
  a person for whom the amount of income under Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act as applied by deeming the terms to be replaced pursuant to Article 28, paragraph (2) of the Supplementary Provisions, in the case where the month in which benefits for medical treatment or the medical care of the person's dependent (meaning a dependent prescribed in Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act; the same applies hereinafter in this item) is received is from April through August 2008, is less than 6,210,000 yen (in the case of a person who has neither a dependent nor a person who was a dependent prescribed in Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act as applied by deeming the terms to be replaced pursuant to Article 28, paragraph (2) of the Supplementary Provisions, a person for whom it is less than 4,840,000 yen);
  <sup>machine translation, not official</sup>

  **二**  次のイ及びロのいずれにも該当する者
  <sup>suppl-4202-116/art-31/par-1/item-2 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-2</sup>
  a person who falls under both of the following:
  <sup>machine translation, not official</sup>

    **イ**  健康保険法施行令第三十四条第二項に規定する被扶養者がいない被保険者であって、被扶養者であった者（健康保険法第三条第七項ただし書に該当するに至ったため被扶養者でなくなった者をいう。以下この号及び附則第三十三条第四項第二号において同じ。）がいるもの
    <sup>suppl-4202-116/art-31/par-1/item-2/sub-1 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-2/sub-1</sup>
    an insured person who has no dependent prescribed in Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act and who has a person who was a dependent (meaning a person who has ceased to be a dependent by coming to fall under the proviso to Article 3, paragraph (7) of the Health Insurance Act; the same applies hereinafter in this item and Article 33, paragraph (4), item (ii) of the Supplementary Provisions);
    <sup>machine translation, not official</sup>

    **ロ**  療養の給付を受ける月が平成二十年九月から十二月までの場合において、その被扶養者であった者について、健康保険法施行令第三十四条第二項に規定する被扶養者とみなして同項の規定を適用した場合の同項の収入の額が五百二十万円未満である者
    <sup>suppl-4202-116/art-31/par-1/item-2/sub-2 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-2/sub-2</sup>
    a person for whom, in the case where the month in which benefits for medical treatment are received is from September through December 2008, the amount of income under Article 34, paragraph (2) of the Order for Enforcement of the Health Insurance Act that results if the person who was a dependent of the person is deemed to be a dependent prescribed in that paragraph and that paragraph is applied is less than 5,200,000 yen.
    <sup>machine translation, not official</sup>

**第二項**  特定収入被保険者に係る健康保険法施行令第四十一条第三項の高額療養費算定基準額は、同令第四十二条第三項の規定にかかわらず、旧健保令第四十二条第三項第一号に定める額とする。
<sup>suppl-4202-116/art-31/par-2 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-2</sup>
The base amount for calculating high-cost medical expenses under Article 41, paragraph (3) of the Order for Enforcement of the Health Insurance Act for an insured person with specified income is, notwithstanding Article 42, paragraph (3) of the Order for Enforcement of the Health Insurance Act, the amount specified in Article 42, paragraph (3), item (i) of the Former Health Insurance Order.
<sup>machine translation, not official</sup>

**第三項**  特定収入被保険者が次の各号に掲げる療養を受けた場合において、健康保険法の規定により支払うべき一部負担金の支払が行われなかったときの健康保険法施行令第四十三条第一項の規定により特定収入被保険者について保険者が同項に規定する保険医療機関等に支払う額の限度については、同項各号の規定にかかわらず、当該一部負担金の額から次の各号に掲げる療養の区分に応じ、当該各号に定める額を控除した額とする。
<sup>suppl-4202-116/art-31/par-3 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-3</sup>
Where an insured person with specified income has received medical care listed in the following items, and the co-payment payable under the provisions of the Health Insurance Act has not been paid, the limit of the amount that the insurer pays, pursuant to Article 43, paragraph (1) of the Order for Enforcement of the Health Insurance Act, to the medical institution providing services covered by health insurance, etc. prescribed in that paragraph in respect of the insured person with specified income is, notwithstanding the items of that paragraph, the amount obtained by deducting, from the amount of the co-payment concerned, the amount specified in each of the following items in accordance with the category of medical care listed in that item.
<sup>machine translation, not official</sup>

  **一**  健康保険法施行令第四十三条第一項第二号に掲げる療養　旧健保令第四十三条第一項第二号イに定める額
  <sup>suppl-4202-116/art-31/par-3/item-1 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-3/item-1</sup>
  medical care listed in Article 43, paragraph (1), item (ii) of the Order for Enforcement of the Health Insurance Act: the amount specified in Article 43, paragraph (1), item (ii), (a) of the Former Health Insurance Order;
  <sup>machine translation, not official</sup>

  **二**  健康保険法施行令第四十三条第一項第三号に掲げる療養　旧健保令第四十三条第一項第三号イに定める額
  <sup>suppl-4202-116/art-31/par-3/item-2 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-3/item-2</sup>
  medical care listed in Article 43, paragraph (1), item (iii) of the Order for Enforcement of the Health Insurance Act: the amount specified in Article 43, paragraph (1), item (iii), (a) of the Former Health Insurance Order.
  <sup>machine translation, not official</sup>

**第四項**  特定収入被保険者に対する保険外併用療養費又は家族療養費（第一項第一号に該当する者に係るものに限る。）に係る高額療養費の支給については、健康保険法施行令第四十三条第三項中「当該各号に定める額」とあるのは、「健康保険法施行令等の一部を改正する政令（平成二十年政令第百十六号）第一条の規定による改正前の当該各号イに定める額」と読み替えて、同項の規定を適用する。
<sup>suppl-4202-116/art-31/par-4 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-4</sup>
With regard to the payment of high-cost medical expenses relating to medical expenses combined with treatment outside insurance coverage or dependent's medical expenses (limited to those relating to a person who falls under paragraph (1), item (i)) for an insured person with specified income, Article 43, paragraph (3) of the Order for Enforcement of the Health Insurance Act is applied by deeming the phrase "the amount specified in each of those items" in that paragraph to be replaced with "the amount specified in sub-item (a) of each of those items before the amendment by the provisions of Article 1 of the Cabinet Order Partially Amending the Order for Enforcement of the Health Insurance Act, etc. (Cabinet Order No. 116 of 2008)".
<sup>machine translation, not official</sup>

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## Cites
- suppl-4202-116/art-31/par-1: 健康保険法施行令第四十二条第二項第二号 → 健康保険法施行令 第四十二条第二項第二号 (Article 42, paragraph (2), item (ii)), art-42/par-2/item-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-2/item-2
- suppl-4202-116/art-31/par-1: この条 → 健康保険法施行令 附則第三十一条 (Supplementary Provisions, Article 31), suppl-4202-116/art-31 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31
- suppl-4202-116/art-31/par-1/item-1: 健康保険法施行令第三十四条第二項 → 健康保険法施行令 第三十四条第二項 (Article 34, paragraph (2)), art-34/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-34/par-2
- suppl-4202-116/art-31/par-1/item-1: この号 → 健康保険法施行令 附則第三十一条第一項第一号 (Supplementary Provisions, Article 31, paragraph (1), item (i)), suppl-4202-116/art-31/par-1/item-1 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-1
- suppl-4202-116/art-31/par-1/item-1: 附則第二十八条第二項 → 健康保険法施行令 附則第二十八条第二項 (Supplementary Provisions, Article 28, paragraph (2)), suppl-4202-116/art-28/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-28/par-2
- suppl-4202-116/art-31/par-1/item-2/sub-1: 健康保険法施行令第三十四条第二項 → 健康保険法施行令 第三十四条第二項 (Article 34, paragraph (2)), art-34/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-34/par-2
- suppl-4202-116/art-31/par-1/item-2/sub-1: 健康保険法第三条第七項 → 健康保険法 第三条第七項 (Article 3, paragraph (7)), art-3/par-7 — https://japanlaw.org/en/health-insurance-act/art-3/par-7 (e-Gov law ID 211AC0000000070)
- suppl-4202-116/art-31/par-1/item-2/sub-1: この号 → 健康保険法施行令 附則第三十一条第一項第二号 (Supplementary Provisions, Article 31, paragraph (1), item (ii)), suppl-4202-116/art-31/par-1/item-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-2
- suppl-4202-116/art-31/par-1/item-2/sub-1: 附則第三十三条第四項第二号 → 健康保険法施行令 附則第三十三条第四項第二号 (Supplementary Provisions, Article 33, paragraph (4), item (ii)), suppl-4202-116/art-33/par-4/item-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-33/par-4/item-2
- suppl-4202-116/art-31/par-1/item-2/sub-2: 健康保険法施行令第三十四条第二項 → 健康保険法施行令 第三十四条第二項 (Article 34, paragraph (2)), art-34/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-34/par-2
- suppl-4202-116/art-31/par-2: 健康保険法施行令第四十一条第三項 → 健康保険法施行令 第四十一条第三項 (Article 41, paragraph (3)), art-41/par-3 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-41/par-3
- suppl-4202-116/art-31/par-3: 健康保険法施行令第四十三条第一項 → 健康保険法施行令 第四十三条第一項 (Article 43, paragraph (1)), art-43/par-1 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-43/par-1
- suppl-4202-116/art-31/par-3/item-1: 健康保険法施行令第四十三条第一項第二号 → 健康保険法施行令 第四十三条第一項第二号 (Article 43, paragraph (1), item (ii)), art-43/par-1/item-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-43/par-1/item-2
- suppl-4202-116/art-31/par-3/item-2: 健康保険法施行令第四十三条第一項第三号 → 健康保険法施行令 第四十三条第一項第三号 (Article 43, paragraph (1), item (iii)), art-43/par-1/item-3 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-43/par-1/item-3
- suppl-4202-116/art-31/par-4: 第一項第一号 → 健康保険法施行令 附則第三十一条第一項第一号 (Supplementary Provisions, Article 31, paragraph (1), item (i)), suppl-4202-116/art-31/par-1/item-1 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-1
- suppl-4202-116/art-31/par-4: 健康保険法施行令第四十三条第三項 → 健康保険法施行令 第四十三条第三項 (Article 43, paragraph (3)), art-43/par-3 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-43/par-3
- suppl-4202-116/art-31/par-4: 健康保険法施行令等の一部を改正する政令（平成二十年政令第百十六号）第一条 → e-Gov law 420CO0000000116, 第一条 (Article 1), art-1 — not held in this collection

## Cited by

5 provisions cite this one. No official source publishes this direction.

- 健康保険法施行令 附則第三十一条第一項 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1
- 健康保険法施行令 附則第三十一条第一項第一号 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-1
- 健康保険法施行令 附則第三十一条第一項第二号イ — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-1/item-2/sub-1
- 健康保険法施行令 附則第三十一条第四項 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-31/par-4
- 健康保険法施行令 附則第三十三条第四項第一号 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-4202-116/art-33/par-4/item-1

---

## Sources

- claude-opus-5-5 — English title of a law in this collection, written for this site, written 2026-11-06
- e-Gov 法令検索, Digital Agency (デジタル庁) — 健康保険法施行令 — the text in force from 2026-10-01 (https://laws.e-gov.go.jp/law/215IO0000000243/20261001_508CO0000000276), retrieved 2026-11-06
- claude-sonnet-5-5 — Machine translation, batch health-insurance-act-enforcement-order-20261106T164949-028, translated 2026-11-07
- This site's parser, version 229 — 健康保険法施行令 — structure, counts, cross-references and defined terms, computed 2026-11-06