# 健康保険法施行令 / Order for Enforcement of the Health Insurance Act — 第十九条 (Supplementary Provisions, Article 19) This is the Markdown twin of https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19. 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. - 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: 第十九条 (Supplementary Provisions, Article 19) — address `suppl-5082-240/art-19` - 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-5082-240/art-19 - 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. --- ### 第十九条 suppl-5082-240/art-19 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19 **第一項** 保険者は、新健康保険法施行令第四十一条の三第一項の規定により、被保険者に対し、高額療養費を支給する場合において、新健康保険法施行令第四十一条の二第一項ただし書に規定する基準日（新健康保険法施行令第四十三条第十二項の規定により基準日とみなされる日を含む。次項において「基準日」という。）の属する月の標準報酬月額が十六万円未満の被保険者である者（新健康保険法施行令第四十二条第十一項第四号に掲げる者を除く。）に該当していることにつき保険者の確認を受けている者については、第二号新健康保険法施行令第四十二条第十一項（第四号に係る部分に限る。）の規定の例による高額療養費算定基準額を用いて、当該高額療養費を算定するものとする。 suppl-5082-240/art-19/par-1 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-1 Where an insurer pays high-cost medical expenses to an insured person pursuant to the provisions of Article 41-3, paragraph (1) of the New Order for Enforcement of the Health Insurance Act, for a person who has received confirmation by the insurer that the person falls under an insured person whose standard monthly remuneration for the month that includes the reference date prescribed in the proviso to Article 41-2, paragraph (1) of the New Order for Enforcement of the Health Insurance Act (including the day deemed to be the reference date pursuant to Article 43, paragraph (12) of the New Order for Enforcement of the Health Insurance Act; hereinafter referred to as the "reference date" in the following paragraph) is less than 160,000 yen (excluding persons listed in Article 42, paragraph (11), item (iv) of the New Order for Enforcement of the Health Insurance Act), the insurer is to calculate those high-cost medical expenses using the base amount for calculating high-cost medical expenses in accordance with the provisions of Article 42, paragraph (11) (limited to the part relating to item (iv)) of the item (ii) New Order for Enforcement of the Health Insurance Act. machine translation, not official **第二項** 保険者は、新健康保険法施行令第四十一条の三第二項の規定により、被保険者に対し、高額療養費を支給する場合において、基準日の属する月の標準報酬月額が十六万円未満の被保険者である者（新健康保険法施行令第四十二条第十二項第四号又は第五号に掲げる者を除く。）に該当していることにつき保険者の確認を受けている者については、第二号新健康保険法施行令第四十二条第十二項（第四号に係る部分に限る。）の規定の例による七十歳以上年間高額療養費算定基準額を用いて、当該高額療養費を算定するものとする。 suppl-5082-240/art-19/par-2 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-2 Where an insurer pays high-cost medical expenses to an insured person pursuant to the provisions of Article 41-3, paragraph (2) of the New Order for Enforcement of the Health Insurance Act, for a person who has received confirmation by the insurer that the person falls under an insured person whose standard monthly remuneration for the month that includes the reference date is less than 160,000 yen (excluding persons listed in Article 42, paragraph (12), item (iv) or (v) of the New Order for Enforcement of the Health Insurance Act), the insurer is to calculate those high-cost medical expenses using the annual base amount for calculating high-cost medical expenses for persons aged 70 or over in accordance with the provisions of Article 42, paragraph (12) (limited to the part relating to item (iv)) of the item (ii) New Order for Enforcement of the Health Insurance Act. machine translation, not official **第三項** 前二項の確認は、厚生労働省令で定めるところにより、新健康保険法施行令第四十一条の三の規定による高額療養費の支給を受ける者の申請により、又は職権で保険者が行うものとする。 suppl-5082-240/art-19/par-3 · https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-3 The confirmation under the preceding two paragraphs is to be made by the insurer, as provided by Order of the Ministry of Health, Labour and Welfare, upon the application of the person who receives payment of high-cost medical expenses under the provisions of Article 41-3 of the New Order for Enforcement of the Health Insurance Act, or by its own authority. machine translation, not official --- ## Cites - suppl-5082-240/art-19/par-1: 新健康保険法施行令第四十一条の三第一項 → 健康保険法施行令 第四十一条の三第一項 (Article 41-3, paragraph (1)), art-41-3/par-1 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-41-3/par-1 - suppl-5082-240/art-19/par-1: 新健康保険法施行令第四十一条の二第一項 → 健康保険法施行令 第四十一条の二第一項 (Article 41-2, paragraph (1)), art-41-2/par-1 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-41-2/par-1 - suppl-5082-240/art-19/par-1: 新健康保険法施行令第四十三条第十二項 → 健康保険法施行令 第四十三条第十三項 (Article 43, paragraph (13)), art-43/par-13 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-43/par-13 - suppl-5082-240/art-19/par-1: 次項 → 健康保険法施行令 附則第十九条第二項 (Supplementary Provisions, Article 19, paragraph (2)), suppl-5082-240/art-19/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-2 - suppl-5082-240/art-19/par-1: 新健康保険法施行令第四十二条第十一項第四号 → 健康保険法施行令 第四十二条第十一項第四号 (Article 42, paragraph (11), item (iv)), art-42/par-11/item-4 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-11/item-4 - suppl-5082-240/art-19/par-1: 第二号新健康保険法施行令第四十二条第十一項 → 健康保険法施行令 第四十二条第十一項 (Article 42, paragraph (11)), art-42/par-11 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-11 - suppl-5082-240/art-19/par-2: 新健康保険法施行令第四十一条の三第二項 → 健康保険法施行令 第四十一条の三第二項 (Article 41-3, paragraph (2)), art-41-3/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-41-3/par-2 - suppl-5082-240/art-19/par-2: 新健康保険法施行令第四十二条第十二項第四号 → 健康保険法施行令 第四十二条第十二項第四号 (Article 42, paragraph (12), item (iv)), art-42/par-12/item-4 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-12/item-4 - suppl-5082-240/art-19/par-2: 第五号 → 健康保険法施行令 第四十二条第十二項第五号 (Article 42, paragraph (12), item (v)), art-42/par-12/item-5 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-12/item-5 - suppl-5082-240/art-19/par-2: 第二号新健康保険法施行令第四十二条第十二項 → 健康保険法施行令 第四十二条第十二項 (Article 42, paragraph (12)), art-42/par-12 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-42/par-12 - suppl-5082-240/art-19/par-3: 前二項 → 健康保険法施行令 附則第十九条第一項 (Supplementary Provisions, Article 19, paragraph (1)), suppl-5082-240/art-19/par-1 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-1 - suppl-5082-240/art-19/par-3: 前二項 → 健康保険法施行令 附則第十九条第二項 (Supplementary Provisions, Article 19, paragraph (2)), suppl-5082-240/art-19/par-2 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-2 - suppl-5082-240/art-19/par-3: 新健康保険法施行令第四十一条の三 → 健康保険法施行令 第四十一条の三 (Article 41-3), art-41-3 — https://japanlaw.org/en/health-insurance-act-enforcement-order/art-41-3 ## Cited by 4 provisions cite this one. No official source publishes this direction. - 健康保険法施行令 附則第二条第一項（健康保険法施行令の一部改正に伴う準備行為） — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-2/par-1 - 健康保険法施行令 附則第三条第一項 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-3/par-1 - 健康保険法施行令 附則第十九条第一項 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-1 - 健康保険法施行令 附則第十九条第三項 — https://japanlaw.org/en/health-insurance-act-enforcement-order/suppl-5082-240/art-19/par-3 --- ## 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-20261106T164949-034, 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