# 健康保険法 / Health Insurance Act — 第七十六条 (Article 76) - Law: 健康保険法 (Health Insurance Act), 大正十一年法律第七十号 - English title "Health Insurance Act": 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: 第七十六条 (Article 76)（療養の給付に関する費用） — address `art-76` - Text in force since: 2026-10-01 - URL (the page that opens at this provision): https://japanlaw.org/en/health-insurance-act/art-76 - Permanent URL (e-Gov law ID, never renamed): https://japanlaw.org/l/211AC0000000070/art-76 - 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. --- ### 第七十六条（療養の給付に関する費用） — (Expenses for Benefits for Medical Treatment) caption: Ministry of Justice translation — Japanese Law Translation Database System art-76 · https://japanlaw.org/en/health-insurance-act/art-76 · https://japanlaw.org/l/211AC0000000070/art-76 **第一項** 保険者は、療養の給付に関する費用を保険医療機関又は保険薬局に支払うものとし、保険医療機関又は保険薬局が療養の給付に関し保険者に請求することができる費用の額は、療養の給付に要する費用の額から、当該療養の給付に関し被保険者が当該保険医療機関又は保険薬局に対して支払わなければならない一部負担金に相当する額を控除した額とする。 art-76/par-1 · https://japanlaw.org/en/health-insurance-act/art-76/par-1 · https://japanlaw.org/l/211AC0000000070/art-76/par-1 Insurers is to pay expenses related to benefits for medical treatment to medical institutions providing services covered by health insurance and pharmacies providing services covered by health insurance. The amount of expenses which a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance may claim to an insurer in relation to benefits for medical treatment is calculated by deducting the amount of co-payment payable to the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance by the insured person in relation to the benefits for medical treatment from the amount of expenses incurred in providing the benefits for medical treatment. Ministry of Justice translation — Japanese Law Translation Database System **第二項** 前項の療養の給付に要する費用の額は、厚生労働大臣が定めるところにより、算定するものとする。 art-76/par-2 · https://japanlaw.org/en/health-insurance-act/art-76/par-2 · https://japanlaw.org/l/211AC0000000070/art-76/par-2 The amount of expenses for benefits for medical treatment referred to in the preceding paragraph is to be calculated as specified by the Minister of Health, Labour and Welfare. Ministry of Justice translation — Japanese Law Translation Database System **第三項** 保険者は、厚生労働大臣の認可を受けて、保険医療機関又は保険薬局との契約により、当該保険医療機関又は保険薬局において行われる療養の給付に関する第一項の療養の給付に要する費用の額につき、前項の規定により算定される額の範囲内において、別段の定めをすることができる。 art-76/par-3 · https://japanlaw.org/en/health-insurance-act/art-76/par-3 · https://japanlaw.org/l/211AC0000000070/art-76/par-3 An insurer may, with the authorization of the Minister of Health, Labour and Welfare, specify otherwise in a contract with a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance with respect to the amount of expenses incurred in providing the benefits for medical treatment referred to in paragraph (1) to be provided at the medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance within the range of the amount calculated pursuant to the provisions of the preceding paragraph. Ministry of Justice translation — Japanese Law Translation Database System **第四項** 保険者は、保険医療機関又は保険薬局から療養の給付に関する費用の請求があったときは、第七十条第一項及び第七十二条第一項の厚生労働省令並びに前二項の定めに照らして審査の上、支払うものとする。 art-76/par-4 · https://japanlaw.org/en/health-insurance-act/art-76/par-4 · https://japanlaw.org/l/211AC0000000070/art-76/par-4 When receiving a claim for expenses incurred in providing medical services from a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance, the insurer is to make payment after conducting an examination in light of the provisions of Order of the Ministry of Health, Labour and Welfare referred to in Article 70, paragraph (1) and Article 72, paragraph (1) and the provisions of the preceding two paragraphs. Ministry of Justice translation — Japanese Law Translation Database System **第五項** 保険者は、前項の規定による審査及び支払に関する事務を医療情報基盤・診療報酬審査支払機構法（昭和二十三年法律第百二十九号）による医療情報基盤・診療報酬審査支払機構（以下「基盤機構」という。）又は国民健康保険法第四十五条第五項に規定する国民健康保険団体連合会（以下「国保連合会」という。）に委託することができる。 art-76/par-5 · https://japanlaw.org/en/health-insurance-act/art-76/par-5 · https://japanlaw.org/l/211AC0000000070/art-76/par-5 An insurer may delegate affairs concerning the examination and payment pursuant to the provisions of the preceding paragraph to the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (hereinafter referred to as the "Infrastructure Organization") under the Medical Information Infrastructure and Medical Fee Examination and Payment Organization Act (Act No. 129 of 1948) or a federation of National Health Insurance Associations prescribed in Article 45, paragraph (5) of the National Health Insurance Act (hereinafter referred to as the "NHI federation"). machine translation, not official **第六項** 前各項に定めるもののほか、保険医療機関又は保険薬局の療養の給付に関する費用の請求に関して必要な事項は、厚生労働省令で定める。 art-76/par-6 · https://japanlaw.org/en/health-insurance-act/art-76/par-6 · https://japanlaw.org/l/211AC0000000070/art-76/par-6 Beyond what is provided for in the preceding paragraphs, necessary matters concerning claims for expenses incurred in providing medical services at a medical institution providing services covered by health insurance or pharmacy providing services covered by health insurance are specified by Order of the Ministry of Health, Labour and Welfare. Ministry of Justice translation — Japanese Law Translation Database System --- ## Cites - art-76/par-2: 前項 → 健康保険法 第七十六条第一項 (Article 76, paragraph (1)), art-76/par-1 — https://japanlaw.org/en/health-insurance-act/art-76/par-1 · https://japanlaw.org/l/211AC0000000070/art-76/par-1 - art-76/par-3: 第一項 → 健康保険法 第七十六条第一項 (Article 76, paragraph (1)), art-76/par-1 — https://japanlaw.org/en/health-insurance-act/art-76/par-1 · https://japanlaw.org/l/211AC0000000070/art-76/par-1 - art-76/par-3: 前項 → 健康保険法 第七十六条第二項 (Article 76, paragraph (2)), art-76/par-2 — https://japanlaw.org/en/health-insurance-act/art-76/par-2 · https://japanlaw.org/l/211AC0000000070/art-76/par-2 - art-76/par-4: 第七十条第一項 → 健康保険法 第七十条第一項 (Article 70, paragraph (1)), art-70/par-1 — https://japanlaw.org/en/health-insurance-act/art-70/par-1 · https://japanlaw.org/l/211AC0000000070/art-70/par-1 - art-76/par-4: 第七十二条第一項 → 健康保険法 第七十二条第一項 (Article 72, paragraph (1)), art-72/par-1 — https://japanlaw.org/en/health-insurance-act/art-72/par-1 · https://japanlaw.org/l/211AC0000000070/art-72/par-1 - art-76/par-4: 前二項 → 健康保険法 第七十六条第二項 (Article 76, paragraph (2)), art-76/par-2 — https://japanlaw.org/en/health-insurance-act/art-76/par-2 · https://japanlaw.org/l/211AC0000000070/art-76/par-2 - art-76/par-4: 前二項 → 健康保険法 第七十六条第三項 (Article 76, paragraph (3)), art-76/par-3 — https://japanlaw.org/en/health-insurance-act/art-76/par-3 · https://japanlaw.org/l/211AC0000000070/art-76/par-3 - art-76/par-5: 前項 → 健康保険法 第七十六条第四項 (Article 76, paragraph (4)), art-76/par-4 — https://japanlaw.org/en/health-insurance-act/art-76/par-4 · https://japanlaw.org/l/211AC0000000070/art-76/par-4 - art-76/par-5: 国民健康保険法第四十五条第五項 → e-Gov law 333AC0000000192, 第四十五条第五項 (Article 45, paragraph (5)), art-45/par-5 — not held in this collection - art-76/par-6: 前各項 → 健康保険法 第七十六条第一項 (Article 76, paragraph (1)), art-76/par-1 — https://japanlaw.org/en/health-insurance-act/art-76/par-1 · https://japanlaw.org/l/211AC0000000070/art-76/par-1 - art-76/par-6: 前各項 → 健康保険法 第七十六条第二項 (Article 76, paragraph (2)), art-76/par-2 — https://japanlaw.org/en/health-insurance-act/art-76/par-2 · https://japanlaw.org/l/211AC0000000070/art-76/par-2 - art-76/par-6: 前各項 → 健康保険法 第七十六条第三項 (Article 76, paragraph (3)), art-76/par-3 — https://japanlaw.org/en/health-insurance-act/art-76/par-3 · https://japanlaw.org/l/211AC0000000070/art-76/par-3 - art-76/par-6: 前各項 → 健康保険法 第七十六条第四項 (Article 76, paragraph (4)), art-76/par-4 — https://japanlaw.org/en/health-insurance-act/art-76/par-4 · https://japanlaw.org/l/211AC0000000070/art-76/par-4 - art-76/par-6: 前各項 → 健康保険法 第七十六条第五項 (Article 76, paragraph (5)), art-76/par-5 — https://japanlaw.org/en/health-insurance-act/art-76/par-5 · https://japanlaw.org/l/211AC0000000070/art-76/par-5 ## Cited by 19 provisions cite this one. No official source publishes this direction. - 健康保険法 第七十四条第一項（一部負担金） — https://japanlaw.org/en/health-insurance-act/art-74/par-1 · https://japanlaw.org/l/211AC0000000070/art-74/par-1 - 健康保険法 第七十六条第二項（療養の給付に関する費用） — https://japanlaw.org/en/health-insurance-act/art-76/par-2 · https://japanlaw.org/l/211AC0000000070/art-76/par-2 - 健康保険法 第七十六条第三項（療養の給付に関する費用） — https://japanlaw.org/en/health-insurance-act/art-76/par-3 · https://japanlaw.org/l/211AC0000000070/art-76/par-3 - 健康保険法 第七十六条第四項（療養の給付に関する費用） — https://japanlaw.org/en/health-insurance-act/art-76/par-4 · https://japanlaw.org/l/211AC0000000070/art-76/par-4 - 健康保険法 第七十六条第五項（療養の給付に関する費用） — https://japanlaw.org/en/health-insurance-act/art-76/par-5 · https://japanlaw.org/l/211AC0000000070/art-76/par-5 - 健康保険法 第七十六条第六項（療養の給付に関する費用） — https://japanlaw.org/en/health-insurance-act/art-76/par-6 · https://japanlaw.org/l/211AC0000000070/art-76/par-6 - 健康保険法 第七十七条第一項（療養の給付に要する費用の額の定めに関する厚生労働大臣の調査） — https://japanlaw.org/en/health-insurance-act/art-77/par-1 · https://japanlaw.org/l/211AC0000000070/art-77/par-1 - 健康保険法 第七十七条第二項（療養の給付に要する費用の額の定めに関する厚生労働大臣の調査） — https://japanlaw.org/en/health-insurance-act/art-77/par-2 · https://japanlaw.org/l/211AC0000000070/art-77/par-2 - 健康保険法 第八十二条第一項（社会保険医療協議会への諮問） — https://japanlaw.org/en/health-insurance-act/art-82/par-1 · https://japanlaw.org/l/211AC0000000070/art-82/par-1 - 健康保険法 第八十五条第九項（入院時食事療養費） — https://japanlaw.org/en/health-insurance-act/art-85/par-9 · https://japanlaw.org/l/211AC0000000070/art-85/par-9 - 健康保険法 第八十五条の二第五項（入院時生活療養費） — https://japanlaw.org/en/health-insurance-act/art-85-2/par-5 · https://japanlaw.org/l/211AC0000000070/art-85-2/par-5 - 健康保険法 第八十六条第二項第一号（保険外併用療養費） — https://japanlaw.org/en/health-insurance-act/art-86/par-2/item-1 · https://japanlaw.org/l/211AC0000000070/art-86/par-2/item-1 - 健康保険法 第八十六条第四項（保険外併用療養費） — https://japanlaw.org/en/health-insurance-act/art-86/par-4 · https://japanlaw.org/l/211AC0000000070/art-86/par-4 - 健康保険法 第八十七条第三項（療養費） — https://japanlaw.org/en/health-insurance-act/art-87/par-3 · https://japanlaw.org/l/211AC0000000070/art-87/par-3 - 健康保険法 第百十条第三項（家族療養費） — https://japanlaw.org/en/health-insurance-act/art-110/par-3 · https://japanlaw.org/l/211AC0000000070/art-110/par-3 - 健康保険法 第百十条第七項（家族療養費） — https://japanlaw.org/en/health-insurance-act/art-110/par-7 · https://japanlaw.org/l/211AC0000000070/art-110/par-7 - 健康保険法 第百四十九条第一項（準用） — https://japanlaw.org/en/health-insurance-act/art-149/par-1 · https://japanlaw.org/l/211AC0000000070/art-149/par-1 - 健康保険法 第二百五条の四第一項（基盤機構等への事務の委託） — https://japanlaw.org/en/health-insurance-act/art-205-4/par-1 · https://japanlaw.org/l/211AC0000000070/art-205-4/par-1 - 健康保険法 第二百五条の四第一項第一号（基盤機構等への事務の委託） — https://japanlaw.org/en/health-insurance-act/art-205-4/par-1/item-1 · https://japanlaw.org/l/211AC0000000070/art-205-4/par-1/item-1 --- ## Sources - e-Gov 法令検索, Digital Agency (デジタル庁) — 健康保険法 — the text in force from 2026-10-01 (https://laws.e-gov.go.jp/law/211AC0000000070/20261001_507AC0000000087), retrieved 2026-10-10 - Japanese Law Translation Database System, Ministry of Justice (法務省) — Health Insurance Act — Ministry of Justice translation (https://www.japaneselawtranslation.go.jp/en/laws/view/3266/tb), retrieved 2026-10-10 - claude-sonnet-5-5 — Machine translation, batch health-insurance-act-20261010T193238-001, translated 2026-10-11 - This site's parser, version 189 — 健康保険法 — structure, counts, cross-references and defined terms, computed 2026-10-10