# 健康保険法 / Health Insurance Act — 第百十五条 (Article 115) - 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: 第百十五条 (Article 115)（高額療養費） — address `art-115` - Text in force since: 2026-10-01 - URL (the page that opens at this provision): https://japanlaw.org/ja/health-insurance-act/art-115 - Permanent URL (e-Gov law ID, never renamed): https://japanlaw.org/l/211AC0000000070/art-115 - 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. --- ### 第百十五条（高額療養費） — (High-Cost Medical Expenses) caption: Ministry of Justice translation — Japanese Law Translation Database System art-115 · https://japanlaw.org/ja/health-insurance-act/art-115 · https://japanlaw.org/l/211AC0000000070/art-115 **第一項** 療養の給付について支払われた一部負担金の額又は療養（食事療養及び生活療養を除く。次項において同じ。）に要した費用の額からその療養に要した費用につき保険外併用療養費、療養費、訪問看護療養費、家族療養費若しくは家族訪問看護療養費として支給される額に相当する額を控除した額（次条第一項において「一部負担金等の額」という。）が著しく高額であるときは、その療養の給付又はその保険外併用療養費、療養費、訪問看護療養費、家族療養費若しくは家族訪問看護療養費の支給を受けた者に対し、高額療養費を支給する。 art-115/par-1 · https://japanlaw.org/ja/health-insurance-act/art-115/par-1 · https://japanlaw.org/l/211AC0000000070/art-115/par-1 When the amount of co-payment made in relation to benefits for medical treatment or the amount calculated by deducting, from the amount of expenses incurred in medical treatment (excluding dietary treatment and living support; the same applies hereinafter in the following paragraph), an amount equivalent to the amount paid as medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing, dependent's medical expenses, or dependent's medical expenses for home-nursing in relation to the medical treatment (referred to as the "amount of co-payment, etc." in paragraph (1) of the following Article) is extremely large, the insurer pays high-cost medical expenses to the person who received payment of the benefits for medical treatment, or medical expenses combined with treatment outside insurance coverage, medical expenses, medical expenses for home-nursing expenses, dependent's medical expenses, or dependent's medical expenses for home-nursing. Ministry of Justice translation — Japanese Law Translation Database System **第二項** 高額療養費の支給要件、支給額その他高額療養費の支給に関して必要な事項は、療養に必要な費用の負担の家計、とりわけ長期にわたって継続的に療養を受ける者の家計に与える影響及び療養に要した費用の額を考慮して、政令で定める。 art-115/par-2 · https://japanlaw.org/ja/health-insurance-act/art-115/par-2 · https://japanlaw.org/l/211AC0000000070/art-115/par-2 The requirements for payment of high-cost medical expenses, the amount thereof, and other necessary matters concerning the payment of high-cost medical expenses are specified by Cabinet Order by taking into consideration the impact of sharing of costs necessary for the relevant medical treatment on household finances, in particular the household finances of persons who receive medical treatment continuously over a long period, and the amount of expenses incurred in the medical treatment. machine translation, not official --- ## Cites - art-115/par-1: 次項 → 健康保険法 第百十五条第二項 (Article 115, paragraph (2)), art-115/par-2 — https://japanlaw.org/ja/health-insurance-act/art-115/par-2 · https://japanlaw.org/l/211AC0000000070/art-115/par-2 - art-115/par-1: 次条第一項 → 健康保険法 第百十五条の二第一項 (Article 115-2, paragraph (1)), art-115-2/par-1 — https://japanlaw.org/ja/health-insurance-act/art-115-2/par-1 · https://japanlaw.org/l/211AC0000000070/art-115-2/par-1 ## Cited by 4 provisions cite this one. No official source publishes this direction. - 健康保険法 第百十五条第一項（高額療養費） — https://japanlaw.org/ja/health-insurance-act/art-115/par-1 · https://japanlaw.org/l/211AC0000000070/art-115/par-1 - 健康保険法 第百十五条の二第一項（高額介護合算療養費） — https://japanlaw.org/ja/health-insurance-act/art-115-2/par-1 · https://japanlaw.org/l/211AC0000000070/art-115-2/par-1 - 健康保険法 第百十五条の二第二項（高額介護合算療養費） — https://japanlaw.org/ja/health-insurance-act/art-115-2/par-2 · https://japanlaw.org/l/211AC0000000070/art-115-2/par-2 - 健康保険法 第百四十九条第一項（準用） — https://japanlaw.org/ja/health-insurance-act/art-149/par-1 · https://japanlaw.org/l/211AC0000000070/art-149/par-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-20261010T183826-003, 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