Article 2The affairs specified by Cabinet Order that are provided for in Article 48 of the Act are as follows:

Article 3The state of disability of a degree of severity specified by Cabinet Order as prescribed in Article 50, item (ii) of the Act is as prescribed in the Appended Table.

Article 4Deleted

Article 5The technical replacement of terms pursuant to the provisions of Article 55-2, paragraph (2) of the Act is as in the following table.

Article 6The laws and regulations specified by Cabinet Order that are provided for in Article 57, paragraph (1) of the Act are as follows:

Article 7(1)The amount of income pursuant to the provisions of Article 67, paragraph (1), items (ii) and (iii) of the Act is to be calculated with regard to the income in the year preceding the year including the day on which the person receives the benefits for medical treatment (if the month including the day on which the person receives the benefits for medical treatment is from January to July, the year before the preceding year; hereinafter the same applies in this paragraph), and the amount is to be the amount listed in item (i) (in the case of a person who is a householder as of December 31 of the year preceding the year including the day on which the person receives the benefits for medical treatment and who is under 19 years of age and belongs to the same household as the householder as of the same date and whose total income amount for the same year (meaning the total income amount prescribed in Article 292, paragraph (1), item (xiii) of the Local Tax Act (Act No. 226 of 1950), and in the case where the total income amount of the person under 19 years of age includes salary income prescribed in Article 28, paragraph (1) of the Income Tax Act (Act No. 33 of 1965), the salary income is to be calculated by deducting 100,000 yen from the amount calculated pursuant to the provisions of paragraph (2) of the same Article (if the amount is less than zero, it is to be zero)) is 380000 yen or less (referred to as a "person eligible for a deduction" in item (ii)), the amount is to be the amount obtained by deducting the amount listed in item (ii) from the amount listed in item (i)):

(2)The amount specified by Cabinet Order that is provided for in Article 67, paragraph (1), item (ii) of the Act is 280000 yen.

(3)The provisions of the preceding paragraph do not apply to a person who falls under any of the following items:

(4)The amount specified by Cabinet Order that is provided for in Article 67, paragraph (1), item (iii) of the Act is 1.45 million yen.

(5)The provisions of the preceding paragraph do not apply to a person who falls under any of the following items:

Article 8(1)In the case where the provisions of Article 64 of the Health Insurance Act (Act No. 70 of 1922) are applied mutatis mutandis pursuant to the provisions of Article 74, paragraph (10) of the Act, the term "medical care covered by health insurance" in the same Article is deemed to be replaced with "medical care covered by late-stage elderly medical care", the term "a physician or dentist, or a pharmacist engaged in dispensing of medicine covered by health insurance at a pharmacy providing services covered by health insurance" is deemed to be replaced with "a physician or dentist", and the term "a physician or dentist (hereinafter collectively referred to as a" physician providing health insurance treatment ") or a pharmacist (hereinafter referred to as a" pharmacist filling health insurance prescriptions ")" is deemed to be replaced with "a physician or dentist".

(2)Beyond what is provided for in the preceding paragraph, the technical replacement of terms under Article 74, paragraph (10) of the Act is as in the following table.

Article 9(1)In the case where the provisions of Article 64 of the Health Insurance Act are applied mutatis mutandis pursuant to the provisions of Article 75, paragraph (7) of the Act, the term "medical care covered by health insurance" in the same Article is deemed to be replaced with "medical care covered by late-stage elderly medical care", the term "a physician or dentist, or a pharmacist engaged in dispensing of medicine covered by health insurance at a pharmacy providing services covered by health insurance" is deemed to be replaced with "a physician or dentist", and the term "a physician or dentist (hereinafter collectively referred to as a" physician providing health insurance treatment ") or a pharmacist (hereinafter referred to as a" pharmacist filling health insurance prescriptions ")" is deemed to be replaced with "a physician or dentist".

(2)Beyond what is provided for in the preceding paragraph, the technical replacement of terms under Article 75, paragraph (7) of the Act is as in the following table.

Article 10(1)In the case where the provisions of Article 64 of the Health Insurance Act are applied mutatis mutandis pursuant to the provisions of Article 76, paragraph (6) of the Act, the term "health insurance" in the same Article is deemed to be replaced with "medical care for elderly people".

(2)Beyond what is provided for in the preceding paragraph, the technical replacement of terms under Article 76, paragraph (6) of the Act is as in the following table.

Article 11The technical replacement of terms under the provisions of Article 78, paragraph (8) of the Act is as in the following table.

Article 12(1)A designated home-nursing provider (meaning the designated home-nursing provider prescribed in Article 59, paragraph (3) of the Act; the same applies hereinafter) is to claim medical expenses for home-nursing by the date specified by Order of Order of the Ministry of Health, Labour and Welfare.

(2)Beyond what is provided for in the preceding paragraph, necessary matters concerning claims for medical expenses for home-nursing are specified by Order of the Order of the Ministry of Health, Labour and Welfare.

Article 12-2The special circumstances to be specified by Cabinet Order as prescribed in Article 82, paragraph (1) of the Act are the circumstances in which the insurer is found to be unable to pay insurance premiums due to any of the following reasons:

Article 12-3The special circumstances to be specified by Cabinet Order as prescribed in Article 82, paragraph (4) of the Act are that the amount of delinquent insurance premiums of insured has significantly decreased or the circumstances prescribed in the preceding Article.

Article 13(1)In the case where the provisions of Article 64 of the Health Insurance Act are applied mutatis mutandis pursuant to the provisions of Article 82, paragraph (6) of the Act, the term "health insurance" in the same Article is deemed to be replaced with "medical care for elderly people".

(2)Beyond what is provided for in the preceding paragraph, the technical replacement of terms under the provisions of Article 82, paragraph (6) of the Act is as in the following table.

Article 14(1)High-cost medical expenses are to be paid in the case where the amount obtained by deducting the amount of high-cost medical expenses to be paid pursuant to the provisions of the following paragraph or paragraph (3) from the sum of the following amounts (hereinafter referred to as the "total sum of households' co-payment, etc." in this paragraph) exceeds the base amount for calculating high-cost medical expenses, and the amount is to be calculated by adding the amount obtained by deducting the base amount for calculating high-cost medical expenses from the total sum of households' co-payment, etc. to the amount calculated by insured.Idea (Bean jam)(meaning the amount arrived at when the amount arrived at when the amount of high-cost medical expenses paid pursuant to the provisions of the following paragraph or paragraph (3) is deducted from the sum total of the following amounts for medical treatment received by the insured in the same month (hereinafter referred to as the "total sum of insured's co-payment, etc.") is divided by the total sum of household's co-payment, etc.)

(2)High-cost medical expenses are to be paid in the case where the amount obtained by deducting the amount of high-cost medical expenses to be paid pursuant to the provisions of the following paragraph from the total of the following amounts pertaining to the medical treatment (referred to as "medical treatment subject to special provisions upon reaching 75 years of age" in Article 15) received by a person who acquired eligibility for an insured on a day other than the first day of a month due to coming to fall under Article 52, item (i) of the Act in the month which includes that day (limited to the period on or after that day) exceeds the base amount for calculating high-cost medical expenses, and the amount is to be the amount obtained by deducting the base amount for calculating high-cost medical expenses from the deducted amount:

(3)High-cost medical expenses are to be paid in the case where the total of the following amounts pertaining to the outpatient treatment (meaning the medical treatments listed in Article 64, paragraph (1), items (i) through (iv) of the Act (excluding those associated with the medical treatment listed in item (v) of the same paragraph); the same applies in the following Article and Article 15, paragraph (4), item (ii) and paragraph (5), items (iii) and (iv)) received by an insured (excluding the case where the provisions of Article 67, paragraph (1), item (iii) of the Act are applied) in the same month exceeds the base amount for calculating high-cost medical expenses, and the amount is to be the amount obtained by deducting the base amount for calculating high-cost medical expenses from the total amount:

(4)In the case where a insured receives specific medical treatment subject to benefits (excluding medical treatment subject to benefits for specified diseases prescribed in the following paragraph in the case where the insured has received certification of a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the same paragraph, and medical treatment prescribed in paragraph (6) in the case where the insured has received certification of a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the same paragraph), when the amounts listed in paragraph (1), item (i), (a) through (j) pertaining to the specific medical treatment subject to benefits received by the insured in the same month for one hospital, clinics, pharmacies, or other persons (referred to as "hospitals, etc." in the following paragraph and paragraph (6)) respectively exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (j) of the same item is paid as high-cost medical expenses.

(5)In the case where a insured receives medical treatment covered by benefits for specified diseases (meaning medical treatment covered by benefits (excluding medical treatment prescribed in the following paragraph in the case where the insured is certified as a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of the same paragraph) for which benefits related to medical care specified by the Minister of Health, Labour and Welfare as prescribed in Article 41, paragraph (7) of the Order for Enforcement of the Health Insurance Act (Imperial Order No. 243 of 1926) are to be paid; the same applies in Article 15, paragraph (5)), when the insured that received the medical treatment covered by benefits for specified diseases is certified as a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of an Order of the Order of the Ministry of Health, Labour and Welfare, and the amounts listed in paragraph (1), item (i), (a) through (j) pertaining to the medical treatment covered by benefits for specified diseases received by the insured from a single hospital, etc. in the same month exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (j) of the same item is paid as high-cost medical expenses.

(6)If an insured receives medical treatment (excluding dietary treatment and living support) for diseases specified by the Minister of Health, Labour and Welfare as diseases that fall under all of the following items, and the insured that received the medical treatment is certified as a Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of Order of the Order of the Ministry of Health, Labour and Welfare, and the amounts listed in paragraph (1), item (i), (a) through (j) pertaining to the medical treatment that the insured received in the same month at one hospital, etc. respectively exceed the base amount for calculating high-cost medical expenses, the amount obtained by deducting the base amount for calculating high-cost medical expenses from the amounts listed in (a) through (j) of the same item is paid as high-cost medical expenses:

(7)Notwithstanding the provisions of paragraph (1), if a insured is a person exempt from taxation on municipal inhabitants tax households and holds the right to receive benefits from a Senior Welfare Pension under the National Pension Act (Act No. 141 of 1959) prior to its amendment pursuant to the provisions of Article 1 of the Act Partially Amending the National Pension Act (Act No. 34 of 1985) which prior laws continue to govern pursuant to the provisions of Article 32, paragraph (1) of the Supplementary Provisions of that Act (other than a Senior Welfare Pension the payment of which has been suspended in full; referred to as a "high-cost medical expense" in Article 16-2, paragraph (2)), and the amount arrived at when the base amount for calculating high-cost medical expenses is deducted from the total sum of the insured's co-payment, etc. for medical treatment that the insured received in the same month exceeds the amount of high-cost medical expenses to be paid to the insured pursuant to the provisions of paragraph (1), the amount of high-cost medical expenses to be paid to the insured is the amount arrived at when the base amount for calculating high-cost medical expenses is deducted from the total sum of the insured's co-payment, etc.

Article 14-2(1)In the case where the sum of the following amounts (hereinafter referred to as the "total amount of insured on the reference date" in this paragraph) exceeds the base amount for calculating high-cost medical expenses, high-cost medical expenses are to be paid to the insured on the reference date prescribed in item (i), and the amount is to be the amount obtained by multiplying the amount obtained by deducting the base amount for calculating high-cost medical expenses from the total amount of insured on the reference date by the high-cost medical expenses allocation rate (meaning the rate obtained by dividing the amount set forth in the same item by the total amount of insured on the reference date); provided, however, that this does not apply to the case where the provisions of Article 67, paragraph (1), item (iii) of the Act apply to the insured on the reference date (meaning the last day of the accounting period (meaning the period from August 1 of each year to July 31 of the following year; the same applies hereinafter); the same applies hereinafter):

(2)The provisions of the preceding paragraph apply mutatis mutandis to the payment of high-cost medical expenses to a person who was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period (limited to a person who was an insured of another Association of Medical Care Systems for the Elderly Aged 75 and older on the reference date). In this case, the terms set forth in the middle column of the following table in the provisions set forth in the left-hand column of the same table are deemed to be replaced with the terms set forth respectively in the right-hand column of the same table.

(3)High-cost medical expenses for a person who was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period (limited to a person who is a Partner, etc. of a Society, etc. (excluding a Householder, etc. of a national health insurance plan who is an insured as prescribed in paragraph (6)) as of the base date; hereinafter referred to as a "Partner, etc. on the Base Date" in this paragraph) are to be paid if the amount set forth in item (i) exceeds the base amount for calculating high-cost medical expenses, and the amount is to be the amount obtained by multiplying the amount set forth in item (ii) by the rate set forth in item (iii); provided, however, that this does not apply if the Partner, etc. on the Base Date is a person equivalent to a person to whom the provisions of Article 67, paragraph (1), item (iii) of the Act apply as of the base date:

(4)The provisions of the preceding paragraph apply mutatis mutandis to the payment of high-cost medical expenses to a person who was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period (limited to a person who is a dependent, etc. of a partner, etc. of a partnership, etc. on the reference date). In this case, the term "a partner, etc. on the reference date" in item (i) of the same paragraph is deemed to be replaced with "a partner, etc. on the reference date (meaning a person who is a partner, etc. of a partnership, etc. on the reference date; the same applies in item (iii))", and the term "item (iii)" is deemed to be replaced with "item (iii)".

(5)The term "Society, etc." as used in paragraph (1) (including as applied mutatis mutandis pursuant to paragraph (2)), paragraph (3) (including as applied mutatis mutandis pursuant to the preceding paragraph), and the preceding paragraph means a Japan Health Insurance Association as an insurer of health insurance (excluding insurance of a specially-insured day laborer insured (meaning a specially-insured day laborer insured as prescribed in Article 3, paragraph (2) of the Health Insurance Act; the same applies in Article 16-3, paragraph (3))), a health insurance society, a Japan Health Insurance Association as an insurer under the Article 123, paragraph (1) of that Act, a Japan Health Insurance Association that provides benefits related to medical care pursuant to the provisions of the Mariners Insurance Act, a municipality (including a special ward), a national health insurance society, a mutual aid association under the National Public Officers mutual aid association Act (Act No. 128 of 1958) or the local public employee mutual aid association Act (Act No. 152 of 1962), or the Promotion and Mutual Aid Corporation for Private Schools.

(6)The term "Partner or Member" as used in paragraph (1) (including as applied mutatis mutandis pursuant to paragraph (2)), paragraph (3) (including as applied mutatis mutandis pursuant to paragraph (4)), and paragraph (4) means a insured covered by health insurance (including a person who was a specially-insured day laborer insured (meaning a person who was a specially-insured day laborer insured prescribed in Article 41-2, paragraph (9) of the Order for Enforcement of the Health Insurance Act; the same applies in Article 16-3, paragraph (3))), a insured covered by mariners' insurance, a partner of a mutual aid association under the National Public Officers' mutual aid association Act or the local public employee mutual aid association Act, a member of an Private School Teachers mutual aid plan under the provisions of the Private School Teachers Mutual Aid Act (Act No. 245 of 1953), the head of a household to which a insured covered by national health insurance belongs, or a partner of a national health insurance society (hereinafter referred to as a "Householder.

(7)The term "dependent, etc." as used in paragraph (1) (including as applied mutatis mutandis pursuant to paragraph (2)), paragraph (3), item (i) (including as applied mutatis mutandis pursuant to paragraph (4)), and paragraph (4) means a dependent pursuant to the provisions of the Health Insurance Act, the Mariners Insurance Act, the National Public Officers' mutual aid association Act (including as applied mutatis mutandis pursuant to other Acts), or the local public employee, etc. mutual aid association Act, or a insured covered by national health insurance other than the Householder, etc. of a national health insurance who belongs to the same household as the Householder, etc. of a national health insurance.

Article 15(1)The base amount for calculating high-cost medical expenses as referred to in Article 14, paragraph (1) is the amount specified in the relevant of the following items for the category of persons set forth in that item:

(2)The base amount for calculating high-cost medical expenses referred to in Article 14, paragraph (2) is the amount specified in the relevant of the following items for the category of persons set forth in that item:

(3)The base amount for calculating high-cost medical expenses as referred to in Article 14, paragraph (3) is the amount specified in the relevant of the following items for the category of persons set forth in that item (or, for medical treatment subject to special provisions upon reaching 75 years of age, the amount arrived at when the amount specified in that item is multiplied by one half):

(4)The base amount for calculating high-cost medical expenses referred to in Article 14, paragraph (4) is the amount specified in the relevant of the following items in accordance with the category of cases set forth in that item (or, for medical treatment subject to special provisions upon reaching 75 years of age, the amount obtained by multiplying the amount specified in that item by one half):

(5)The base amount for calculating high-cost medical expenses as referred to in Article 14, paragraph (5) is the amount specified in the relevant of the following items for the category of case set forth in that item:

(6)The base amount for calculating high-cost medical expenses referred to in Article 14, paragraph (6) is 10,000 yen (or 5000 yen for medical treatment subject to special provisions upon reaching 75 years of age).

(7)The base amount for calculating high-cost medical expenses referred to in Article 14, paragraph (7) is 15000 yen.

(8)The base amount for calculating high-cost medical expenses referred to in paragraph (1) of the preceding Article (including as applied mutatis mutandis pursuant to paragraph (2) of that Article) and paragraph (3) of that Article (including as applied mutatis mutandis pursuant to paragraph (4) of that Article) is 144000 yen each.

Article 16(1)In the case where an insured receives medical treatment at a single Medical Institution Providing Services Covered by Health Insurance, etc. (meaning the Medical Institution Providing Services Covered by Health Insurance, etc. prescribed in Article 57, paragraph (3) of the Act; hereinafter the same applies in this Article) or a designated home-nursing provider (hereinafter referred to as the "Medical Institution, etc." in this Article) in the same month, when co-payment, the amount of co-payment for medical expenses combined with treatment outside insurance coverage (meaning the amount calculated by deducting the amount of medical expenses combined with treatment outside insurance coverage from the amount of expenses calculated for medical treatment pertaining to the payment of the medical expenses combined with treatment outside insurance coverage in the case where the provisions of Article 74, paragraph (5) of the Act, as applied mutatis mutandis pursuant to Article 76, paragraph (6) of the Act, apply to the payment of medical expenses combined with treatment outside insurance coverage; the same applies hereinafter), or the amount of co-payment for medical expenses for home-nursing (meaning the amount calculated by deducting the amount of the medical expenses for home-nursing from the amount of expenses calculated for designated home-nursing pertaining to the payment of the medical expenses for home-nursing in the case where the provisions of Article 74, paragraph (5) of the Act, as applied mutatis mutandis pursuant to Article 78, paragraph (8) of the Act, apply to the payment of medical expenses for home-nursing; the same applies hereinafter) is not made, the Association of Medical Care Systems for the Elderly Aged 75 and older is to pay, on behalf of the insured, to the Medical Institution, etc., high-cost medical expenses to be paid to the insured pursuant to the provisions of Article 14, paragraphs (1) through (3) (including expenses whose amount is calculated pursuant to the provisions of paragraph (7) of the same Article; the same applies in:

(2)When a payment pursuant to the provisions of the preceding paragraph is made, it is deemed that high-cost medical expenses pursuant to the provisions of Article 14, paragraphs (1) through (3) are paid to the insured to the extent of the payment.

(3)In the case where insured has received medical treatment for which medical expenses for general diseases caused by atomic bombs or other medical treatment benefits specified by Order of the Ministry of Health, Labour and Welfare are to be paid with regard to medical institutions, etc., or where insured that has received certification from the Association of Medical Care Systems for the Elderly Aged 75 and older pursuant to the provisions of Article 14, paragraph (6) has received medical treatment prescribed in the same paragraph with regard to medical institutions, etc., if co-payment, the amount of co-payment for medical expenses combined with treatment outside insurance coverage, or the amount of co-payment for medical expenses for home-nursing has not been made, the Association of Medical Care Systems for the Elderly Aged 75 and older is to pay to the medical institutions, etc. an amount equivalent to the amount to be paid to the insured as high-cost medical expenses pursuant to the provisions of paragraphs (4) through (6) of the same Article.

(4)When a payment pursuant to the provisions of the preceding paragraph has been made, it is deemed that high-cost medical expenses pursuant to the provisions of Article 14, paragraphs (4) through (6) have been paid to the insured.

(5)With regard to the application of the provisions of Article 14, paragraphs (4) through (6) and the provisions of paragraph (1), a medical institution providing services covered by health insurance, etc. that provides both dental care and medical care other than dental care is deemed to be different medical institution providing services covered by health insurance, etc. for dental care and medical care other than dental care, respectively.

(6)If an insured receives medical treatment including the medical treatment listed in Article 64, paragraph (1), item (v) of the Act and other medical treatment in the same month at a single Medical Institution Providing Services Covered by Health Insurance, etc., with regard to the application of the provisions of Article 14, paragraphs (4) through (6), the medical treatment including the medical treatment listed in the same item and other medical treatment are deemed to be received at different Medical Institutions Providing Services Covered by Health Insurance, etc.

(7)With regard to the payment of high-cost medical expenses under the provisions of Article 14-2 in the case where an insured forfeits its eligibility during an accounting period and does not become an Person Covered by Medical Insurance (meaning an insured or a member prescribed in Article 7, paragraph (4) of the Act; the same applies in Article 16-4, paragraph (1)) during the accounting period on or after the day on which the eligibility is forfeited, or in other cases specified by the Order of the Ministry of Health, Labour and Welfare, the provisions of Article 14-2 and paragraph (8) of the preceding Article apply by deeming the day preceding the date (in cases specified by the Order of the Ministry of Health, Labour and Welfare, the day specified by the Order of the Ministry of Health, Labour and Welfare) to be the base date.

(8)Necessary matters concerning the procedures for the payment of high-cost medical expenses are specified by Order of the Ministry of Health, Labour and Welfare.

Article 16-2(1)Sizable medical and nursing expenses is to be paid to a insured on the base date in the case where the sum of the following amounts (hereinafter referred to as the "total sum of households' co-payment for long-term care" in this paragraph) exceeds the sum of the base amount for calculating the total amount of long-term care plus the base amount for payment prescribed in Article 43-2, paragraph (1) of the Order for Enforcement of the Health Insurance Act (hereinafter referred to as the "base amount for payment" in this Article), and the amount is to be the amount obtained by multiplying the amount obtained by deducting the base amount for calculating the total amount of long-term care from the total sum of households' co-payment for long-term care plus the base amount for calculation by the total long-term care allocation rate (meaning the rate obtained by dividing the amount listed in item (i) by the total sum of households' co-payment for long-term care plus the base amount for calculation) by the insured's total long-term care allocation rate (meaning the rate obtained by dividing the amount listed in the same item pertaining to the medical treatment received by a insured on the base date prescribed in the same item by the amount listed in the same item); provided, however, that this does not apply when the sum of the amounts listed in items (i) through (iii) or the sum of the amounts listed in items (iv) and (v):

(2)If the Amount of insured on the Base Date is a Person Exempt from Local Taxes (meaning a person (including a person who is exempted from the municipal inhabitants tax pursuant to the provisions of a Municipal Ordinance, and excluding a person who does not have domicile in the place where the Order of the Ministry of Health, Labour and Welfare Act is enforced as of the date of assessment of the municipal inhabitants tax) pursuant to the provisions of the Local Tax Act for the fiscal year preceding the fiscal year to which the Base Date belongs (if any day from August 1 to March 31 of the preceding year is deemed to be the Base Date pursuant to the provisions of Article 16-4, paragraph (1), the fiscal year to which the day deemed to be the Base Date belongs) (the Head and all household members of the household to which the person belongs are deemed to be exempt from the municipal inhabitants tax as of the day specified by the municipal inhabitants tax in the month to which the Base Date belongs; the same applies in paragraph (1), item (iii) of the following Article) and the person has the right to receive benefits from a Senior Welfare Pension, and the sum of the amounts set forth in items (i) through (iii) of the preceding paragraph pertaining to the medical treatment received by the insured on the Base Date, the amount set forth in the same item pertaining to the medical treatment received by a dependent, etc. of the insured on the Base Date, and the amounts set forth in items (iv) and (v) of the same paragraph pertaining to In-Home Service, etc. or Preventive Long-Term Care Service, etc. received by the insured on the Base Date (hereinafter referred to as the "Total Amount of Co-payment for a Senior Welfare Pension Recipient insured, etc." in this paragraph) exceeds the amount obtained by adding the Total Base Amount of Long-Term Care Calculation and the Payment Base Amount, and the amount obtained by multiplying the amount obtained by deducting the Total Base Amount of Co-payment for a Senior Welfare Pension Recipient insured, etc. from the Total Amount of Co-payment for a Senior Welfare Pension Recipient insured, etc. by the Total Long-Term Care Allocation Rate (meaning the rate obtained by dividing the amount set forth in item (i) of the preceding paragraph pertaining to the medical treatment received by the insured on the Base Date by the Total Amount of Co-payment for a Sizable medical and nursing expenses Recipient insured, etc.; the same applies hereinafter in this paragraph) exceeds the amount of Sizable medical and nursing expenses to be paid for the insured on the Base Date pursuant to the provisions of the preceding paragraph, the amount of surcharge to be paid for the insured on the Base Date is the amount obtained by multiplying the amount obtained by deducting the Senior Welfare Pension insured insured insured

(3)The provisions of the preceding two paragraphs apply mutatis mutandis to the payment of Sizable medical and nursing expenses to a person who was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period (limited to a person who was an insured of another Association of Medical Care Systems for the Elderly Aged 75 and older on the reference date). In this case, the phrase "(the amount set forth in item (i)" in paragraph (1) is deemed to be replaced with "(the total sum prescribed in item (i) pertaining to the medical treatment received by a person prescribed in paragraph (3) who belongs to the same household as of the reference date during the time when the person was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period (hereinafter referred to as the" total sum of households' co-payment for insured expenses set forth in paragraph (3) "in this paragraph)", the phrase "the amount set forth in the same item pertaining to the medical treatment received by an insured on the reference date prescribed in the same item is deemed to be replaced with the total sum prescribed in item (i) pertaining to the medical treatment received by a person prescribed in paragraph (3) during the time when the person was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period is deemed to be replaced with the total sum of households' co-payment for insured expenses set forth in paragraph (3)", the phrase "insured for a household on the reference date" in item (i) of the same paragraph is deemed to be replaced with "the insured of another Association of Medical Care Systems for the Elderly Aged 75 and older (hereinafter referred to as the" insured for a household on the reference date "in this Article) to which a person who was an insured of the relevant Association of Medical Care Systems for the Elderly Aged 75 and older on the reference date (hereinafter referred to as the" insured on the reference date "in this Article) belongs as of the reference date (hereinafter referred to as the" on the reference date "in this Article), the phrase" of the Association of Medical Care Systems for the Elderly Aged 75 and older "is deemed to be replaced with" of the other Association of Medical Care Systems for the Elderly Aged 75 and older (referred to as the "Association of Medical Care Systems for the Elderly Aged 75 and older on the reference date" in the following item) ", the phrase" the amount set forth in item (i) of the preceding paragraph pertaining to the medical treatment received by the insured on the reference date insured Association of Medical Care Systems for the Elderly Aged 75 and older Association of Medical Care Systems for the Elderly Aged 75 and older.

(4)Sizable medical and nursing expenses for a person who was an insured of the Association of Medical Care Systems for the Elderly Aged 75 and older during the accounting period (limited to a person who is a Member, etc. (excluding a Householder, etc. of a national health insurance plan who is an insured) or a dependent, etc. on the Base Date) is to be paid if the amount obtained by deducting the total amount of combined long-term care payment for persons 70 years of age or older (meaning the amount obtained by deducting the base amount for combined long-term care calculation set forth in paragraph (6) from the total household amount of combined co-payment for long-term care for persons 70 years of age or older set forth in the same paragraph (if the amount is equal to or less than the base amount for payment or if the calculation of the total household amount of combined co-payment for long-term care for persons 70 years of age or older falls under the proviso of the same paragraph, the amount is zero)) from the sum of the amounts equivalent to the amounts set forth in the items of paragraph (1) calculated as specified by Order of the Ministry of Health, Labour and Welfare by deeming the person who is a Member, etc. or the dependent, etc. to be the insured on the Base Date (hereinafter referred to as the "Total Amount of Burden Subject to Aggregation" in this paragraph through paragraph (6)) (hereinafter referred to as the "Total Household Amount of Combined Co-payment for Long-Term Care" in this paragraph and item (i) of the following paragraph) exceeds the amount obtained by adding the base amount for combined long-term care calculation to the base amount for payment, and the amount is the amount obtained by multiplying the amount obtained by deducting the base amount for combined long-term care calculation from the total household amount of combined co-payment for long-term care, etc. by the combined long-term care allocation rate and then multiplying the product by the combined long-term care allocation rate; provided, however, that this does not apply when the sum of the Total Amount of Burden Subject insured

(5)The combined long-term care allocation rate and the combined insured long-term care allocation rate set forth in the preceding paragraph listed in the following items are the rates specified respectively in the following items:

(6)If the sum of the amount calculated pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare as the amount equivalent to the amount pertaining to medical treatment, In-Home Service, etc., or Preventive Long-Term Care Service, etc., received in or after the month following the month including the day on which the person reaches 70 years of age (hereinafter referred to as the "Amount Subject to Aggregation" in this paragraph and the following paragraph) out of the Amount Subject to Aggregation (hereinafter referred to as the "Total Sum of Household Co-Payment for Total Long-Term Care for 70 years of Age or Older" in this paragraph) exceeds the sum of the Base Amount for Total Long-Term Care Calculation and the Payment Base Amount, the amount obtained by first deducting the Base Amount for Total Long-Term Care Calculation from the Total Sum of Household Co-Payment for Total Long-Term Care for 70 years of Age or Older, multiplying the product by the Total Long-Term Care Allocation Rate for 70 years of Age or Older, and then multiplying the product by the Total Long-Term Care Allocation Rate for insured for 70 years of Age or Older is paid as a Sizable medical and nursing expenses to the person prescribed in paragraph (4); provided, however, that this does not apply when the sum of the Amount Subject to.

(7)The combined proportion for long-term care for 70 years of age or older and the combined proportion for insured long-term care for 70 years of age or older set forth in the preceding paragraph set forth in the following items are the rates specified respectively in the following items:

Article 16-3(1)The base amount for calculating the total amount of long-term care referred to in paragraph (1) of the preceding Article (including as applied mutatis mutandis pursuant to paragraph (3) of the same Article) is the amount specified in each of the following items according to the classification of persons set forth in the following items:

(2)The base amount for calculating the total amount of long-term care referred to in paragraph (2) of the preceding Article (including as applied mutatis mutandis pursuant to paragraph (3) of the same Article) is 190000 yen.

(3)With regard to the base amount for calculating the total amount of long-term care set forth in paragraph (4) of the preceding Article, the provisions listed in the middle column of the following table apply mutatis mutandis according to the category of persons listed in the left-hand column of the same table respectively; and with regard to the base amount for calculating the total amount of long-term care for 70 years of age or older set forth in paragraph (6) of the same Article, the provisions listed in the right-hand column of the same table apply mutatis mutandis according to the category of persons listed in the left-hand column of the same table respectively. In this case, the necessary technical replacement of terms is specified by Order of the Ministry of Health, Labour and Welfare.

Article 16-4(1)With regard to the payment of the Sizable medical and nursing expenses in the case where a insured forfeits its eligibility during an accounting period and does not become an Person Covered by Medical Insurance during the accounting period on or after the day on which the Order of the Ministry of Health, Labour and Welfare forfeits its eligibility or in other cases specified by the Order of the Ministry of Health, Labour and Welfare, the provisions of the preceding two Articles apply by deeming the day preceding the relevant day (in the case specified by the Order of the Ministry of Health, Labour and Welfare, the day specified by the Labor Standards Order) to be the base date.

(2)Order of the Ministry of Health, Labour and Welfare provides for the necessary particulars concerning the procedures for the payment of Sizable medical and nursing expenses.

Article 17The provisions of Article 12-2 apply mutatis mutandis to the special circumstances specified by Cabinet Order as prescribed in Article 92, paragraphs (1) and (2) of the Act.

Article 18(1)The standards specified by Cabinet Order prescribed in the main clause of paragraph (2) of the same Article pertaining to the calculation of insurance premiums imposed by a Association of Medical Care Systems for the Elderly Aged 75 and older on a insured (excluding a the proviso to Article 104, paragraph (2) whose address is in an area that falls under the standards specified by the Minister of Health, Labour and Welfare of the insured of the Act (hereinafter referred to as a "insured in a Specified Area"); hereinafter the same applies in this paragraph) are as follows:

(2)The standards specified by Cabinet Order as prescribed in the the proviso to Article 104, paragraph (2) of the Act pertaining to the calculation of insurance premiums imposed by a Association of Medical Care Systems for the Elderly Aged 75 and older on a insured in a specified region are as follows:

(3)The standards specified by Cabinet Order prescribed in paragraph (2) of the same Article with regard to the total sum of the total amount of insurance premiums that the Association of Medical Care Systems for the Elderly Aged 75 and older imposes on Article 104, paragraph (2) pursuant to the provisions of insured of the Act for each fiscal year during the specified period (hereinafter referred to as the "total amount of insurance premiums imposed" in this paragraph) (including the amount to be reduced if the per capita amount of insured insurance premiums calculated based on the provisions of paragraph (1) or the preceding paragraph is to be reduced in accordance with the standards prescribed in the following paragraph or paragraph (5)) are as follows:

(4)The standards specified by Cabinet Order as prescribed in insured of the Act pertaining to the calculation of insurance premiums imposed by a Association of Medical Care Systems for the Elderly Aged 75 and older on a Article 104, paragraph (2) with small income are as follows:

(5)The standards specified by Cabinet Order as prescribed in insured of the Act pertaining to the calculation of insurance premiums imposed on Article 104, paragraph (2) where the Association of Medical Care Systems for the Elderly Aged 75 and older was a dependent are as follows:

Article 19Those specified by Cabinet Order as prescribed in the Article 107, paragraph (1) of the Act are the Article 110 that are not subject to the special collection of insurance premiums pursuant to the provisions of the Long-Term Care Insurance Act applied mutatis mutandis in the Long-Term Care Insurance Act of the Act (hereinafter referred to as the "insured applied mutatis mutandis").

Article 20(1)Pension benefits specified by Cabinet Order as prescribed in Article 107, paragraph (2) of the Act are pension benefits specified in Article 40, paragraph (1) of the Order for Enforcement of the Long-Term Care Insurance Act Act.

(2)Benefits similar to pension benefits specified by Cabinet Order as prescribed in Article 107, paragraph (2) of the Act are to be benefits similar to pension benefits specified in Article 40, paragraph (2) of the Order for Enforcement of Long-Term Care Insurance Act.

Article 21The technical replacement of terms concerning the mutatis mutandis application of Article 110 pursuant to the provisions of Long-Term Care Insurance Act of the Act is as in the following table.

Article 22The amount specified by Cabinet Order, referred to in Article 134, paragraph (1), item (i) and paragraphs (2) through (6), Long-Term Care Insurance Act as Applied Mutatis Mutandis, is 180000 yen.

Article 23Long-Term Care Insurance Act as applied mutatis mutandis The insured specified by Cabinet Order that is provided for in Article 135, paragraphs (1) through (3) means a region that falls under any of the following:

Article 24In a case as prescribed in Article 135, paragraph (6), Long-Term Care Insurance Act, as applied mutatis mutandis, insurance premiums are to be collected for an Old Age, etc., pension benefit pertaining to the special collection of insurance premiums of Long-Term Care Insurance pursuant to the provisions of Long-Term Care Insurance Act.

Article 25The technical replacement of terms pursuant to the provisions of Article 138, paragraph (2), Long-Term Care Insurance Act as Applied Mutatis Mutandis (including the cases where it is applied mutatis mutandis in Article 140, paragraph (3), Long-Term Care Insurance Act as Applied Mutatis Mutandis) is as follows.

Article 26The technical replacement of terms pursuant to the provisions of Article 140, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis is as follows.

Article 27The technical replacement of terms under the provisions of Article 141, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis is as follows.

Article 28(1)The provisions of the Long-Term Care Insurance Act Articles 136 through 138 (excluding the Article 137, paragraphs (4) and (5), and paragraph (9) of the same Act (limited to the part pertaining to paragraph (5) of the same Article)) and the Article 140 apply mutatis mutandis to the case where the notice pursuant to the provisions of the Long-Term Care Insurance Act Article 134, paragraph (2) applied mutatis mutandis is given and the insurance premiums are to be collected by the method of special collection pursuant to the provisions of the Long-Term Care Insurance Act Article 135, paragraph (2), and paragraphs (5) and (6) applied mutatis mutandis (limited to the part pertaining to paragraph (2) of the same Article). In this case, each term or phrase listed in the middle column of the following table in the provisions of the Long-Term Care Insurance Act listed in the left-hand column of the same table is deemed to be replaced with the corresponding term or phrase listed in the right-hand column of the same table.

(2)The technical replacement of terms under the provisions of Article 138, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to the preceding paragraph (including as applied mutatis mutandis in Article 140, paragraph (3) of the same Act as applied mutatis mutandis pursuant to the preceding paragraph) is as in the following table.

(3)The technical replacement of terms under the provisions of Article 140, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to paragraph (1) is as shown in the following table.

Article 29(1)The provisions of the Long-Term Care Insurance Act Articles 136 through 138 (excluding the Article 137, paragraphs (4) and (5), and paragraph (9) of the same Act (limited to the part pertaining to paragraph (5) of the same Article)) and the Article 140 apply mutatis mutandis to the case where the notice pursuant to the provisions of the Long-Term Care Insurance Act Article 134, paragraph (3) as applied mutatis mutandis is given and insurance premiums are to be collected by the method of special collection pursuant to the provisions of the Long-Term Care Insurance Act Article 135, paragraph (2), and paragraphs (5) and (6) as applied mutatis mutandis (limited to the part pertaining to paragraph (2) of the same Article). In this case, each term or phrase listed in the middle column of the following table in the provisions of the Long-Term Care Insurance Act listed in the left-hand column of the same table is deemed to be replaced with the corresponding term or phrase listed in the right-hand column of the same table.

(2)The technical replacement of terms under the provisions of Article 138, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to the preceding paragraph (including as applied mutatis mutandis in Article 140, paragraph (3) of the same Act as applied mutatis mutandis pursuant to the preceding paragraph) is as in the following table.

(3)The technical replacement of terms under the provisions of Article 140, paragraph (3), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to paragraph (1) is as shown in the following table.

Article 30(1)The provisions of the Long-Term Care Insurance Act Articles 136 through 139 (excluding the Article 136, paragraph (2) and Article 137, paragraphs (4) and (5), and paragraph (9) of the same Act (limited to the part pertaining to paragraph (5) of the same Article)) apply mutatis mutandis to the case where a notice is given pursuant to the provisions of the Long-Term Care Insurance Act Article 134, paragraph (2), or paragraph (3) as applied mutatis mutandis (excluding the case where part of the insurance premiums for the fiscal year imposed on the insured pertaining to the notice pursuant to the provisions of the Long-Term Care Insurance Act Article 135, paragraph (2) as applied mutatis mutandis are collected by the method of special collection) or where a notice is given pursuant to the provisions of the Long-Term Care Insurance Act Article 134, paragraph (4) as applied mutatis mutandis, and the insurance premiums are to be collected by the method of special collection pursuant to the provisions of the Long-Term Care Insurance Act Article 135, paragraph (3), and paragraphs (5) and (6) as applied mutatis mutandis (limited to the part pertaining to paragraph (3) of the same Article). In this case, each term or phrase listed in the middle column of the following table in the provisions of the Long-Term Care Insurance Act listed in the left-hand column of the same table is deemed to be replaced with the corresponding term or phrase listed in the right-hand column of the same table.

(2)The technical replacement of terms under the provisions of Article 138, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to the preceding paragraph is as shown in the following table.

Article 31(1)The provisions of the Long-Term Care Insurance Act Articles 136 through 139 (excluding the Article 136, paragraph (2) and Article 137, paragraphs (4) and (5), and paragraph (9) of the same Act (limited to the part pertaining to paragraph (5) of the same Article)) apply mutatis mutandis to the case where the notice pursuant to the provisions of the Long-Term Care Insurance Act Article 134, paragraph (5) as applied mutatis mutandis is given and the insurance premiums are to be collected by the method of special collection pursuant to the provisions of the Long-Term Care Insurance Act Article 135, paragraph (3), and paragraphs (5) and (6) as applied mutatis mutandis (limited to the part pertaining to paragraph (3) of the same Article). In this case, each term or phrase listed in the middle column of the following table in the provisions of the Long-Term Care Insurance Act listed in the left-hand column of the same table is deemed to be replaced with the corresponding term or phrase listed in the right-hand column of the same table.

(2)The technical replacement of terms under the provisions of Article 138, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to the preceding paragraph is as shown in the following table.

Article 32(1)The provisions of the Long-Term Care Insurance Act Articles 136 through 139 (excluding the Article 136, paragraph (2) and Article 137, paragraphs (4) and (5), and paragraph (9) of the same Act (limited to the part pertaining to paragraph (5) of the same Article)) apply mutatis mutandis to the case where the notice pursuant to the provisions of the Long-Term Care Insurance Act Article 134, paragraph (6) as applied mutatis mutandis is given and the insurance premiums are to be collected by the method of special collection pursuant to the provisions of the Long-Term Care Insurance Act Article 135, paragraph (3), and paragraphs (5) and (6) as applied mutatis mutandis (limited to the part pertaining to paragraph (3) of the same Article). In this case, each term or phrase listed in the middle column of the following table in the provisions of the Long-Term Care Insurance Act listed in the left-hand column of the same table is deemed to be replaced with the corresponding term or phrase listed in the right-hand column of the same table.

(2)The technical replacement of terms under the provisions of Article 138, paragraph (2), Long-Term Care Insurance Act as applied mutatis mutandis pursuant to the preceding paragraph is as shown in the following table.

Article 33Deleted

Article 34The technical replacement of terms pursuant to the provisions of the Article 130 of the Act is as follows.

Article 35The provisions of Article 30, Article 34, Article 35, and Article 37 of the Order for Enforcement of the National Health Insurance Act apply mutatis mutandis to the procedures for a request for examination by the Certification Committee for Old-Old Healthcare and the Article 128, paragraph (1) of the Act. In this case, each term or phrase listed in the middle column of the following table that appears in the provisions of the same Order listed in the left-hand column of the same table is deemed to be replaced with the corresponding term or phrase listed in the right-hand column of the same table.

Article 36The cases specified by Cabinet Order that are provided for in the Article 133, paragraph (2) of the Act are the following cases: