Adding/removing a family member
Health insurance provides insurance benefits not just to insured persons but also to their dependent family members. These family members are referred to as “dependents”. Family members must meet certain conditions related to “residency in Japan,” “the extent of the family relationship,” and “income” before they are authorized as dependents.
- Description
- Procedures
- FAQ
- POINT
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- Dependents must be certified by the Health Insurance Society.
- If there is any change in your dependents, submit notification of the change within five days.
- Note:Submit the above documents within five working days of the date on which the reason for dependency arose (including that date). If the Health Insurance Society receives the documents within five days and certifies dependency, certification will be retroactive to the date on which the reason for dependency arose.
If the documents are received more than five working days later, the date of certification will be the date on which the Health Insurance Society received the documents and certified dependency. Contact the Society in advance if you expect delays.(For a newborn child, the date of certification will be the date of birth.)
However, for a newborn child, the date of certification will be the date of birth, regardless of the date the documents are received.
(Although the five-day rule does not apply, please try to submit the documents as quickly as possible.)
Dependent certification
The Health Insurance Society certifies whether family members qualify as dependents based on laws, regulations, and official notices governing health insurance. The dependent certification process reviews various particulars, including whether the insured person is the main provider of the family member's livelihood and is able to be the main provider continuously.
In the Health Insurance Society certification process, it is vital that the insured person and family members, who best know the conditions of their annual income and livelihoods, properly understand the dependent certification system.
In addition, since certification of an ineligible family member would result in use of valuable health premiums to pay for insured medical care for ineligible persons and serious costs to the employer and other insured persons, the Society will cancel the eligibility of dependents subject to falsified applications or for which no applications were submitted and bill them for all costs paid by the Society (medical care costs and health activities) while they were ineligible.
- Start by checking to make sure you can apply to name the family member as a dependent!
＜＜List of documents required for dependent certification＞＞
- Reference link
- Applying to name a child as a dependent (newborn, student)
- Applying to name a child as a dependent (e.g., certification after leaving employment)
- Handling of self-employed family members (including agricultural workers)
- Applying to name a spouse as a dependent
- Applying to name an actual (adopted) parent or a mother or father in law with you as a dependent
Extent of family relationship
Only family members within the third degree of consanguinity may be certified as dependents. Conditions for dependent eligibility also vary depending on whether or not the family member lives with the insured person.
Income standards
To be certified as a dependent, a family member must live primarily off the income of the insured person.
| If the family member lives with the insured person | If the family member lives apart from the insured person |
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| In principle, the family member’s annual income must be less than 1.3 million yen (1.8 million yen if aged 60 or above, or disabled) and it must be less than one-half the income of the insured person. | The family member's annual income must be less than 1.3 million yen (1.8 million yen if aged 60 or above, or disabled) and must be less than the amount of the allowance sent to the family member from the insured person. |
| Exception | Even if a family member’s annual income is less than 1.3 million yen, if his or her base allowance daily amount of unemployment benefits under employment insurance is 3,612 yen/day or more, he or she cannot be certified as a dependent while receiving unemployment benefits. See "While a dependent receives unemployment benefits under employment insurance." |
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New requirement concerning residency in Japan for dependent certification
From April 2020, a requirement related to residency in Japan is added to the requirements for certification of health insurance dependents. In principle, from April 1, 2020, those who do not have addresses in Japan cannot be certified as dependents (with certain exceptions—for example, students studying abroad).
Rationale underlying the domestic residency requirement
Determinations of residency are based on whether a person is registered to the basic resident register (i.e., whether or not the person has a certificate of residence). In principle, those who have certificates of residence in Japan meet the domestic residency requirement.
- Note: Even those who have certificates of residence in Japan will not satisfy the domestic residency requirement if they clearly do not reside in Japan—for example, those employed overseas.
Exceptions to the domestic residency requirement
Those whose livelihoods are recognized to be based in Japan, such as students studying abroad temporarily, are considered to meet the domestic residency requirement on an exceptional basis, even if they actually reside overseas.
【Cases qualifying as exceptions to the domestic residency requirement】
①Students studying abroad
②Family members accompanying an insured person posted abroad
③Those traveling abroad temporarily for sightseeing, recreation, volunteer activities, or other reasons unrelated to employment
④Those who enter into a family relationship to an insured person while the insured person is posted abroad
⑤In addition to those described under ①-④ above, others whose livelihoods are recognized to be based in Japan in consideration of purposes of traveling abroad and other circumstances
Cases in which a person cannot be certified as a dependent even if he or she resides in Japan
Those who come to Japan on medical visas or on long-stay visas for sightseeing or recreational purposes cannot be certified as dependents, even if they reside in Japan.
Interim measure
As an interim measure, if a person who would lose his or her eligibility as a dependent due to the addition of the domestic residency requirement is hospitalized in a medical care institution in Japan as of the date of enactment of the requirement (April 1, 2020), his or her eligibility will continue during the period of hospitalization.
If there has been a change in dependents
You must take specific steps if the number of dependents increases due to marriage or childbirth or a family member is no longer eligible as a dependent for reasons such as employment, living apart from the insured person, or death. The Health Insurance Society checks the eligibility status of dependents annually.
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