Family membership

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.

POINT

Dependents must be certified by the Health Insurance Association.
If there is any change in your dependents, submit notification of the change within five days.
Beginning in April 2024, a certificate of residence showing Individual Numbers must be attached when applying for dependent certification. See here for details.

Requirements for health insurance dependent certification

1. When the dependent cohabits with the insured person

［Income earners eligible to be named dependents］

Those whose livelihood depends on the income of the insured person
(This refers to those for whom the insured person pays most living expenses and whose principal means of support is the income of the insured person.)

Less than 60 years of age	Annual income of less than 1.3 million yen (108,334 yen /month) and less than one-half the annual income of the insured person.
60 years of age or older, or with a disability	Annual income of less than 1.8 million yen (150,000 yen /month) and less than one-half the annual income of the insured person.

[Persons eligible to be named dependents]

Persons who can either live with or apart from the insured
Relatives within the third degree of consanguinity
◆The insured person’s parents, grandparents, great-grandparents, spouse (including common-law spouse), children, grandchildren, and siblings
Persons who must cohabit with the insured to be named dependents
◆Relatives within the third degree of consanguinity other than those listed above (e.g., spouse’s parents)
◆Parents and children of the insured person’s common-law spouse

Note: Those aged 65-74 and recognized to have certain disabilities and all elderly persons aged 75 and older are insured under the Medical Care System for the Advanced Elderly and cannot be named as dependents.

2.When the dependent lives apart from the insured

In addition to the requirements under Section 1 above, the insured person must provide the dependent with an allowance greater than the dependent’s annual income.
Cohabiting with the insured means sharing the same residence and household budget. Other cases are considered as living separately.
Cohabiting or living separately is determined based on the certificate of residence submitted at the time of dependent certification.

Requirements of the AIG Health Insurance Association’s dependent certification criteria

STEP1Dependent application procedures
Your family members are eligible for coverage under your health insurance policy if your income is their principal means of support.
Check to confirm they meet the requirements described under <Step 2> before applying.
Based on the documents you submit, the AIG Health Insurance Association will comprehensively determine whether your family members meet the requirements to be named dependents. Note that in certain cases, depending on how their living expenses are paid, family members cannot be authorized as dependents, even if they meet these requirements.
STEP2Requirements for dependents

Dependent certification criteria

Dependent	Spouse, children, parents, grandparents, great-grandparents, grandchildren, siblings	Spouse’s parents, spouse’s children, other relatives within the third degree of consanguinity
Category	Dependent on insured for living	Dependent on insured for living and cohabiting with the insured
Income requirements	(1) Annual income base amount 1 (i) Under 60: less than 1.3 million yen (108,333 yen equivalency/month) (ii) 60 or above or with disabilities: less than 1.8 million yen (149,999 yen equivalency/month) (2) Income = salary (including commuting allowance), unemployment allowance,2 and pension or other such income (For self-employed individuals and others with business income, this determination is made based on the actual income amount.) (3) For those cohabiting with the insured, income must be less than the annual income base amount and less than one-half the annual income of the insured. (4) For those living apart from the insured, income must be less than the annual income base amount and less than the amount of allowance provided by the insured.
Confirmation of allowance if living apart	(1) The fact of the provision of an allowance and amount thereof will be confirmed, except in the following cases: ① Living apart from the spouse or child due to an unaccompanied job posting ② Living apart from the child due to school attendance (2) Allowance standards The insured must remit an amount equal to or more than the dependent’s monthly income each month. (The minimum remittance amount is 50,000 yen.) The fact of the remittance will be confirmed for the most recent three months at the time of dependent certification. The fact of the remittance will be confirmed in the annual dependent certification survey. Retain all relevant statements and receipts. Acceptable remittance methods Copies of records of remittance showing the name of the remitter (insured person), name of the recipient (dependent), amount, and date of funds transfer. Such records of remittance may be a receipt for an ATM funds transfer, receipt for a funds transfer made at a bank window, or proof of Internet remittance. Direct handing of cash and copies of bank passbooks are not acceptable.	These family members are not eligible to be named dependents if they live apart from the insured.
Confirmation of primary provider	(i) In principle, the primary provider for a child must be one of his or her parents. (ii) In the case of a married couple, each spouse is the primary provider for the other. (iii) When a single household has multiple providers, the individual with the highest income is defined as the primary provider. (iv) When the dependent is one parent not cohabiting with the insured The insured person shall be deemed the primary provider if the allowance he or she provides exceeds the annual income of the other parent.

*1 If both parents are in good health, the annual income base amount shall be the amounts indicated below, depending on the age of the parents. Submit documents indicating the incomes of both parents even when applying to name only one parent as a dependent.

Age of parents	Annual income requirements	Certification results
Both parents less than 60 years of age	Parents’ total income < 1.3 million yen	Both approved
	1.3 million yen < Parents’ total income < 2.08 million yen	1.3 million yen < Parents’ total income < 2.08 million yen
	Parents’ total income > 2.08 million yen	Neither approved
One parent less than 60 years of age, one parent 60 or older	Parents’ total income < 1.55 million yen	Both approved (Subject to the condition that annual income is less than 1.3 million yen if less than 60 years of age or less than 1.8 million yen if aged 60 or older)
	1.55 million yen < Parents’ total income < 2.48 million yen	One parent (the parent having the lower annual income) approved
	Parents’ total income > 2.48 million yen	Neither approved
Both parents 60 or older	Parents’ total income < 1.8 million yen	Both approved
	1.8 million yen < Parents’ total income < 2.88 million yen	Only one parent (the parent having the lower annual income) approved
	Parents’ total income > 2.88 million yen	Neither approved

Annual income base amount for parents (both parents): cost of living adjustment for a married couple set at 80%

*2 Under the Health Insurance Act, unemployment benefits under unemployment insurance (unemployment allowance) received by a person seeking employment is also considered income. If unemployment benefit received per day as calculated using the following formula is equal to 3,612 yen or more (5,000 yen or more if aged 60 or older or someone with a disability), the family member cannot be named a dependent until receipt of unemployment benefits ends.
【Formula:】
(Base allowance daily amount × designated number of days receiving benefits) ? (waiting period [seven days] + maximum number of days benefits can be paid + designated number of days receiving benefits)

Government measures to address annual income barriers (starting in October 2023)

参考リンク

Support enhancement package for overcoming annual income barriers (Ministry of Health, Labour and Welfare)

What are annual income barriers?

Annual income barriers refer to threshold income amounts that determine whether or not taxes and social insurance premiums are incurred.
Individuals who have dependent status and work part-time or other non-regular jobs will lose their dependent status if their annual income exceeds a certain figure, and become an insured person under a company health insurance plan, National Health Insurance, or other insurance system. They will then be required to pay social insurance premiums, which may result in lower take-home pay.
One of two different annual income barriers applies for social insurance premiums, depending on company size and other factors: 1.06 million yen or 1.3 million yen.

(Source: Provisional measures to address annual income barriers (Ministry of Health, Labour and Welfare))

1.06 million yen annual income barrier	At companies with 101 or more employees, an employee will incur social insurance premiums if certain conditions, such as when monthly wages are 88,000 yen or more (i.e., annual income is approximately 1.06 million yen or more), are satisfied. 参考リンク Health insurance coverage for those working reduced hours (e.g., part-time employees)
1.3 million yen* annual income barrier	Social insurance premiums are incurred automatically without exception, since the worker no longer meets the dependent eligibility criteria.

1.06 million yen annual income barrier

At companies with 101 or more employees, an employee will incur social insurance premiums if certain conditions, such as when monthly wages are 88,000 yen or more (i.e., annual income is approximately 1.06 million yen or more), are satisfied.

参考リンク

Health insurance coverage for those working reduced hours (e.g., part-time employees)

1.3 million yen* annual income barrier

Social insurance premiums are incurred automatically without exception, since the worker no longer meets the dependent eligibility criteria.

* 1.8 million yen if aged 60 or above or disabled

Handling for the 1.3 million yen annual income barrier

Requirements for health insurance dependent certification include the family member’s annual income being less than 1.3 million yen (less than 1.8 million yen if 60 years of age or older or with a disability) and less than one-half the annual income of the insured. However, dependent certification may be based on an amount of income not including temporary increases by submitting an employer’s certificate of temporary income fluctuation for dependent certification and a copy of the employment contract, along with the documents normally required.
(This measure is applicable for no more than two consecutive years for a single person.)

Employer’s certificate

[Notes]

① When it is clear that the projected annual income will exceed 1.3 million yen from the terms of the employment contract or other conditions which provide for constant receipt of an amount in excess of the income requirement or due to an increase in base pay, the income increase will not be recognized as temporary.
② This measure does not apply to those who do not have an employment relationship with a specific employer, such as freelancers or the self-employed.
③ The Association will make a comprehensive judgment after confirming all documents submitted for dependent certification. Note that submitting an employer’s certificate does not necessarily mean that the dependent will be certified.

Handling for the 1.06 million yen annual income barrier

Companies that help increase worker income through means such as payment of allowances to encourage social insurance coverage* will be provided subsidies for a finite term.

* Allowances to encourage social insurance coverage
These allowances are intended to encourage employee insurance coverage for those working reduced hours and to reduce the burden of insurance premiums when workers who had been ineligible for insurance are newly covered by insurance.
Allowances to encourage social insurance coverage are to be paid apart from salaries and bonuses. They are not considered when calculating the standard monthly remuneration or standard bonuses used to determine insurance premiums.

* Eligible persons: Those with standard monthly remuneration of 104,000 yen or less
* Maximum allowance amount excluded from standard remuneration: Amount equivalent to the insurance premiums newly incurred by the employee due to insurance coverage
* A time-limited measure not to exceed two years

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]

(1) Students studying abroad
(2) Family members accompanying an insured person posted abroad
(3) Those traveling abroad temporarily for sightseeing, recreation, volunteer activities, or other reasons unrelated to employment
(4) Those who enter into a family relationship to an insured person while the insured person is posted abroad
(5) In 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 Association checks the eligibility status of dependents annually.

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