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.
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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.
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.
Living together
This refers to the state of living in the same residence and on the same household budget with the insured person.
Even in cases in which the resident registration shows separate households (separate heads of household), if the address is the same and the residence and household budget are shared, they are considered cases of living together. However, if the household budgets are separate even though the address is the same, like two-household residences, such cases are regarded as cases of living separately.
Cases in which the insured person lives apart due to an unaccompanied job posting by his or her company are considered cases of living together.
The Health Insurance Society dependent certification criteria
The following conditions must be satisfied for a family member to be certified as a dependent.
If he or she has multiple sources of income, each income will be converted to an annual amount. We will then confirm that the total of all annual amounts is less than 1.3 million yen (1.8 million yen if aged 60 or older or a disability pension recipient) to determine whether he or she qualifies as a dependent.
- He or she must reside in Japan and be registered as a resident.
- He or she must be within the third degree of consanguinity of the insured person and live mainly on the income of the insured.
- His or her income must satisfy the income criteria and must be less than one-half of the insured person’s income.
- He or she must not be an insured person under his or her employer’s health insurance or other social insurance programs (excluding National Health Insurance).
Income criteria
1.Basic amounts vary by type of income.
| Type of income | standard unit | Under 60 years old (excluding disability pensioners) |
60 years old or older or disability pensioners (excluding members of the medical care system for the elderly) |
Notes |
|---|---|---|---|---|
| Salary | monthly amount | Less than 108,334 yen | Less than 150,000 yen | This includes part-time jobs. Gross salary before deduction of commuting subsidies, tax exemption, etc. is considered as income. The average of the last three months is considered as the monthly income. |
| Pension | annual amount | Less than 1,300,000 yen | Less than 1,800,000 yen | Survivor pensions, corporate pensions, and private pensions are all considered income. The amount of pension payment before deduction of nursing care insurance premiums, etc. is considered as income. |
| Business income (self-employment, etc.) | annual amount | Less than 1,300,000 yen | Less than 1,800,000 yen | We will look at the amount of your income as a result of your tax return. However, if there is a special deduction for blue tax returns, that amount will be added to the amount of income and considered as income. In addition, if the amount of salary of a full-time employee of a blue business is more than the income threshold, the employee cannot be a dependent. |
| Stock dividends, interest, etc. | annual amount | Less than 1,300,000 yen | Less than 1,800,000 yen | Regular income (except for lump-sum payments) is considered income. |
| Unemployment benefits, etc. | daily amount | Less than 3,562 yen | Less than 4,932 yen | If the daily amount exceeds the standard amount, even if the period of receipt is short, the person cannot be a dependent during the period of receipt. |
| Injury and sickness benefits, maternity benefits, absence (compensation) benefits, etc. | daily amount | Less than 3,562 yen | Less than 4,932 yen | If the daily amount exceeds the standard amount, even if the period of receipt is short, the person cannot be a dependent during the period of receipt. |
- ◎“Annual” in annual income (annual amount) does not necessarily refer to the calendar year from January 1 through December 31.
The income considered is anticipated income over the future period of one year (12 months) from the time the reason for requesting dependent certification arose.
2. Naming parents, parents-in-law, etc. as dependents
Normally, married couples are considered to have strong ties in maintenance of livelihood, since they are obligated to care for each other.
If the family member named as a dependent has a spouse, both spouses’ total income criterion must be considered in addition to the criterion under 1 above.
Both parents’ total income criterion (annual amount)
| Mother, mother-in-law, etc. | |||
|---|---|---|---|
| Under 60 years old (excluding disability pensioners) |
60 years old or older or disability pensioners (excluding members of the medical care system for the elderly) | ||
| Father, father-in-law, etc. | Under 60 years old (excluding disability pensioners) |
Less than 2,600,000 yen | Less than 3,100,000 yen |
| 60 years old or older or disability pensioners (excluding members of the medical care system for the elderly) |
Less than 3,100,000 yen | Less than 3,600,000 yen |
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Even if one parent’s income satisfies the criteria, if the other’s income is so high that their total income exceeds the base amount for both parents’ total income, both parents will be deemed ineligible to be named dependents.
Dependents for whom both spouses provide
If both spouses earn income and provide for one or more children, then regardless of their number, the children will be the dependents of the spouse whose annual income (i.e., income expected over the coming one-year period based on past, present, and future income and other considerations) is higher.
However, if the difference in annual income between the spouses is no more than 10% of the annual income of the spouse who earns more, the children are deemed to be dependents of the spouse on whom they depend mainly for their living by notification to the insurer.
If the insured person's projected income over the coming one-year period will be less than that of the spouse due to time taken for maternity leave or childcare leave or for other reasons, submit a notification to the spouse’s insurer to name the newly born child as a dependent of the spouse.
However, during such leave, to ensure the stability of dependent status, a dependent already certified by the Hitachi Health Insurance Society will remain the dependent of the spouse of whom he or she currently is a dependent.
Living separately
Since a condition of being a dependent is that the family member rely mainly on the insured person’s income for his or her living, when naming a family member who lives apart from the insured as a dependent, he or she must be provided an allowance that satisfies all of the following conditions, in addition to having income that satisfies the income criteria:
Allowance conditions:
- Must be of an amount greater than the monthly income of the person to be named a dependent.
- Must be of an amount of at least 50,000 yen/month.
- Must be of an amount of less than one-half the insured person’s income.
- Must be provided every month.
- * In principle, allowances delivered by hand or provided at one time for multiple months are not acceptable.
- * Please provide the allowance in a manner in which monthly documentation of the allowance (such as bank transfer receipts) can be retained.
Domestic Residency Requirement
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.
Government measures to address annual income barriers (starting in October 2023)
- Reference link
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. |
|---|---|
| 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 disability pensioners
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
Handling for the 1.3 million yen annual income barrier
Although dependent certification is based on checking of taxation certificates and other documents from the previous year, if the worker’s annual income is expected to temporarily exceed 1.3 million yen due to longer hours because of labor shortage or other factors, the worker may choose to retain his or her dependent status simply by attaching a certificate from the employer.
(In principle, this handling is available no more than two consecutive times for a single worker.)
Employer Certification Form (PDF)
Employer Certification Form (Word)
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.
Loss of dependent eligibility
A current dependent who no longer satisfies the dependent certification criteria will lose eligibility as a dependent.
If a dependent meets any of the descriptions below, please undertake the necessary procedures to remove him or her from your dependents.
* If the insured person loses eligibility, then his or her dependents also will lose eligibility automatically.
- He or she has begun employment.
- He or she has become eligible as an insured person under his or her employer’s health insurance.
- His or her income has increased to above the base amount.
- He or she has become a dependent of another person.
- He or she is a family member who must live together with the insured to be a dependent and has started to live apart from the insured.
* See "Scope of family members" at the top of the page. - He or she lives apart from the insured and his or her allowance no longer satisfies the criteria.
- He or she no longer is registered as a resident in Japan.
- He or she no longer is the spouse of the insured due to divorce.
- He or she is a child for whom both spouses provide and the spouse's annual income now exceeds that of the insured person.
* Submit a notification after confirming certification by the spouse's insurer. - He or she has gone into business on his or her own (regardless of the size of the business).
- He or she has joined the Medical Care System for the Advanced Elderly.
- He or she has died.
- He or she no longer depends on the insured for his or her living for any other reason.
The Society is unable to cover the medical care costs, subsidies for health examinations, etc. when a Society health insurance card has been used on or after the date of loss of eligibility. (Such medical care costs, etc. will be billed by the Society at a later date.)
Please complete the relevant procedures promptly to avoid mistaken use of the health insurance card after loss of eligibility.