Dependent certification criteria

Certification conditions

1. １．The family member must be within the scope of dependents specified in the Health Insurance Act.
2. ２． The family member must not currently be covered by other health insurance (other than National Health Insurance).
   Note: You cannot apply to name a family member aged 75 or older as a dependent. Such individuals are covered by the Medical Care System for the Advanced Elderly.
3. ３．There must be no other family member with a superseding obligation to care for the family member as his or her dependent. (Superseding obligation to care for the family member: e.g., the family member’s spouse; your father if the family member is your mother; your parents if the family member is a sibling or a grandparent.)
4. ４． If another family member has a superseding obligation to care for the family member as his or her dependent, explain why he or she does not have the ability to do so and why the insured person must support the family member as a dependent.
5. ５．The family member must rely primarily on the insured person for his or her livelihood (i.e., the insured person must pay most of the family member’s cost of living).
6. ６．The insured person must have the ability to provide for the livelihood of the family member.
7. ７．The family member must satisfy the income requirements for dependent eligibility.
8. ８．A child of two parents who both work (unless one is on leave) is to be the dependent of the parent whose income is higher.
   In a family with multiple children, all children must be the dependents of the parent whose income is higher. The Health Insurance Act does not permit children in the same family to be dependents of different parents.
9. ９．The family member must satisfy the domestic residency requirement.

Reference link

Domestic residency requirement added to dependent certification

Certification of self-employed persons as dependents: *Effective April 1, 2023.

It is generally accepted that self-employed persons are economically independent individuals who have chosen to take responsibility for all results of their business undertakings and make their living therefrom. These individuals should therefore join National Health Insurance as a general rule.
However, a self-employed person may be certified as a dependent if the income earned from self-employment is insufficient to make a living and it can be judged that the person relies primarily on the insured person’s income.
A self-employed person cannot be certified as a dependent even when his or her income has decreased if the decrease is temporary and unlikely to persist in the following year and beyond.

Income requirements for dependent eligibility

１．Dependent income standards

1. （１）The family member’s income must not exceed the following amounts:

   Income example	Unit	Income standard
   		Under 60 years of age	Aged 60 or older or under 60 but eligible to receive disability pension
   Unemployment benefits, Injury and Sickness Allowance, Maternity Allowance, or other income paid on the daily basis	Daily amount	Less than 3,612 yen	Less than 5,000 yen
   Salary (before deductions, including transportation expenses and bonuses), pension benefits (public or private), remittances, or other recurring income	Monthly amount	Less than 108,334 yen	Less than 150,000 yen
   Real estate income, interest, investments, or other income (income whose amounts cannot be ascertained without completing a final income tax return)	Annual amount	Less than 1.3 million yen	Less than 1.8 million yen

   • **If a family member has multiple sources of income, determination of eligibility will be based on his or her total income.
   • **In some cases, expenses deducted from income for tax purposes are not deductible for health insurance purposes.
   • **In principle, all income is included, whether taxable or not.
   
   Support enhancement package for overcoming annual income barriers
   The Ministry of Health, Labour and Welfare has notified of detailed administrative procedures and other provisions related to the support enhancement package for overcoming annual income barriers (October 20, 2023). A family member whose income fluctuates temporarily, whether due to longer working hours associated with labor shortage, etc., will be eligible to earn or retain his or her dependent status provided the person submits an employer’s certificate of temporary income fluctuation (Ministry of Health, Labour and Welfare form), together with other normally required documents, and the Health Insurance Association recognizes such income fluctuation as temporary. Note that any increase in income that can reasonably be expected to continue into the future, whether due to increased base pay or new permanent allowance, will not qualify as a temporary income increase. See here for details.
2. （２）The family member’s income must be less than one-half that of the insured person.
3. （３）If the family member lives apart from the insured person, his or her annual income must not exceed the allowance remitted to him or her by the insured person.

２．Scope of income

1. （１）Salary income (before taxes and other deductions, including allowances such as transportation expenses; includes nontaxable income and bonuses)
2. （２）Pension income (all pensions both public and private, whether taxable or not)
   Examples: Employees’ Pension, National Pension, mutual aid association pensions, corporate pensions, Suntory pension, survivors’ pensions, disability pension, private pensions, etc.
3. （３）Real estate income (rental income on land, buildings, parking lots, etc.)
4. （４）Interest income (interest on deposits, securities, etc.)
5. （５）Investment income (stock dividends, etc.)
6. （６）Miscellaneous income (payment for manuscripts, royalties, payment for speeches, etc.)
7. （７）Injury and Sickness Allowance and Maternity Allowance from health insurance
8. （８） Unemployment benefits under employment insurance (Hello Work)
9. （９）Allowances from persons other than the insured person (living expenses, child support, etc.)
10. （10）Other recurring sources of income (capital gains, etc.)
    *Excludes one-time temporary income.

How income is treated:

• ● If the family member began working (or the amount of pension benefits he or she receives changed) during the year:
  ⇒ Based on estimated income starting the first day of employment (or first day of change in benefits amount)
• ● If the family member has left his or her employer:
  ⇒ Income considered to be zero yen if the family member receives no income after leaving his or her employer

●Allowances remitted to family members living apart from the insured person

To be eligible as dependents, family members living apart from the insured person must rely on recurring allowance remittances from the insured person, via a financial institution, for the majority of his or her livelihood.

Cases in which allowances are not necessary even if the family member lives apart from the insured person:
Ａ．The family member lives apart from the insured person due to an unaccompanied job posting.
Ｂ．A child under the age of 25 lives apart from the insured person to attend school.

●Date of dependent certification

The date of dependent certification is the date on which the Health Insurance Association confirms the facts of dependency following submission of the Notification of Health Insurance Dependent (Change) and other necessary documents.
(If the date on which the facts of dependency were confirmed falls one month or more after the date on which the reason for making the family member a dependent arose, the date of dependent certification will be the date on which the Health Insurance Association confirms the facts of dependency. In such cases, dependent certification will not be retroactive to the date on which the reason for making the family member a dependent arose.)
However, in case of childbirth, the child’s date of dependent certification will be his or her date of birth.

Reference links

Documents needed when applying for dependent certification

Dependent certification and receipt of unemployment benefits or other compensation for loss of income

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