Family Dependents
Health insurance not only provides benefits to insured persons but also their family dependents. These family members are referred to only as dependents, and their scope is defined by law.
The EY Japan Health Insurance Society needs to certify family members as dependents.
When Designate a Family Member as a Dependent
A family member whose livelihood is maintained by the insured person can be designated as a dependent for health insurance. Health insurance provides dependents with insurance benefits without charging them premiums. In order to become a dependent, it is necessary to satisfy certain requirements as defined by law, etc.; for example, being a resident of Japan, being within the scope of family, and having a certain amount of income.
Additionally, there are different criteria for dependents under health insurance from “dependents” under corporate law and tax law. Therefore, procedures other than dependent allowances and year-end adjustments are required.
To add a family member as a dependent, please fill in the necessary information in the documents below, attach the necessary attachments, and submit the materials within five days. (Refer to the “Application Forms” page for information on where to submit application forms.)
- Notification of Change of Dependents (Addition)
PDF Completed Sample - Dependent Certification Check SheetPDF
- Dependent Application
PDF Completed Sample - Necessary documents to include in the list of documents required for dependent certification.
- Petition for reasons for delay（If there is a delay of 3 months or more from the date of occurrence of the event）PDF
Health insurance also defines the scope of family members who can be dependents.
| Individuals qualifying as dependents regardless of whether living with the insured person |
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| Individuals who must live with the insured person |
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Standards for Certification of Dependents
In order to become a dependent, in addition to being a family member, it is necessary to satisfy the following conditions and for the health insurance society to confirm that “the applicable person is dependent on the insured person.” Based on the application documents, etc., the health insurance society will comprehensively and rigorously examine whether the applicable person can be classified as a dependent.
Domestic Residence Requirements
Partial revisions to the Health Insurance Act and other laws added a provision that a dependent shall, in principle, live in Japan for certification as a dependent on April 1, 2020.
As an exception to this requirement, individuals such as foreign exchange students or family accompanying an insured person overseas who have been living in Japan before departure and who have a high likelihood of returning to live in Japan in the future due to the purpose for stay overseas satisfy the requirement for a dependent to live in Japan even without an address in Japan (certificate of residence).
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A dependent shall, in principle, live in Japan (certificate of residence)
*However, foreign nationals residing in Japan for a long stay (up to one year) on a medical-stay visa or for the purpose of tourism or recreation do not qualify as a dependent even if living in Japan (certificate of residence) according to an exemption in the Health Insurance Act.
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An individual who does not have an address in Japan (certificate of residence) but whose basis of livelihood is in Japan
*Individuals are approved as an exception to the requirement for a dependent to live in Japan by confirming their visa status and other circumstances.
| Reason | Supporting Document |
|---|---|
| Students studying overseas | Copy of the visa and student ID as well as enrollment and admission certificates |
| Persons accompanying an insured person stationed overseas | Copy of the visa and letter of appointment for overseas assignment as well as a copy of a residence certificate issued by an overseas public institution |
| Persons temporarily traveling overseas for any purpose other than employment (tourism, recreation, volunteer activities, etc.) |
Copy of the visa, proof of the volunteer dispatching agency, and the volunteer participation agreement |
| Person who has a personal relationship, such as birth or marriage, with the insured person while assigned overseas | Copy of documents certifying birth, marriage, etc. |
| Persons who are recognized as having their livelihood based in Japan in consideration of the purpose of travel and other circumstances (children born while a dependent is living overseas for reasons such as foreign study, etc.) |
Copy of documents certifying birth, marriage, etc. |
*Please include a Japanese translation signed by the translator for any supporting documents written in a different language with the rest of the materials.
Income Requirements
- The annual income of the individual must be less than 1.3 million yen (1.8 million yen for individuals aged 60 or older or persons with disabilities)
- The annual income of the individual must be less than half that of the insured person
- Annual income must be less than assistance (money sent) from the insured person
- The total income and financial support of the dependent is above the amount needed to maintain a standard quality of life
When applying for a dependent, it is necessary to submit documents which can prove that money has been sent, such as a transfer request form from a financial institution (identifying the source and destination of the sent money).
Other
- The insured person provides the individual financial support
The insured person must be providing the majority of living expenses to the individual. Even if the income criteria are met, the individual will not qualify as a dependent if economically independent. - The insured person must have the ability to financially support the individual
The insured person must have the ability to provide consistent economic support to the family member. Even if all of the other requirements are met, the individual will not qualify as a dependent if the EY Japan Health Insurance Society determines the insured person does not have the means to provide financial support.
- A person with a higher priority obligation to support the individual, such as the mother or father in the case of siblings and grandparents, does not have the ability to do so.
- There are unavoidable reasons that the insured person must support the family member.
- The child shall be the dependent of the member of the couple whose estimated income for the next year is greater
- If the difference in annual income between the husband and wife is 10% or less of the greater amount, the child shall be the dependent of the person supporting the household indicated in the notification
Individuals who are age 16 or older but under age 60 are at an age that allows them to work. In many cases, these individuals can live independently without the economic support of the insured person. Accordingly, to become a dependent, documents must be submitted certifying that the person is unable to work, and notification must be submitted indicating that the insured person is providing a majority of the living expenses to the individual.
As a general rule, an individual who is receiving unemployment benefits is unlikely to be able to live mainly on the income of the insured person. Therefore, these individuals usually do not qualify as dependents. However, these individuals may qualify as a dependent if the amount of unemployment benefits is small*. In addition, individuals who are waiting for benefits or who are in a benefit restriction period can qualify as dependents because they have no income.
Confirmation of Dependent Qualifications (Verification)
The EY Japan Health Insurance Society conducts confirmation of dependent qualifications with a set deadline and reviews continued certification as a dependent. Individuals who are unable to submit the required documentation at the time of this review may lose their eligibility as a dependent. Therefore, insured persons need to prepare and be ready to submit proof of remittance and other documents at any time.
Punitive Measures for Fraudulent Applications
If the EY Japan Health Insurance Society discovers an insured person has obtained certification of a family member who is not actually receiving financial support through a fraudulent application, the family member will not only lose eligibility as a dependent but also be required to reimburse the EY Japan Health Insurance Society for any and all medical expenses and other payments made during the relevant period.
Removing a Family Member as a Dependent
Procedures to take a family member off the dependents list must be taken if the family member who was certified as a dependent no longer fulfills the requirements for certification as a dependent due to employment, living separately from the insured person, death or other such reasons.
Please fill out the necessary information in the form below and, if the dependent has a health insurance card or an Eligibility Confirmation Document, please attach it and submit it. (Please submit the materials within five days after the change. Refer to the “Application Forms” page for information on where to submit application forms.)
- Notification of Change of Dependents (Removal)
PDF Completed Sample - Health Insurance Card or Eligibility Confiemation Document (If the relevant dependent has it.)
| The annual income of a dependent reaches 1.3 million yen or more (or 1.8 million yen or more for individuals age 60 or older) on an ongoing basis |
*Please note that individuals lose qualification as a dependent as of the time they begin working (earning an income), not when their earnings exceed the maximum annual income. This policy also applies if the individual has started working but is unable to enroll in a health insurance plan at the new employer. Please make sure to complete the procedures to remove the individual as a dependent.
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| A dependent begins receiving employment insurance (unemployment or other benefits) |
(Individuals who have extended the payment period, etc.) Please make sure to complete the procedures to remove the individual as a dependent if benefit payments will be made at a later date. |
| A dependent no longer has a relationship with the insured person |
*An individual who has been removed as a dependent needs to either enroll in National Health Insurance or another health insurance program as an insured person or complete procedures to become a new dependent of the family member who is providing financial support.
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Date of Dependent Removal
The date for removing a dependent is the day on which the reason for submitting the Notification of Change of Dependents arose.
However, in the case of death, the day after the individual passed away is the day on which the dependent is removed. The date of removal as a dependent will be the date on which he/she got a job and joined his/her employer's health insurance as an insured person.
Ramifications of Forgetting to Remove a Dependent
*Please notify the healthcare provider on your next visit if an individual has been formally removed as a dependent and enrolled in a different health insurance plan.