> Private School Mutual Aid >To Become a Dependent
To Become a Dependent
Application should be made within 30 Days
Individuals in a member’s family who depend on the member for financial support can become a dependent.
When a family member of the member is sick or injured, gives birth, or dies, the member may suffer from financial burden and hardships on their livelihood. Therefore, the member can claim for relatives within the third degree who are financially supported by the member as dependent(s).
To qualify for benefits, an “application form for dependency approval” must be submitted to PMAC through the member’s school. It shall come with documents that prove the relationship between the dependent and the member, the dependent’s date of birth, and his/her income, to confirm that the member financially supports the dependent. After examination of the documents and approval by PMAC, the individual can receive medical treatment covered by health insurance, etc. as a dependent.
If a new member has a dependent person who satisfies the requirements for dependency, the date when the membership is established is considered as the approval date. Or, if a member has a new dependent person who satisfies the requirements for dependency, the date when the person satisfies requirements as an approval date. This application should be made to PMAC via the member’s school within 30 days after the conditions for becoming a dependent are fulfilled. If the application is not made within 30 days after membership is established or the requirements for becoming a dependent are fulfilled, the date when the application form is received by PMAC is considered to be the approval date of dependency (if the date when the application form is sent can be confirmed, this date is the approval date of dependency). Any sicknesses or injuries before the approval date are not covered by PMAC health insurance.
The requirements for dependency approval do not necessarily match with the conditions for receiving a dependent allowance provided by the member’s school.
Note 1: A dependent can receive benefits from the date when the dependency is approved. Any medical fees incurred before the approval date are not covered by PMAC. Therefore, the member must make sure to submit an application for dependency approval as soon as a person becomes a dependent.
Note 2: If a person covered under the National Health Insurance satisfies the requirements for dependency approval due to an income decrease, the date when the application is received is the approval date of dependency (if the date when the application form is sent can be confirmed, this date is considered to be the approval date of dependency).
Persons Eligible to be Dependents
A dependent is defined as a person whose livelihood is mainly supported by the member’s income.
Scope of dependents
Upper limit of dependents’ income
Note 1: These incomes differ from the “income” prescribed in the income tax law. It is the total amount of annual constant income earned from the time of applying for dependency approval, which includes benefits (Employment Insurance, Sickness and Injury Allowance, etc.) and pension benefits (Survivors’ Pension, private pension, etc.).
Note 2: For salary and pension benefit income, the income is the amount before the corresponding deductions are made. For business income, the income is the amount after all the necessary expenses are deducted.
Note 3: If a person is eligible for social insurance from his/her place of employment, the person cannot be a dependent regardless of the employment type. Even when a person is not eligible for social insurance, the person cannot be a dependent either if the monthly salary is expected to exceed the upper income limit (108,333 yen per month).If a person has a pension income whose upper limit of income is 1,800,000 yen, the monthly ceiling including the pension income is 149,999 yen.
Documents Required for Application for Approval
In addition to the “application form for dependency approval”, documents that can prove the relationship (from a member’s side), that the parties are living in the same household, and the financial dependency relationship must be attached.
Example of attachments that proves one’s income
Note: The necessary documents vary depending on whether the person is receiving Employment Insurance benefits or disclaiming/postponing them.
When a person becomes no longer a dependent
As a result of employment, increased income, death, separation, etc., if a person no longer fulfills the requirements to be a dependent, the person will be unable to receive medical treatment using the Membership Card for a Dependent. In such cases, an “application form for dependency cancellation” must be submitted to PMAC through the member’s school promptly.