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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

  • Persons who live separately from the member but are still approved to be dependents
    1. Spouse (including common-law spouse)
    2. Children, parents, grandchildren, grandparents, brothers and sisters
  • Persons who must live together with the member to be approved as dependents
    1. Relatives within the third degree other than above
    2. Common-law spouse’s parents and children
    3. Surviving parents and children after a common-law spouse's death

Scope of dependents

Upper limit of dependents’ income

Income type Under age 60 Age 60 or older
Salary income only
Under 1,300,000 yen/year
Under 1,300,000 yen/year
Earnings in addition to salary (excluding pension benefits)
Under 1,300,000 yen/year
Under 1,300,000 yen/year
Disability Pension benefits
Under 1,800,000 yen/year
Under 1,800,000 yen/year
Old-age/Survivors’ Pension Benefits
Under 1,300,000 yen/year
Under 1,800,000 yen/year

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.

  • When a married couple is raising a child (or children), regardless of the number of dependents, dependent(s) will be of the party with the higher income in principle.
  • Even if a person is eligible to be a dependent, unless the application procedures are made and approved, the person cannot be a dependent. Once approved, a “Membership Card for a Dependent” is issued.

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.

1. Documents that prove the relationship and birthdates

A copy of family register, certificate verifying items on the family register, proof of birth (marriage) registration, certificate of residence (only when applying for an approval of a spouse or child and the member is the householder)

Note: Multiple copies of the family register may be required depending on the reason for dependency.

2. Documents showing that the parties are living in the same household

For individuals who are financially supported by a member and approved as a dependent only when they live in the same household as the member, a “certificate of residence” that shows all household members of the member is required.

3. Documents for confirming dependency

For individuals other than a spouse and children, a document of “reasons for dependency” with the member’s name and seal.
Note that if there is a person with a primary duty to support that individual (example: if the mother of the member is applying, the person with the primary duty to support her is the member’s father), documents that verify the income and state of participation in health insurance of the priority person responsible for support is required.

4. Proof of income

For individuals aged 18 or older, the following documents are required. However, since the requirement varies depending on the situation, it is recommended that contact is made with the personnel responsible for the PMAC procedures at the school in advance.

Example of attachments that proves one’s income

Individuals without income (homemakers, students)
  • A certificate of tax exemption (that proves that the income is 0 yen)
  • A certificate of enrollment (copy of a student card showing its expiration date is also accepted) is acceptable only for students who have not reached the fiscal year end after their 22nd birthday.
  • Note:
    Students engaged in part-time jobs are included in the “individuals with income” section below.
Individuals with income (part-time workers)
  • A certificate of expected annual income issued by the employer and proof that shows the individual does not participate in social insurance
Self-employed individuals
  • A copy of a tax return with the stamped seal of a taxation office on it.
Retired individuals
  • A copy of a retirement record of Employment Insurance (1)/(2) or a copy of benefit qualified certificate of unemployment benefit and a written pledge, etc. (Note)
  • If not participating in employment insurance, a retirement certificate from the workplace and a certificate proving that the person does not participate in employment insurance.
Individuals aged 60 or older
  • A copy of pension revision (determination) notification
  • If an individual is not receiving pension benefits, an affidavit stating the reasons for not receiving them

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.

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