•Income test: annual income under 1.3 million yen (1.8 million if aged 60+ or disabled; 1.5 million for someone aged 19-22 other than the insured person's spouse, where the dependency start date falls on or after October 1, 2025), and the income must be less than half the insured person's if you live together, or less than the money they send you if you live apart. Annual income here means what is expected from the start date onward, not what was earned before - roughly 108,333 yen a month from employment, or 3,611 yen a day for someone on employment insurance
•Dependent status means no additional insurance premiums. Note that criteria may vary by the employer's health insurance society
•The dependant notification goes to the Japan Pension Service - a service centre or your local pension office - through your employer, within 5 days of the event. Tell your employer promptly once the marriage registration is accepted
•To be a dependant you must have an address registered in Japan. People without Japanese nationality who are here on Designated Activities for medical treatment or long-stay tourism do not qualify. Living abroad can still qualify in certain exceptional cases
•From April 1, 2026, the way annual income is assessed for dependent status changes: if the wage set in your employment contract implies annual income under 1.3 million yen and no other income is expected, you are in principle treated as a dependent
•A dependant's income includes unemployment benefits, public pensions, and health insurance sickness or maternity allowances. During the waiting period before unemployment benefits start you can still qualify, but once the daily benefit reaches 3,612 yen you must file to remove them from your cover
•Where both spouses have income, dependants are registered under whichever of them earns more over the year, regardless of how many dependants there are
•Whether someone counts as aged 19 to under 23 is judged by their age on December 31 of the year the dependant status is granted. For anyone in that age band already approved as a dependant on or before September 30, 2025, a removal notification is required if their annual income is expected to reach 1.5 million yen from October 1, 2025 onwards