Can a foreign employee's overseas family be added as health-insurance dependents?

In short: Whether a foreign employee can add the family they left in their home country as health-insurance dependents turns on the "domestic residence requirement" added in April 2020 (Reiwa 2). In principle, only family members who have an address (a residence record) in Japan can be dependents. However, family members who fall under an "overseas special exception," such as a child studying abroad, may be added even while overseas. Family members overseas for the purpose of working are, in principle, outside the scope. It is the insurer, not the company, that certifies.

"An employee who came from Vietnam says he wants to add the wife and child he left at home as health-insurance dependents. Can he do that even though they live overseas?" — as hiring of foreign talent increases, questions like this are on the rise. This article, for the business owners and HR staff who employ foreign talent, sets out the "domestic residence requirement" for health-insurance dependents, the overseas exceptions, and what to check at the time of hiring.

Since when has there been a "domestic residence requirement" for health-insurance dependents?

Since 1 April 2020 (Reiwa 2). On that day, an amendment took effect that added "having an address in Japan (the domestic residence requirement)" to the requirements for health-insurance dependents. Until then, family members living overseas could be dependents if they met requirements such as maintenance of livelihood, but after the amendment, in principle only family members who have a residence record in Japan can be dependents.

The "address" here is judged by whether there is a residence registration in the Basic Resident Register (whether there is a residence record). A person with a residence record in Japan is, in principle, treated as meeting the domestic residence requirement.

In other words, for the family of a foreign employee too, if that family comes to Japan and registers residence, they can become dependents by meeting the other requirements (such as maintenance of livelihood). Conversely, if the family remains living in the home country, they cannot in principle be added unless they fall under the "overseas special exception" described next.

Is there an exception for family living overseas?

Yes. The domestic residence requirement has an "overseas special exception," under which a family member who falls into any of the following may be recognized as a dependent even while overseas.

Overseas special exception (falling under any one)	Example
A student studying abroad	A child studying at a school overseas
A person accompanying an insured person posted abroad	A spouse or child accompanying an employee posted overseas
A person who travels overseas temporarily for sightseeing, recuperation, volunteer activity, or another purpose other than work	Family during a temporary overseas trip
A person whose status relationship with the insured person arose while the insured person was posted abroad	A child born while the insured person was posted overseas, etc.
A person who, taking into account the purpose of travel and other circumstances, is recognized as having the basis of their life in Japan	Family recognized, in line with the above, as having the basis of their life in Japan

The important point is the phrase "for a purpose other than work." Family members who are overseas in order to work there do not, in principle, fall under the overseas special exception. Also, where a foreign employee's wife and children whom they left in their home country have never lived in Japan and are living in the home country, they often do not fit the above categories, and it is generally the case that they cannot be added as dependents as things stand.

In a consultation where "the family is overseas but I want to add them as dependents," the starting point is first to confirm, in light of the actual situation, which of the overseas special exceptions the family falls under (or does not). There are quite a few cases where the judgment is difficult.

What to check about dependent procedures when hiring a foreign employee?

Here is what to check and prepare regarding dependents when you hire a foreign employee.

Item to check	Point
Family's place of residence	Do they have a residence record in Japan, or are they overseas? If overseas, do they fall under an overseas special exception?
Relationship / maintenance of livelihood	The status relationship (kinship) with the insured person, and whether their livelihood is chiefly maintained
Income	Whether the income of the family member to become a dependent is within the certification standard (confirm expected annual income)
Attached documents	Documents that confirm kinship and maintenance of livelihood. For documents in a foreign language, attach a Japanese translation
Documents for the overseas exception	Where applicable, copies of a visa, student ID, overseas-posting order or residence certificate, or a "dependent status statement," etc.

For a foreign employee, the documents proving kinship and maintenance of livelihood are often in a foreign language, in which case a Japanese translation is required. Because preparing the documents takes time, confirming this early at the time of hiring makes the procedure smoother.

The idea of income (the 1.3 million yen and other certification standards) and the treatment when income temporarily rises are judged within the same framework as for Japanese family members. For details, see can an employer's certification carry you through a temporary rise in income past the 1.3 million yen wall. For the whole picture of hiring procedures for foreign workers, see when hiring a foreign worker, which office do you notify of what.

The one that ultimately decides dependent certification is the insurer (Kyokai Kenpo or a health insurance society), not the company. The company only goes as far as assembling the documents and filing; whether to certify is decided by the insurer. Depending on the health insurance society, there may be its own practice or additional documents.

Note that this is the question of whether a foreign employee working in Japan can add their overseas family as dependents. Conversely, social insurance when a Japanese employee is posted overseas (the social security agreement and the prevention of dual enrollment) is a separate matter, set out in what happens to social insurance on an overseas posting — the social security agreement and dual enrollment. The persons concerned and the issues are the reverse, so please do not confuse the two.

Who should handle the residence-status procedures?

In hiring foreign talent, separately from the social-insurance and labor-insurance procedures (the work of a Shakai Hoken Roumushi), residence-status (visa) procedures arise. The application to the Immigration Services Agency — applying for a certificate of eligibility, renewing the period of stay, changing the status of residence, and so on — is the work of a Gyoseishoshi.

Yotsuba has a Shakai Hoken Roumushi office (四葉社会保険労務士事務所) and a Gyoseishoshi office (四葉行政書士事務所), but the two are independent entities, and you contract with each separately. A contract with one does not double as a contract with the other. Please understand in advance that the responsibilities are divided: social-insurance and dependent procedures are handled by the Shakai Hoken Roumushi, and residence-status procedures by the Gyoseishoshi.

When you are unsure, in foreign employment, whom to consult for social insurance, labor, or residence status, first see when hiring a foreign worker, how the consultation windows are divided.

Frequently asked questions

Q. Can a foreign employee add the wife and children they left in their home country as health-insurance dependents?
A. In principle, the family must have a residence record in Japan (the domestic residence requirement). Family living in the home country cannot, in principle, be added unless they fall under an "overseas special exception" such as studying abroad or accompanying an overseas posting. The final certification is decided by the insurer (Kyokai Kenpo or a health insurance society).

Q. Can a child studying abroad be added as a dependent?
A. A "student studying abroad" falls under an overseas special exception and may be recognized as a dependent even while overseas. Documents that confirm the fact of studying abroad, such as a student ID or a certificate of enrollment, are required. However, a family member who is overseas for the purpose of working is, in principle, outside the scope.

Q. What should we do when the attached documents are in a foreign language?
A. When documents proving kinship or maintenance of livelihood are in a foreign language, it is generally required to attach a Japanese translation and file. Because preparing translations can take time, we recommend confirming this early at the time of hiring.

Q. Can we entrust the social-insurance procedures and the residence-status (visa) procedures to the same place?
A. The responsibilities are divided. Social-insurance and dependent procedures are the work of a Shakai Hoken Roumushi, and residence-status procedures are the work of a Gyoseishoshi. 四葉社会保険労務士事務所 and 四葉行政書士事務所 are independent entities, and you contract with each separately.

Sources

• Health Insurance Act, Article 3, Paragraph 7 (definition of a dependent; the domestic residence requirement). Under the amendment that took effect on 1 April 2020 (Reiwa 2) (the Act partially amending the Health Insurance Act, etc., for appropriate and efficient operation of the medical insurance system; Act No. 9 of 2019), "having an address in Japan" was added to the requirements for a dependent. "Address" is judged by whether there is a residence registration in the Basic Resident Register (e-Gov Law Search, Health Insurance Act, Act No. 70 of 1922; accessed 26 August 2026).
• The overseas special exception. As exceptions to the domestic residence requirement, the following are provided: (1) a student studying abroad, (2) a person accompanying an insured person posted abroad, (3) a person who travels overseas temporarily for sightseeing, recuperation, volunteer activity, or another purpose other than work, (4) a person whose status relationship with the insured person arose while the insured person was posted abroad, and (5) a person who, taking into account the purpose of travel and other circumstances, is recognized as having the basis of their life in Japan. Where applicable, the dependent (change) notification must be accompanied by a "dependent status statement" and documents confirming the kinship and maintenance-of-livelihood relationship (Japan Pension Service, "Procedures when an employee's family lives overseas" / Ministry of Health, Labour and Welfare, "On the domestic residence requirement for dependents, etc.," 13 November 2019, Hoho-hatsu No. 1113-1; accessed 26 August 2026).
• Where documents proving kinship or maintenance of livelihood are in a foreign language, attaching a Japanese translation is generally required. Please confirm the specific form and attached documents in each insurer's guidance (guidance on the dependent (change) notification from Kyokai Kenpo and each health insurance society; accessed 26 August 2026).
• Dependent certification is ultimately decided by the insurer the insured person belongs to (Kyokai Kenpo or a health insurance society). Depending on the health insurance society there may be its own practice and additional documents.
• Application to the Immigration Services Agency regarding residence status (visa) is the work of a Gyoseishoshi, and the responsibility is divided from the social-insurance and dependent procedures (the work of a Shakai Hoken Roumushi).

This article does not decide whom to consult. Social-insurance and dependent-certification procedures are the work of a Shakai Hoken Roumushi, and residence-status procedures are the work of a Gyoseishoshi. For fees when consulting 四葉社会保険労務士事務所, see the fee schedule; for frequently asked questions, see the FAQ.

This article is general information. Whether an individual is certified as a dependent is decided by the insurer. Whether the system applies and individual procedures are handled by a qualified professional after a consultation, in light of the latest primary sources (the Ministry of Health, Labour and Welfare, the Japan Pension Service, each insurer, etc.) and individual circumstances. Written by Joji Uramatsu (Shakai Hoken Roumushi, Gyoseishoshi, Registered Real Estate Transaction Specialist).