I'm a dual citizen; USA & Dutch.

I've worked in Luxembourg for the past 5 years. I was a cross-border commuter, living with my family in Germany (wife + 3 kids).

I've recently accepted a job in Japan. Our current arrangement is that I live in Tokyo, while my family remains in Germany. This situation is temporary, lasting anywhere from 6 to 9 months.

For tax reasons, it is best to register my family as dependents in Japan (see this site for an example calculation). If I register them as dependents, they would also be covered by the Japanese national health insurance.

Thing is, if they are insured in Japan, they'd have to pay all medical expenses in advance and send all receipts to our Japanese insurer to re-claim it (possibly after getting it translated to Japanese, which is generally expensive). I've been told that this generally takes over 4 months, if it happens at all. Also, communication with the insurer is very difficult, as the level of English in Japan is generally abysmal.

This is not ideal.

Therefore, we're looking for a better solution. My wife is "unemployed" (meaning, she does the hardest job of all). Now, if we'd get health insurance from a German insurer, we apparently fall in a category that is not really well defined. In practice this means I pay the amount I would normally pay if I would be working for a German employer, sans any discount. This amounts to about €650.

But in Japan, I already pay roughly €800 for health insurance. This is regardless of whether they are my dependents or not -- this is a fixed amount (see the link above).

We've asked the German insurer if they can act as a proxy; that the German insurer acts as a communication channel between us and the Japanese insurer. According to our previous German insurer (TK), this is not possible.

A dubious solution we've conjured up is that my wife takes a "job" for a friend of ours who has their own business. My wife would get paid a minimal €450.01/month (which goes into our bank account and straight back to our friend). This way, officially speaking, my wife would be "employed", thus reducing our insurance burden to a little over €100.

This is not ideal.

So, in my situation, what is the cheapest way to have everyone insured without breaking/bending the law?

UPDATE: so we spoke with a German insurance agent. He said that German law requires her to be insured, so if she'd have a Japanese insurer, she'd have to go to Frankfurt in person (4h drive with 3 kids) with a bunch of forms to prove that the Japanese health insurance covers the same things as a German insurer would. There are no insurers that will act like a proxy (so it's not limited to TK), and on top of all that, individual hospitals and doctors have the right to refuse the Japanese insurance.

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    Usual Japanese domestic insurance does not work outside of Japan.
    – Rambalac
    Commented May 16, 2018 at 5:21
  • @Rambalac hmmmm...you're saying it's not possible to enroll my family in Japanese health insurance? My employer said that this was possible. Perhaps something got lost in translation; I'll double-check Commented May 16, 2018 at 8:31
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    Regarding the solution with your wife being employed and earning at least € 450,01 per month: That would work, but she needs to actually work or both your wife and the employer friend will be in trouble (if found out, but there are spot checks).
    – chirlu
    Commented May 16, 2018 at 10:27
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    I don't think "Does anyone know a better way?" is an answerable question. SE sites are not advice forums.
    – fkraiem
    Commented May 16, 2018 at 10:47
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    @fkraiem "SE sites are" → "Expats beta is", because actually, this type of question gets asked pretty often on Stack Overflow, Super User, etc., generally with favorable reception. Moreover, I think a suggestion for improvement is much more constructive than merely stating that the question doesn't fit this site. What are your thoughts on my latest change? Commented May 18, 2018 at 4:16

2 Answers 2


If you go to Japan, can you just deregister from Germany, and also from German insurance (TK)? Then you can have Japan insurance only.

Your wife can then become freiwillig versicherte at TK on her own. Unfortunately, it seems that legally your income will be still taken into account and she will then probably pay the maximum amount. But this will be NOT 800+ Euro according to this link, rather it will be "just" 329,66 + 56,42 = 386 Euro per month. All children will be registered through her for free.


The cheapest way is what you mentioned. Your wife becoming employed and the children being insured with her at no extra cost and you are completely out of the picture.

If not, they will assess your income and consider half of it when calculating the premium for what's called the "Hausfrautarif". This I expect will be expensive as I assume you earn above the German threshold of ca. €60K per annum.

Would be interested to know if you accepted a job with your current company in Japan, meaning you could apply for a secondment which brings new options or when you say it's temporary, are your family planning to come to you in Japan or will you return to Germany after the temp. period??

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