Foreign health insurance surplus nears W1tr

Foreign subscribers contributed more to South Korea’s national health insurance system than they received in medical benefits last year, leaving a gap of nearly 1 trillion won ($755 million), public data showed.

Premiums assessed on foreign subscribers totaled 2.51 trillion won in 2025, while insurance benefits amounted to 1.52 trillion won, according to data released by the National Health Insurance Service through the government’s public data portal.

The difference amounted to 989.1 billion won, meaning premiums charged to foreign subscribers exceeded the medical benefits they received.

However, benefit payments for Chinese subscribers exceeded their assessed premiums by 49.6 billion won. Premiums assessed on Chinese subscribers totaled 947.7 billion won, while the insurer paid 997.3 billion won in benefits.

Benefit payments for Chinese subscribers have generally exceeded assessed premiums since 2017, when the gap stood at 110.8 billion won. The deficit narrowed to 2.7 billion won in 2023 before turning into a surplus of 5.5 billion won in 2024. The balance returned to a deficit last year.

Separate figures on benefits received after insurance eligibility had ended showed that Chinese and US nationals accounted for the largest and second-largest amounts, respectively, in 2025.

According to the data, 22,793 Chinese nationals received 10.97 billion won in health insurance benefits after their coverage had ended, followed by 2,226 US nationals who received 6.88 billion won.

South Korea has tightened residency requirements for foreign nationals seeking health insurance coverage.

In December 2018, the government extended the minimum residency requirement for eligible foreign residents to enroll in national health insurance from three months to six months.

Since April 2024, most foreign family members seeking coverage as dependents of workplace subscribers, without paying separate premiums, have had to live in Korea for at least six months. Spouses and children under 19 are among those exempt from the waiting period.