The surplus in South Korea's health insurance finances from foreign subscribers topped 1 trillion won for the first time on record in 2025, while the balance for Chinese nationals swung back to a deficit of about 40.9 billion won just one year after moving into the black.
The overall surplus from foreign subscribers reached 1.01 trillion won ($703 million) in 2025, according to data on insurance contributions and benefit payments by nationality that the National Health Insurance Service submitted to the office of Rep. Jeon Jin-sook of the National Assembly's Health and Welfare Committee on the 25th. Foreign subscribers paid 2.54 trillion won in premiums, while the service paid out 1.52 trillion won in benefits, including medical treatment costs at hospitals and clinics. The balance has remained in surplus every year since 2017.
By country, Vietnam posted the largest surplus at 160.1 billion won, followed by Nepal at 126.2 billion won, Indonesia at 91.8 billion won, Cambodia at 85.6 billion won, Myanmar at 84 billion won, the U.S. at 81.9 billion won, the Philippines at 55.9 billion won, Uzbekistan at 48.1 billion won and Russia at 13.1 billion won. Most of the top 10 countries recorded surpluses.
Chinese nationals, by contrast, accounted for a deficit of 40.9 billion won. They paid 956.4 billion won in premiums in 2025, while the service paid out 997.3 billion won in benefits.
The balance for Chinese nationals had been in deficit for years — 110.8 billion won in 2017, 150.9 billion won in 2018, 98.7 billion won in 2019, 10.9 billion won in 2021, 22.9 billion won in 2022 and 2.7 billion won in 2023 — before turning to a surplus of 5.5 billion won in 2024. It reverted to a deficit in 2025.
The government has introduced a series of changes to curb financial leakage in health insurance coverage for foreign nationals. In July 2019, it made enrollment mandatory for foreign nationals staying in the country for six months or longer. From April 2024, it tightened requirements so that foreign nationals and overseas Koreans must reside in the country for at least six months to be registered as dependents of workplace subscribers. Identity verification at hospitals and clinics became mandatory in May 2024.
Some in political circles argue for introducing a reciprocity principle, under which benefits for foreign nationals would be differentiated according to the level of health coverage their home countries provide to Korean citizens. The government has taken a cautious stance, citing concerns over diplomatic friction, trade rules and discrimination against nationals of specific countries.
Separately, data on detected cases of fraudulent claims involving the lending and misuse of health insurance cards, submitted to Rep. Kim Sun-min of the Rebuilding Korea Party, a member of the National Assembly's Science, ICT, Broadcasting and Communications Committee, showed a total of 184,443 cases from 2021 through Aug. 31, 2026. The resulting losses amounted to 4.09 billion won.