Foreign health insurance surplus tops 1 trillion won
Korea's national health insurance system collected a record 1.01 trillion won ($763 million) surplus from foreign subscribers in 2025, though Chinese subscribers returned to a deficit.
A National Health Insurance Service branch office is seen in Seoul on Oct. 13.NEWS1
Korea's national health insurance system recorded a surplus of 1.01 trillion won ($763 million) from foreign subscribers in 2025, the first time the annual surplus exceeded 1 trillion won.
The overall surplus contrasted with a 40.9 billion won deficit for Chinese subscribers, whose balance slipped back into the red after recording a surplus in 2024.
The figures come from data the National Health Insurance Service (NHIS) submitted to Democratic Party Rep. Jeon Jin-sook, a member of the National Assembly's Health and Welfare Committee, which were disclosed Sunday.
The NHIS assessed foreign subscribers 2.54 trillion won in premiums last year but paid 1.52 trillion won in benefits for their medical care. The financial balance for foreign subscribers has remained in surplus since 2017.
Chinese subscribers were the only group to record a deficit among the 10 nationalities with the most NHIS subscribers. Premiums assessed for Chinese subscribers totaled 956.4 billion won, compared to 997.3 billion won in benefits.
The NHIS reported surpluses of 160.1 billion won for Vietnamese subscribers, 126.2 billion won for Nepalese subscribers and 91.8 billion won for Indonesian subscribers.
The deficit for Chinese subscribers had previously narrowed from 150.9 billion won in 2018 to 2.7 billion won in 2023, before turning into a 5.5 billion won surplus in 2024, the Ministry of Health and Welfare said.
“The health insurance balance for Chinese subscribers is improving,” the ministry said in October 2025. But the deficit returned in 2025, ending that improvement.
“Chinese subscribers have a higher proportion of older people, while subscribers from other countries are mostly of working age, creating a structural difference,” a ministry official said. “We will closely monitor the trend and strengthen management.”
Over the years, the government has revised its health insurance rules for foreign residents, citing that the changes are meant to curb improper benefit claims and strengthen the system’s finances. Since July 2019, foreigners who have stayed in Korea for at least six months have generally been required to enroll in the health insurance program and pay premiums.
Kang Cheong-hee, president of the National Health Insurance Service, speaks at a press conference in Jongno District, central Seoul, on Sept. 8.NATIONAL HEALTH INSURANCE SERVICE
A further change in April 2024 requires foreign nationals seeking coverage as dependents of enrolled employees to have lived in Korea for at least six months, in principle.
The government said the change was meant to address cases in which people enroll, receive treatment and then leave the country shortly afterward, a practice sometimes referred to in Korea as “health insurance hit-and-run.”
Some politicians have called for applying the principle of reciprocity to health insurance coverage for foreigners. They argue that family members of Chinese workers insured in Korea can qualify for coverage if they meet certain conditions, while China has no comparable dependent coverage system for Koreans.
The head of the NHIS has rejected the idea, however. “Reciprocity is a principle in diplomacy, but no country applies reciprocity to health coverage,” Kang Cheong-hee, president of the NHIS, said at a press conference in Jongno District, central Seoul, on Sept. 8. “When someone is sick, the principle is to treat them first.”
This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
