Foreign nationals’ health insurance surplus tops 1 trillion won; Chinese enrollees post a 40.9 billion won deficit

[Financial News] For the first time, the surplus in the health insurance balance for foreign nationals exceeded 1 trillion won. Premiums paid by foreign enrollees substantially outstripped health insurance benefits, and the surplus trend has continued since 2017. However, the health insurance balance for Chinese nationals returned to a deficit just one year after turning positive in 2024. 
On the 25th, according to data submitted by the National Health Insurance Service (NHIS) to the office of Jeon Jin-suk, a Democratic Party of Korea lawmaker on the National Assembly’s Health and Welfare Committee, the overall health insurance balance for foreign nationals posted a surplus of 1.0128 trillion won last year. Foreign enrollees paid 2.537 trillion won in premiums, while benefit costs borne by the NHIS, including treatment at hospitals and clinics, totaled 1.5243 trillion won. As a result, the health insurance finances for foreign nationals have remained in surplus since 2017. 
By nationality, Vietnam recorded the largest surplus, at 160.1 billion won. It was followed by Nepal (126.2 billion won), Indonesia (91.8 billion won), Cambodia (85.6 billion won), Myanmar (84 billion won), the United States (81.9 billion won), the Philippines (55.9 billion won) and Uzbekistan (48.1 billion won). 
By contrast, the health insurance balance for Chinese nationals posted a deficit of 40.9 billion won. Chinese enrollees paid 956.4 billion won in premiums last year, but the benefits paid by the NHIS totaled 997.3 billion won, exceeding that amount. 
The health insurance balance for Chinese nationals had generally remained in deficit since posting a deficit of 110.8 billion won in 2017. The deficit narrowed to 2.7 billion won in 2023, and the balance turned to a surplus of 5.5 billion won in 2024, but returned to a deficit last year.
The government has tightened enrollment and dependent-registration requirements to improve the stability of the health insurance finances for foreign nationals. Since July 2019, enrollment in health insurance has been mandatory for foreign nationals who have stayed in South Korea for at least six months. In April 2024, a requirement to have resided in South Korea for at least six months was introduced for foreign nationals and overseas Koreans registering as dependents. From May that year, medical institutions were also required to verify patients’ identities. 
Debate over the health insurance system for foreign nationals continues. Some in political circles are calling for reciprocity, under which health insurance benefits would be applied differently according to the level of medical coverage the other country provides to South Korean nationals. The government, however, has maintained a cautious stance, citing the possibility of diplomatic friction, trade rules and controversy over discrimination based on nationality. 

[email protected] Lim Su-bin Reporter