SEOUL, South Korea – Foreign residents, including overseas Koreans, continue to be net contributors to South Korea’s National Health Insurance system, according to recent data. This trend challenges the misconception that foreigners are a burden on the country’s healthcare resources.
The National Health Insurance Service (NHIS) reported that in 2023, foreign subscribers paid 2.069 trillion won ($1.55 billion) in premiums while receiving only 1.329 trillion won ($998 million) in benefits. This resulted in a surplus of 740.3 billion won ($556 million) for the year.
“This data clearly shows that foreign residents are not freeloading off the Korean healthcare system,” said Rep. Nam In-soon of the Democratic Party, who released the figures. “In fact, they’re helping to strengthen the financial stability of our national health insurance program.”
The surplus from foreign subscribers has been consistent over the past five years:
| Year | Surplus (billion won) |
| 2019 | 373.6 |
| 2020 | 587.5 |
| 2021 | 525.1 |
| 2022 | 556.0 |
| 2023 | 740.3 |
However, a closer look at the numbers reveals some nuances. Among the top 10 nationalities of foreign subscribers, only Chinese nationals consistently received more in benefits than they paid in premiums. In 2023, this deficit for Chinese subscribers amounted to 64 billion won ($48 million).
An NHIS official explained, “The deficit for Chinese nationals decreased after the mandatory subscription policy was implemented in July 2019. However, it has been rising again since 2022, likely due to an increase in Chinese regional subscribers following the COVID-19 pandemic.”
To address concerns about potential abuse of the system, South Korea has been tightening regulations for foreign subscribers. Since April 2023, foreigners and overseas Koreans must reside in the country for at least six months before becoming eligible as dependents on a workplace subscriber’s plan. This measure aims to prevent so-called “medical tourism” where individuals enter the country briefly to receive medical treatment under the national insurance system.
As South Korea continues to balance providing healthcare access to its foreign residents with maintaining the financial health of its insurance system, the overall positive contribution of foreign subscribers suggests that fears of abuse may be largely unfounded.
| Year | Category | Insurance Premiums (A) | Benefits (B) | Surplus (A-B) |
| 2023 | Total | 2,069.0 | 1,328.7 | 740.3 |
| Foreigner | 2,004.3 | 1,273.5 | 730.8 | |
| Overseas Korean | 64.7 | 55.2 | 9.5 | |
| 2022 | Total | 1,789.2 | 1,233.2 | 556.0 |
| Foreigner | 1,728.6 | 1,183.8 | 544.8 | |
| Overseas Korean | 60.6 | 49.4 | 11.2 | |
| 2021 | Total | 1,634.7 | 1,109.6 | 525.1 |
| Foreigner | 1,579.3 | 1,066.8 | 512.5 | |
| Overseas Korean | 55.4 | 42.8 | 12.6 | |
| 2020 | Total | 1,541.7 | 954.2 | 587.5 |
| Foreigner | 1,491.5 | 918.6 | 572.9 | |
| Overseas Korean | 50.2 | 35.6 | 14.6 | |
| 2019 | Total | 1,296.5 | 922.9 | 373.6 |
| Foreigner | 1,253.0 | 887.2 | 365.8 | |
| Overseas Korean | 43.5 | 35.7 | 7.8 |
Note: “Foreigners” includes ethnic Koreans with foreign citizenship, while “Overseas Koreans” refers to Korean nationals residing abroad who maintain their Korean citizenship.
