The Jongno branch of the National Health Insurance Service in central Seoul on Feb. 2, 2024 [YONHAP]
Long-term foreign residents from countries with low access to health care do not have to worry about seeing a doctor in Korea, as they can readily use the same health care service provided to Korean citizens.
Any foreigner who has lived in the country for six months or longer has been entitled to use the country’s universal health care since July 2019, according to the National Health Insurance Service (NHIS).
The system’s easy accessibility has led to an increase in the number of foreigners using the service, as well as in their medical bills. Around 4.1 million foreign patients received health care in Korea in 2024, up from 3.2 million in 2019, as demonstrated by data released by People Power Party (PPP) Rep. Kim Mi-ae’s office in 2025. Their medical bills surged by 68 percent, from 950 billion won ($628.6 million) to 1.6 trillion won, over the same period.
This increase in foreign residents’ medical bills is nearly twice that of Korean nationals, which stood at 36 percent, though the latter still spent a significant 67 trillion won in 2019 and 90 trillion won in 2024 on their medical expenses.
Patients crowd a hospital waiting room in Seongbuk District, central Seoul on Nov. 23, 2025. [YONHAP]
This upward trend for foreigners has come under scrutiny over the years, with some Korean citizens arguing that foreigners exploit the system run by taxpayer money.
And last year, a group of lawmakers proposed a bill to limit foreigners’ insurance coverage.
Extent of accessibility
Foreigners who have stayed in Korea for six months automatically become eligible for the country’s universal health care, alleviating their burden of paying medical bills entirely out of pocket.
Under the system, foreign patients currently pay only 20 percent of inpatient care costs and 30 percent of prescription medication costs. Inpatient care includes hospital stays after surgery or emergency treatment.
People walk by a sign for a pharmacy in Seoul on July 18, 2022. [YONHAP]
Patients have to pay a bigger percentage of their medical bills if they receive treatments not covered by health care, but being insured allows a foreign worker to typically pay anywhere between 300,000 and 1 million won for an appendectomy — far less than the 2 to 5 million won range for those without insurance.
Universal health care benefits also extend to doctor visits, rehabilitation or health screenings, but treatments that the minister of health and welfare determines as not being necessary for everyday life, such as plastic surgery or laser eye surgery, fell outside coverage as of April, according to the NHIS.
Move for limitation
With foreigners’ medical bills soaring in recent years, the government has moved to overhaul the insurance system, including tightening the eligibility requirements.
The bill that Rep. Kim and 25 PPP lawmakers proposed last year would limit health care benefits to foreigners from countries that provide health insurance coverage comparable to that available to their Korean residents. Kim defended the bill by claiming that many family members of Korean insurance holders “temporarily enter the country to use health care and fly out.”
Travelers return through Terminal 2 of Incheon International Airport on May 5. [NEWS1]
The bill — which remained stalled in the National Assembly as of May — would block a significant number of foreigners from using Korea’s health care system.
The government previously addressed the issue in 2024, when it revised the law to allow only dependents of Korean health insurance holders who have resided in the country for at least six months from the date of their arrival to be eligible for the system’s benefits. Before the revisions, such dependents were able to access insurance upon entering Korea.
Spouses or children under 19 years old are still exceptions; they become eligible for insurance as long as they are legally related to a Korean insurance holder.
“I think that [the government’s move to tighten eligibility for health care] completely makes sense, and any country should verify that they offer benefits to the people who are contributing to society rather than free riding,” Diana Chan, a British national living in Korea, told the Korea JoongAng Daily. “However, I think that the rules should be adjusted so that they are the same for foreigners and Koreans. I don’t know the minimum threshold for salary [needed] for Koreans to qualify, either. If there is a minimum threshold for Koreans, I hope that it is equal, if not close to being equal, to how much foreigners are contributing to the economy.”
Benefit fraud
The government’s move to reduce the scope of health care benefits for foreign residents came after a total of 119,544 foreigners were found to be illegally using Korea’s insurance system between January 2020 and March 2025. As a result, the NHIS had to pay about 19 billion won in benefits for uninsured foreigners, according to data released last year by PPP Rep. Kim Seung-su’s office.
Illegal uses of health care include using another person’s residence card or health insurance eligibility to receive medical treatment, falsely claiming dependent status or receiving insurance-covered treatment despite not qualifying for coverage under the law.
The number of foreigners who illegally used the system stood at 40,265 in 2021, when people could not fly in and out freely due to restrictions during the Covid-19 pandemic, according to data from Rep. Kim Seung-su last year. The numbers declined to 18,491 in 2022 and 14,630 in 2023 before rising to 17,087 in 2024.
Continued fraud can lead to greater financial losses for the NHIS, which has remained in surplus since 2021 but has seen its annual surplus decline each year. The NHIS saw a surplus of 499 billion won last year, down from 1.7 trillion won in 2024.
Financial strains due to aging population
While the growing number of foreigners using health care services may have added financial pressure to the system, another big challenge is the country’s declining number of taxpaying citizens.
Korea has recorded a fertility rate below one child per woman since 2018, with the figure at 0.8 in 2025. If the low birthrate persists, sustaining the current health care system will become increasingly difficult and could lead to higher taxes or reduced benefits.
“The size of the surplus continues to shrink, making efforts to improve the sustainability of the system’s finances increasingly necessary,” the NHIS was quoted as saying by a Korean outlet earlier this year. “Persistently slow economic growth and a declining working-age population are weakening the foundation for insurance premium revenue.”
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