Policy mandates foreigners pay full average health premium if below national average
Foreign residents in South Korea face an increasing financial burden from health insurance premiums, as their costs continue to rise at a disproportionate rate compared to local subscribers.
According to data from South Korea’s health insurance authorities released Friday, the average monthly health insurance premium per household for foreign residents who are enrolled in the universal health care system as "local subscribers" has steadily increased over the past five years, rising from 118,180 won ($81) in 2021 to 135,280 won this year. The premium for a local subscriber is calculated based on their asset level, while "employer-provided" subscribers pay a premium determined by their income.
Foreign nationals who have lived in South Korea for more than six months are eligible to apply for the national health insurance system. However, if they are unemployed or self-employed, they must apply under the "local subscriber" category, rather than the employer-provided plan. Even if a foreign worker is employed but the employer does not cover the insurance premium, they still must register under the local subscriber category.
Meanwhile, the average monthly premium for all local subscribers has declined from 90,864 won in 2020 to 82,186 won in 2024, widening the gap between the two groups to 1.62 times as of 2024.
The root of this disparity stems from a policy introduced in 2019, which mandates that if the calculated premium for a foreign local subscriber falls below the national average —encompassing all insured individuals, including those with employer-provided coverage— they must still pay the full average premium amount. Since local subscribers do not benefit from employer contributions toward their insurance, they typically face higher premiums than their employed counterparts, leading to an automatic increase in the minimum premium for foreign local subscribers.
Health authorities argue that it is difficult to accurately assess the income and assets of foreign local subscribers, making it necessary to apply a universal minimum premium. However, critics say this approach disproportionately impacts foreign workers, particularly those in low-income brackets, forcing them to pay more than they otherwise would under a system that fairly evaluates their financial status.
Foreign local subscribers also face limitations in family coverage. While Korean local policyholders can include parents, unmarried siblings and even in-laws under their household coverage, foreign nationals can only include their spouse and minor children. As a result, families living together — such as migrant workers with elderly parents or adult children — are required to pay separate premiums for each member, placing a heavier financial strain on them.
In addition, foreign residents face harsher penalties for unpaid premiums. If a foreign subscriber fails to make payments, their health coverage is immediately suspended until the full amount is settled, leaving them without medical protection. In contrast, Korean subscribers can still receive health care benefits if they have missed fewer than six payments or have made partial repayments.
As the debate over fair treatment for foreign national workers in South Korea continues, advocates emphasize the need for reforms that would bring the national health insurance system in line with global standards and prevent excessive financial burdens on vulnerable groups.
jychoi@heraldcorp.com
