This is the second in a series of articles about how foreigners can fall through cracks in the Korean health service. ― Ed.

Investing more than 50 million won ($46,331) in the local economy, marrying a permanent resident and living here for eight years might seem commitment enough to the country to benefit from the same public health coverage as Korean citizens.

Not so for “Sarah,” an expatriate whose quarterly trips to Australia to see her elderly father disqualify her from enrollment in the Korean national health insurance scheme.

“When I first (started) being an investor I had to give up Korean national health insurance for some reason. I then went along recently thinking it would just be a fait accompli, that I could reregister because I am facing some very expensive health treatment at the moment, and was basically told ‘sorry, no you don’t qualify because you haven’t been here for three months,” the woman, who did not wish to use her real name, told The Korea Herald.

Because Sarah doesn’t have regular salaried employment and can’t be in the country for 90 days without interruption, she is not covered by the national scheme ― despite living here most of the year and having provisional permanent resident status.

“I don’t necessarily leave here through choice always. It’s because my dad is 88 and is trying to run a sheep farm on his own in Australia,” she said.

Sarah, who runs her own business here on a D2-3 investor visa, has had to pay out of pocket for extensive medical treatment she has undergone.

“I just had treatment this week, and it cost me 7 million won because I didn’t have Korean health insurance. It would have been a lot cheaper with it.”

After having invested so much time and money in Korea, she can’t understand why she shouldn’t be able to pay into the scheme and benefit from subsidized medical care.

“It’s not like I am going to them as a visitor or an English teacher. I am basically a quasi-permanent resident in this country with the rights and privileges of a Korean and yet I am not being treated like a Korean. That’s how I see it,” she said.

“I really feel quite anxious about not having insurance.”

Private insurance is not an option for Sarah as private policies only cover ailments and procedures not covered under the national scheme.

“We are just lucky we can afford this, you know,” said Sarah, “we have prioritized this. But there must be other people who would really struggle with that amount.”

Park Min-soo, a spokesman for the health insurance policy division of the Ministry of Health and Welfare, told The Korea Herald that the requirement for foreigners to be in the country for 90 days without interruption only applied to those without salaried work of at least 60 hours a month.

“If there is not such a requirement there will be some problem. The medical costs in Korea are lower than other advanced countries so some people may come here just for high cost medical treatment, so we require a minimum resident period for three months,” Park said, adding that there was a problem with foreigners, mainly Americans, coming to Korea for treatment, staying the required period and returning home.

Park said the Health Ministry currently had no plans to change its policy, and that to the contrary there were voices in the National Assembly calling for the minimum resident period to be extended.

“Both ways have some problems. Extend, we will reduce that kind of problem (medical tourism) but we can make another kind of problem because people cannot by covered by the national health insurance. I think, currently, three months is proper,” he said.

Park recommended that foreigners with a serious medical condition take up regular employment to ensure they are covered.

Sarah, who herself volunteers to help foreigners who fall through the cracks of the health service, is now trying to arrange her schedule around the three-month requirement, but she is angry that the system shuts her out.

“I have my own business, I pay my own way so that just makes me feel even more hurt that I can’t get access to things that should really be fairly automatic, especially given I’ve just had surgery this week in hospital. I just would like to be part of this system that I was always a part of for so long.”

By John Power (john.power@heraldcorp.com)