Health insurance in South Korea: How to choose the right plan

If you’re planning to move to South Korea as an expat, you’re going to need to understand how healthcare and health insurance works. First, let’s start with the most important detail: Anybody who stays in the country for more than six months has to sign up for the local healthcare system. This is known as the ‘National Health Insurance Service’ (NHIS). We explain how this works in more detail below.

In South Korea, virtually all residents use NHIS as their default healthcare option. Broadly, the system is effective, and healthcare outcomes are positive. For example, life expectancy is 84 – the third-highest in the OECD, and higher than the average of 81. And as many as 69% of people in the country are satisfied with the quality of healthcare, vs. the OECD average of 64%.

As such, South Korea regularly sits at or near the top of global healthcare system rankings. But that doesn’t mean it’s perfect. In particular, Korean health insurance out-of-pocket costs are much higher than in other developed countries around the world. That’s why additional private or international health insurance is very popular.

How does healthcare in South Korea work?

In South Korea, the NHIS is the backbone of the healthcare system. In practice, almost everybody in the country is enrolled in the system. Unless you’re a short-term resident or tourist, any private insurance you take out has to work alongside NHIS – not instead of it.

NHIS was first rolled out in the 1970s and 80s. At first, it was available to employees of large companies, but it gradually expanded to include the whole population by 1989. In the early 2000s, the government merged several health organizations into a single integrated system. This created the NHIS as it stands today.

Today, healthcare in South Korea is a universal, single-payer healthcare system. This means most people pay regular insurance payments via salary deductions or direct payments. Then, there are extra charges (co-pays) when you receive treatment.

Despite it being a universal system, most healthcare providers in South Korea are private businesses. But costs are tightly regulated by the government, which means it still operates like a single, unified system in practice.

How does NHIS work?

The National Health Insurance Service is a single insurance scheme that covers virtually everybody in the country. Citizens and long-term residents participate in the system by default. Expats who are staying for longer than six months also have to enroll.

Compared to other public health systems around the world, NHIS has relatively wide coverage. It includes most standard treatments like general check-ups, pregnancy, tests, surgeries, and rehabilitation. But it also goes further, by including basic dental/optical checkups, as well as some alternative medicines (e.g., acupuncture).

If you’re an employee, you pay into NHIS via a fixed deduction from your salary. This is a set, flat fee of 7.19%, regardless of how much you earn. However, it’s split 50/50 between you and your employer, meaning you only pay 3.595%.

If you’re not employed, the situation is slightly different. In this case, you’re known as a ‘subscriber’, and have to pay the whole cost yourself. However, the amount varies depending on your income – unlike with employees.

The NHIS system doesn’t cover all your costs. You usually have to pay an extra 20-60% co-pay, with each treatment having its own rate.

Here are some examples of these costs:

• Inpatient treatment: 20%
• Medications: 30%
• High-level outpatient care: 60%
• General hospital outpatient care: 50%
• Clinic outpatient care: 30%
• Rare/incurable diseases (registered patients): 10%
• Cancer treatment (registered patients): 5%

These co-pays mean that out-of-pocket spending is much higher than in other countries. In fact, 29% of healthcare spending in South Korea is out-of-pocket, much higher than the OECD average of 18%.

Private health insurance in South Korea

In South Korea, private health insurance almost always works alongside the standard NHIS system. There are two main options here to consider:

Private supplementary insurance

These are private insurance plans that are designed to work alongside NHIS.

Private supplementary insurance is an increasingly popular option, with around 72% of people in the country choosing to buy it. In fact, this number has risen sharply from 51% in 2011. Given the high price of co-pays in South Korea, it’s easy to understand why.

There are several key benefits to choosing additional private insurance:

• The most important reason: Private insurance covers most of the cost of NHIS co-pays.
• Supplementary insurance also pays for treatments not usually covered by NHIS. This includes advanced dental and optical procedures.
• If you’re hospitalized, it also offers access to an upgraded private room.
• If you’re diagnosed with serious conditions (e.g., cancer), private insurance schemes can offer a lump-sum payment.

International health insurance

This option is similar to private insurance in several crucial ways. Most importantly, it works alongside the standard NHIS system to boost your coverage and reduce out-of-pocket payments.

But alongside the standard benefits of private health insurance, it also offers:

• Inpatient and outpatient coverage around the world
• Repatriation back to your home country, in the case of emergency or death
• Comprehensive health insurance until you qualify for NHIS
• Extra health coverage in South Korea and your country or origin

This option is particularly attractive for expats and anybody who regularly travels outside of the country.

However, one important caveat: International health insurance doesn’t exempt you from NHIS. If you’re staying for more than six months, you can only use this alongside NHIS – just like with standard private insurance.

Read more: How international health insurance works

Healthcare for expats: What you need to know

In principle, health insurance for expats is simple. There are two options here:

• Staying for less than six months: You do not have to sign up for NHIS or private health insurance. But if you need healthcare during your stay, you’ll have to pay 100% of the costs yourself. Therefore, travel insurance or international health insurance is strongly recommended.
• Staying for more than six months: You have to sign up for NHIS, just like everybody else in South Korea. You may also choose to buy extra private or international health insurance to get global healthcare coverage.

In addition, anybody on one of these visas is automatically enrolled in NHIS on arrival:

• D-2 (Degree Student)
• D-4 (Language Trainee)
• E-9 (Non-professional Employment)
• F-5 (Permanent Resident)
• F-6 (Marriage Migrant)

Read more: International health insurance for visa seekers

How to sign up for NHIS

For most people, enrolling in NHIS is now automatic. If you’re an employee, it’s done by your organization – and payments will be taken from your salary.

If you’re not a salaried employee, you need to first apply for an Alien Residency Card (ARC). You need to do this within 90 days of arrival – and can’t sign up for NHIS without it.

You should be registered with NHIS automatically if you have an ARC and stay longer than six months. Nonetheless, it’s wise to contact your local immigration office to clarify the progress of your application.

How to choose the right healthcare in South Korea

Here is a quick comparison of the different health insurance options we’ve discussed in this piece:

* Standard rate for employees, income-based rates apply for people not fixed employment

Even though most people qualify for NHIS, the right healthcare option will be slightly different for everybody. Here are a few examples to explain what insurance people in different situations might choose:

• English teacher: NHIS is mandatory, and you’ll usually be signed up by your employer. Add extra private insurance if you want to reduce co-pays, or international insurance if you regularly travel home.
• Corporate expat: Again, NHIS is mandatory and your employer will sign you up. The organization may also add supplementary private insurance as well.
• Student: Compulsory NHIS covers most of your healthcare needs as a student. International health insurance can be a good idea if you travel abroad during breaks.
• Freelancer: If you’re staying for longer than 6 months, NHIS is required – but you’ll have to sign up for yourself. For freelancers, policy costs will depend on your income. Consider extra international health insurance for English support and worldwide coverage.
• Spouse/dependent: You’re likely covered under your spouse’s insurance.
• Short-term visitor (< 6 months): NHIS not required. Get international or travel health insurance to avoid out-of-pocket costs.

Straightforward health insurance for expats in South Korea

If you’re an expat in South Korea, there are plenty of great reasons to get international health insurance. As well as covering co-pays, it also provides comprehensive coverage when you travel abroad. Most importantly, it also reduces out-of-pocket costs before you’ve actually enrolled in NHIS.

At Feather, we know that international health insurance can be more complex than it needs to be. As expats ourselves, we wanted to make it easier. That’s why our policies are designed to make effective healthcare coverage as easy as possible for you, including:

• English-speaking support
• Full global healthcare coverage
• Policies approved in just a few hours
• Full coverage while you transition to NHIS.

Want to find out more? Get in touch with our support team to chat through your situation today.