A year after South Korea introduced stricter health insurance rules for foreign residents, misuse of the system has noticeably dropped, especially among Chinese nationals.
According to the National Health Insurance Service, the number of Chinese dependents enrolled under Korea’s national health insurance fell from 111,059 in March 2024 to 106,243 in March 2025. That is a decrease of nearly 5,000 people within one year.
The policy change was introduced amid growing concerns that foreign nationals were listing non-resident family members as dependents to access medical care in Korea at little or no cost. Many of them traveled briefly to Korea for treatment, without ever paying into the system.
Chinese nationals, who make up a large share of Korea’s foreign population, were the most frequent users of this loophole. In some cases, individuals registered not just immediate family but also distant relatives to receive covered procedures.
In response, the government amended the law in April 2024. Now, any foreign dependent must reside in Korea for at least six consecutive months before becoming eligible for coverage.
The financial impact has been substantial.
NHIS data shows that health insurance accounts linked to Chinese nationals moved from a 2.7 billion won ($2 million) deficit in 2023 to a 5.5 billion won surplus in 2024.
Other nationalities showed similar trends. Vietnamese dependents fell from 20,499 to 18,881, while Americans decreased from 6,673 to 6,207. Surpluses linked to those groups increased by 37.6 billion won and 5.3 billion won, respectively.
Overall, the total surplus generated by foreign dependents rose from 730.8 billion won to 943.9 billion won over the past year.
“There was a clear improvement in the financial balance after the reform,” said an NHIS official. “The effect was especially noticeable among Chinese nationals, who account for nearly half of all foreign residents in Korea.”
mjh@heraldcorp.com
