Everything You Need To Know About The Korean National Health Care System


Everything You Need To Know About The Korean National Health Care System

 

By law, South Korea has a National Health Insurance (NHI) system which every resident in the country is eligible to receive coverage for regardless of nationality or profession. The National Health Insurance Corporation (NHIC) is the only public insurance corporation that is currently operated by the Ministry of Health and Welfare in Korea.

This system works by being funded by mandatory contributions from all South Korean residents and government subsidies. Foreigners living in South Korea who have been registered with the NHIC are eligible to receive the same benefits as South Korean residents. Payment for the National Healthcare Service is made through your employer after deducting 3% of your monthly salary, this deduction is matched by the company for a total of 6% of your salary being allocated towards the National Health Insurance. Unless you are self-employed or working part-time, in this situation you are responsible for paying. The amount to be paid for Healthcare Coverage each month depends on your income and economic standing. 

There are two kinds of health insurance in South Korea: Employee health insurance (covered by your workplace), and Self-employed health insurance (paid personally by you). Foreigners living in South Korea with a sponsored visa do not have to enroll and pay on their own. If you are living here and are self-employed or freelancing, you will need to pay a minimum of 114,000 won per month for coverage if you have been in South Korea for 6 months or longer.

 

What is covered by National Health Insurance?

The cover provided by the National Healthcare Coverage is quite comprehensive! It includes regular health check-ups, tests, and diagnoses, prescriptions, dentist visits, treatments, surgeries, preventive care, nursing, hospitalisation, rehabilitation, and transportation.

The above-mentioned insurance benefits are the same for all contributors to the NHI plan. It is important to know that medical expenses are not 100% covered. When receiving health care you must still pay a certain amount towards the service which is called a "co-payment". The amount of a co-payment that you are responsible for paying depends on where you receive care and the type of service received.

Typically, the amount of a copayment is 20% of inpatient hospital care, 30% to 50% of outpatient care, and 35% to 40% of pharmacy bills. Many Koreans also decide to join private health insurance companies so they can receive more comprehensive coverage than what is provided by the National Health Insurance plan.

The coverage you receive will mostly depend on where you are treated. In Korea, there are four different kinds of hospitals: clinic (개인병원, 의원), hospital (병원), general hospital (종합병원), and tertiary hospital (대학병원). A tertiary hospital – or university hospital – is fully equipped with a large range of services and departments and generally have the most experienced specialists. 

 

 

At these hospitals outpatient treatments are only 40% covered, meaning you have to pay the remaining 60% of the bill in addition to needing a referral from your local clinic. If you want to receive care at these hospitals without a doctor’s referral, you will have to pay 100% of the bill. This prevents people from going to these large hospitals for minor problems. If you visit your local clinic instead, the percentage of coverage will be about 70%, which encourages people to visit local clinics to save money! Preventive care is also encouraged and 100% coverage of general health exams is offered to everyone covered by National Health Insurance! If it happens that you require such as long term inpatient care or non-elective surgeries and have large bills to pay as a result, there is also a program called “Compensation for Excessive Co-payment.” If your portion of the co-payment comes to more than KRW 1,200,000 within 30 days, 50% of the excess amount will be covered by the NHIS!

 

What is NOT Covered by Korean National Health Insurance?

Two major things that are not covered under the NHIS are accidents or physical injuries, and MRI scans. MRI scans are covered, however, if you are being treated for cancer or a life-threatening disease. In regards to accidents and physical injuries, the government holds people responsible for their actions and as such, states that accidents and physical injuries are not covered. This also relates to accidents where you or any other people are involved, for example, if you injure yourself then you are responsible for paying 100% of your medical bills. If you injure someone else, you will be responsible for paying THEIR medical bills. Vice versa, if someone injures you, they will be responsible for YOUR medical bills. In all cases, the government is not responsible and it is not covered by your National Health Insurance. 

While most medical practitioners must follow the rules set by the government, some practices are not covered by the NHIS, allowing them to set their own pricing.

Some of these practices include: 

  • Medicine, materials, or medical services provided for a disease that does not affect the patient’s daily life. 

  • Medicine, materials, or medical services that do not improve essential body functions. For example, Cosmetic surgery, acne scar removal, etc.

 

How to Register for the Korean National Health Insurance Service

 

 

Through Your Company

Your monthly contribution will be calculated by your employer based on your salary. Both you and your employer should pay 3% of your monthly salary for a combined total of 6% in contributions. 

Your enrollment in the plan should also be handled by your company. You will need to give them your ARC (Alien Registration Card) in order to do this, and do not need to visit the NHIS office.  

For non-public school English teachers, a way to test that you are legally registered by your school is to ensure you are enrolled in NHIS by checking your pay-stubs for a low tax amount (3.3% for independent contractors) and make sure you receive your health insurance booklet in the mail. If you don’t receive one, follow up with your company and demand they handle your enrollment in the program. 

 

Self-Employed, Freelancers, and Unemployed

This applies to H1 visas, F2-F6 visas, student visas, and more. Below is the process you must follow to enroll yourself in the program. You must also have an active ARC card to be able to enroll yourself! 

  1. Visit one of the NHIS (국민건강보험) offices in Korea.

  2. Ask to be enrolled in the 지역 건강보험 (Community Health Insurance Plan). 

  3. The attendant will use your ARC to find your information.

  4. They will ask if you are enrolling on behalf of any dependents. If you are, they should have the same address as you.

  5. You will be given an insurance passbook right away so you do not need to wait for one in the mail. 

  6. You will be asked to prepay for at least one month or pay based on the number of days that have passed since your 6 months stay in Korea. (If you apply 8 months after living in Korea, you will be asked to pay for the previous 2 months. 

    • If you switch from employed insurance to self-employed insurance, you will not need to pay, but make sure to visit the NHIS office right away!

  7. You will receive monthly bills by mail. To pay these you can set up an automatic transfer for the month to be deducted, or manually transfer the amount each month.  All payments are due by the 25th of each month. 

 

Automatic Enrolment

If you are living in South Korea on an H1 or an F series visa, you will automatically begin receiving bills in the mail after 6 months of living here. Having a visa in South Korea allows you to apply for an ARC card – which you will need for setting up a phone plan, banking, etc. Because your information is registered with the government, they can see when you have reached 6 months of living in the country! Once you start receiving these bills you will need to pay them the same way you would if you were registered for self-employed insurance (see instructions #7 above).

 

How to Use Your National Healthcare Insurance 

 

After you have received your health booklet either in the mail or in person, you are registered in the National Healthcare Insurance System. When you visit any medical institution (hospital, clinic, dentist) you will be asked for your ARC card. Your information can be looked up through your ARC number since it is technically your resident number and is connected to your account. The health book simply acts as proof of insurance, but you do not need to bring it when going for appointments. Keep this in a safe place at home! 

 

What to do When Leaving Korea?

If you are planning to leave South Korea you will want to suspend or terminate your enrollment in the National Health Insurance System. If you plan to leave South Korea for more than 30 days, the cancellation will happen automatically once you leave the country. When you return to Korea, you will be required to wait again for 6 months before being able to enroll in the program. If you decide to leave South Korea earlier than 6 months, or you decide to leave before your visa ends, you will need to notify that you will not be re-entering the country within 30 days so they do not send you any bills! You can read more about how to cancel your National Health Insurance here

If you plan to return to South Korea and do not want to wait 6 months to enroll again, you can opt to register for 임의계속가입 (Continuation of Coverage), which is a continuation of your health insurance. You will have to pay the same amount monthly that was being taken out of your paycheck or that you were paying on your own via bank transfer while you are out of the country. Make sure you sign up for this before you leave! 

 

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