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Korea Guide

NHIS Mandatory National Health Insurance

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DALL·E 2024-01-09 09.18.49 - A webtoon-style illustration of the Korea National Health Insurance Service, focusing on promoting wellbeing with fewer characters. The scene depicts  Large.png
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Category
Korea Guide
Date
Jan 12, 2024
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Published
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A comprehensive guide to the Korean National Health Insurance System (NHIS) - its coverage, enrollment, premiums, and accessing healthcare services in South Korea. Learn about exemptions and how to apply
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Introduction

The Korean National Health Insurance System (NHIS) is a mandatory health insurance program in South Korea. It provides healthcare coverage to all residents, including both Korean citizens and foreigners living in the country.

Coverage and Benefits

Under the NHIS, you have access to a wide range of healthcare services, including hospital visits, doctor consultations, prescription medications, and preventive care. The insurance coverage also extends to specialized treatments and surgeries, ensuring that you receive necessary medical care without facing significant financial burdens.

Enrollment and Eligibility

All residents of South Korea are required to enroll in the NHIS, regardless of their nationality or visa status. For Korean citizens, enrollment is automatic through the resident registration system. Foreigners residing in Korea for more than six months will automatically be enrolled.

Premiums and Contributions

The NHIS is funded through monthly premiums, which are based on an your income level. Both employers and employees contribute to the insurance premiums, with the amount varying depending on the income and employment status. The premiums are deducted from the monthly salary for employees, while self-employed you are responsible for making their own contributions.

Accessing Healthcare Services

With the NHIS, you can easily access healthcare services at various medical institutions across South Korea. When you go to a hospital, just show them your Resident Card (ARC), and then they can verify if you have entered the health care system.

Payment for NHIS Contribution

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Every month, you will receive mail sent to your home address from NHIS asking you to pay your contribution. The contribution amount varies based on your income. If you are employed, the contribution will be roughly 7% of your income, with the company paying half and you paying the other half. If you have no income, there is a base fee of around 127,510 Won, along with a long-term care fee of 16,300 Won, totaling 143,840 Won per month (2023).
If you are a student at a Korean university, you only need to pay 50% of the base fee, which is 63,755 Won.
There are several ways to pay your contribution:
  1. KakaoPay: Scan the QR Code to directly wire the amount to NHIS.
  1. Convenience Store: Take the receipt to your nearest convenient store (GS25, 7-ELEVEN, CU, MINI STOP) and pay with any payment method, including card or cash.
  1. Automatic Transfer: If you have a Korean bank account, you can set up automatic transfers. Call 033811200 (Foreign Language Hotline) and ask for an automatic transfer. They will take your data, and monthly deductions will be made automatically from your Korean bank account.

Exemption from NHIS

Steps to Exempt Yourself from NHIS in Korea for Certain Visas

  1. Check Eligibility: Determine if you are eligible for exemption from the Korean National Health Insurance System (NHIS) based on your visa type. Time-limited visas such as Working Holiday, Student Visa, and Digital Nomad Visa may qualify for exemption.
  1. Prepare Required Documents: Gather the necessary documents for exemption application, which may include:
      • Copy of your valid passport
      • Copy of your visa
      • Proof of alternative insurance coverage (e.g., travel insurance, private health insurance)
      • Exemption Application Form
  1. Visit the Local NHIS Office: Locate the nearest NHIS office and visit during their operating hours. You may need to make an appointment in advance.
  1. Submit Exemption Application: Complete the exemption application form provided by the NHIS. Include all required documents and ensure that they are properly filled out and signed.
  1. Provide Insurance Information: Submit documentation or proof of your alternative insurance coverage that meets the NHIS exemption requirements. This may include policy details, coverage dates, and information about the insurance company.
  1. Wait for Processing: After submitting your application, the NHIS will review your documents and evaluate your eligibility for exemption. The processing time may vary, so it is advisable to inquire about the estimated timeframe during your visit.
  1. Receive Exemption Decision: Once the NHIS has processed your application, you will receive a decision regarding your exemption status. If approved, you will be exempted from the NHIS and will not be required to pay contribution fees.
  1. Maintain Proof of Exemption: Keep a copy of the exemption approval or any relevant documents as proof of your exemption status. This may be required for future reference or renewal of your visa.
Please note that the specific requirements and procedures for exemption from NHIS may vary based on your visa type and your circumstances. It is recommended to contact the NHIS or visit their official website for the most up-to-date information and guidance regarding exemption applications.
 

Exemption Application Form

  1. Insurance Launched in Korea: This implies that the foreign insurance policy must be recognized and valid in Korea. Policies that are exclusively foreign without any recognition or partnership with Korean insurance providers may not be considered sufficient for exemption.
  1. Insured’s Name and Date of Birth: The policy must clearly state the insured person's full name and date of birth, ensuring that the insurance coverage is verifiably linked to the person applying for the exemption.
  1. Insurance Subscription Date: The start date of the foreign insurance coverage must be prior to the date on which you register as a resident in Korea. This suggests that the foreign insurance was already in effect before their residency in Korea began and is not a new policy acquired after arrival.
  1. Medical Coverage for Common Disease Injuries: The insurance must provide coverage for general medical issues and injuries that a person might typically encounter, thus ensuring that you have comprehensive coverage that is equivalent to or better than what the Korean National Health Insurance would offer.
  1. Number of Guarantees: There should be no cap on the number of times an insured can claim insurance for medical treatments. This ensures that the foreign insurance coverage does not fall short of the unlimited coverage provided by the Korean National Health Insurance Service.
  1. Health Protection in Korea: The insurance must be valid and applicable within Korea, meaning it should provide protection and coverage for medical services received in Korea, just as the Korean National Health Insurance would.
  1. Maximum Medical Coverage Amount: The policy must not have a maximum coverage limit, or if it does, it should be a substantial amount (at least one billion won), to ensure that any and all kinds of medical expenses can be covered without financial strain to the insured.
Note: Formal translation and apostille by authorized company not needed; you can translate the policies into Korean yourself (Translation Applications, Friends…).
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Automatic Cancellation

Once your visa expires and you leave the country, your health insurance will automatically cancel, and you don't have to worry about calling the NHIS to cancel your contribution payment. When you leave the country for more than 30 days, your subscription will also be canceled, and you will be re-enrolled after 6 months.
 

Unpaid Contribution Fees

Not paying the contribution fees for the National Health Insurance Service (NHIS) in Korea can have several consequences. Here are some potential outcomes:
  1. Loss of Coverage: Failure to pay the contribution fees may result in the suspension or loss of health insurance coverage. This means that you will not be able to access healthcare services covered by the NHIS, including hospital visits, doctor consultations, and prescription medications.
  1. Ineligibility for Exemptions: If you fail to pay the contribution fees, you may become ineligible for certain exemptions or benefits provided by the NHIS. For example, if you are on a time-limited visa and wish to be exempted from the NHIS, non-payment of contribution fees may jeopardize your eligibility for exemption.
  1. Accumulated Debt: Unpaid contribution fees can accumulate as debt over time. The NHIS may impose penalties or interest on overdue payments, leading to a larger financial burden in the future.
  1. Difficulty in Re-enrollment: If your NHIS coverage is canceled due to non-payment, re-enrollment may become challenging. In some cases, you may need to go through additional procedures or face delays in rejoining the NHIS, potentially leaving you without health insurance coverage during that time.
It is important to fulfill your financial obligations by paying the NHIS contribution fees to ensure continuous access to healthcare services and avoid any potential negative consequences. If you are facing difficulties in making payments, it is advisable to reach out to the NHIS or seek guidance from relevant authorities to explore possible solutions or alternative arrangements.
Please note that the consequences may vary depending on the specific circumstances and regulations of the NHIS. It is always recommended to consult with the NHIS or relevant authorities for accurate and up-to-date information regarding the consequences of non-payment of contribution fees.
 

Conclusion

In conclusion, the Korean National Health Insurance System (NHIS) provides comprehensive healthcare coverage to all residents, including Korean citizens and foreigners living in South Korea. Through the NHIS, you have access to a wide range of medical services, including hospital visits, doctor consultations, prescription medications, and preventive care. Enrollment in the NHIS is mandatory for all residents, and premiums are based on income level. The insurance card, known as the National Health Insurance Card, is used to verify coverage and facilitate seamless payment processes. Exemptions from the NHIS are possible under certain conditions, and unpaid contribution fees can lead to consequences such as loss of coverage and accumulated debt. It is important to fulfill financial obligations by paying the NHIS contribution fees to ensure continuous access to healthcare services. Remember to consult with the NHIS or relevant authorities for accurate and up-to-date information regarding the NHIS and its policies.
Please note that the process and regulations may vary depending on visa type and your circumstances. It is recommended to visit the NHIS office early during your stay in Korea to ensure a smooth process and avoid any potential issues with your NHIS contribution.
Take advantage of the Korean National Health Insurance System and prioritize your health and well-being during your time in Korea.
 
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