Korean health insurance — what foreigners pay, and the one part you can opt out of
Verified firsthand · National Health Insurance Act Article 109, its Enforcement Decree Articles 44 and 44-2, Enforcement Rule Article 61-2, and the Long-Term Care Insurance Act Article 7(4) with Decree Article 3-2, read directly on law.go.kr on 2026-08-27
Two things surprise most foreign workers about Korean health insurance. The first is that nobody asked them if they wanted it — enrolment happens by operation of law. The second is that one line of the deduction, the one almost nobody notices, can be removed on request if you hold the right visa.
Short answer
Employee (직장가입자) — deducted from your payslip
Health insurance 7.19% → you pay half 3.595%
Long-term care 0.9448% → you pay half 0.4724%
Your share, total 4.0674% of monthly pay
Opt-out E-9 · E-10 · H-2 · D-3 · E-8 may APPLY to leave long-term care
On 2.5m won a month that is about 11,810 won saved per month
You do not choose to join
National Health Insurance Act, Article 109(2) says a foreigner working at a covered workplace becomes an employee subscriber if any one of these is true:
| 1 | registration under the Resident Registration Act, Art. 6(1)3 | |
| 2 | domestic residence report under the Overseas Koreans Act, Art. 6 | |
| 3 | ALIEN REGISTRATION under the Immigration Act, Art. 31 | ← most people |
The wording is "becomes", not "may join". If you are registered and employed, you are in. There is no application to file and no way to decline.
If you are not an employee subscriber, Article 109(3) can still pull you in as a local subscriber (지역가입자) once you have lived in Korea for six months (Enforcement Rule Article 61-2(1)) and hold alien registration plus a qualifying status.
Some statuses do not wait six months — they are enrolled from the start:
| F-5 | permanent residence |
| E-9 | non-professional employment |
| F-6 | marriage migrant plus study / general training statuses designated by the Minister of Health and Welfare |
Article 109(4) adds the family exception: an employee subscriber's spouse and children under 19 (including the spouse's children) are covered as dependants without the residence-period requirement.
The rates, and where they come from
Enforcement Decree Article 44(1) sets the health insurance rate at 719 per 10,000 — 7.19% (amended 23 December 2025).
Long-Term Care Insurance Act Enforcement Decree Article 4 sets long-term care at 9,448 per 1,000,000 — 0.9448% of monthly pay (amended 30 December 2025).
The long-term care premium is not calculated straight off your salary. Article 9(1) of that Act computes it as:
health insurance premium × (long-term care rate ÷ health insurance rate)
0.9448 ÷ 7.19 ≈ 0.1314 → about 13.14% of your health insurance premium
Employees split both with the employer, which is where 4.0674% comes from.
Local subscribers are assessed differently — on property and income points, at 211.5 won per point (Decree Article 44(2)). That calculation is done by the NHIS, not by you.
The part you can drop
This is the piece worth reading twice.
Long-Term Care Insurance Act, Article 7(4):
Notwithstanding paragraph (3), where a foreigner prescribed by Presidential Decree, such as a foreign worker under the Act on the Employment of Foreign Workers, files an application, the Corporation may exclude them from long-term care insurance subscribers, as prescribed by Ministry of Health and Welfare Ordinance.
Enforcement Decree Article 3-2 names who qualifies:
| Foreign workers under the Foreign Workers Employment Act | E-9 · E-10 · H-2 |
| Technical trainees | D-3 |
| Seasonal workers | E-8 (D-3 and E-8 were added by the 12 May 2026 amendment) |
Two words in that article decide everything: "may" and "files an application". Nothing happens automatically. If you never apply, the deduction continues for as long as you work in Korea.
0.4724% of 2,500,000 won = about 11,810 won a month
= about 141,700 won a year
The trade-off is real but small for this group: leaving the scheme means you would not receive long-term care benefits, which are nursing-care benefits for old age and severe disability — not something a worker in their twenties or thirties is likely to claim during a Korean work stint. Decide with that in mind, and ask the NHIS (1577-1000) how to file.
Falling behind on premiums is worse for you than for a Korean
Article 109(10) is the harshest provision in this article, and it applies only to foreigners:
Where a foreigner staying in Korea who is a local subscriber has been in arrears for a period prescribed by Presidential Decree or longer, no insurance benefits shall be provided from the date of arrears until full payment, notwithstanding Article 53(3). The proviso to Article 53(3) and paragraphs (5) and (6) shall not apply.
Read what the last sentence removes: the instalment-payment and relief provisions that apply to Korean subscribers are switched off. In practice that means hospital bills come back to you in full while the arrears stand.
We could not confirm the exact number of months that counts as "a period prescribed by Presidential Decree" — it sits in Decree Article 76-5, which we have not read. We do not guess at it. If you are behind, call 1577-1000 and ask directly.
Leaving the country for a while
Enforcement Decree Article 44-2: premiums are waived for a stay abroad of three months or more. If the NHIS accepts that you are abroad for work, one month is enough.
Frequently asked questions
My employer says I do not need health insurance. Is that possible? Not if you are registered and working at a covered workplace — Article 109(2) makes you a subscriber by law, whatever your employer says. Verify it with the NHIS rather than with the employer.
I am a student. Am I enrolled? Study and general training statuses designated by the Minister of Health and Welfare are enrolled as local subscribers without the six-month wait. Check your specific status with the NHIS, since the designation list is ministerial, not statutory.
I already paid for a private plan. Can I use that instead? No. Public enrolment is not optional and does not depend on other cover you hold.
How do I check what I am paying? Your payslip shows both lines separately — 건강보험 and 장기요양보험. Multiply your monthly pay by 3.595% and 0.4724% and the numbers should match.
Sources
National Health Insurance Act (국민건강보험법)
Art. 109 — special provisions for foreigners (paras 2, 3, 4, 10)
https://www.law.go.kr/법령/국민건강보험법
Enforcement Decree — Art. 44 (rates, amended 2025-12-23) · Art. 44-2 (waiver while abroad)
Enforcement Rule — Art. 61-2 (local subscriber registration by foreigners),
in force 2026-08-11, MOHW Ordinance No. 1187
Long-Term Care Insurance Act (노인장기요양보험법)
Art. 7(4) — exclusion on application · Art. 9 — premium calculation
Enforcement Decree — Art. 3-2 (who may apply, amended 2026-05-12) · Art. 4 (rate, amended 2025-12-30)
https://www.law.go.kr/법령/노인장기요양보험법
National Health Insurance Service: 1577-1000 (foreigner service desk;
the NHIS site has English, 中文, 日本語 and Tiếng Việt editions)
