Foreign residents suffer discrimination in health insurance system: report

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By Lee Hyo-jin

Residents of foreign nationality who are enrolled in Korea's national health insurance program suffer from discrimination in the system compared to their Korean national counterparts, according to a recent report released by the National Assembly Research Service.

The report, released on April 20, found that the rise of foreign national subscribers has helped improve the National Health Insurance Service (NHIS)'s fiscal soundness, but many of them experience disadvantages over Korean national enrollees.

Foreign nationals who are employed in companies here are enrolled in the national health insurance via their employers. Those who are freelancers or self-employed are automatically registered as "regional subscribers" after they have resided in Korea for six months.

As of 2021, of the 1.64 million foreign national residents in Korea, 1.26 million are registered for the state health insurance. The number of foreign national subscribers registered via their employer increased to 690,000 from 640,000 in 2017. During the same period, the number of regional subscribers surged to 570,000, more than double the 270,000 in 2017.

The report pointed out that regional subscribers of foreign nationality are suffering from unfair treatment.

Under the current system, insurance premiums for regional subscribers are imposed only on the head of household, not to each member of the household. But unlike Korean national regional subscribers, who can register any cohabitating person in their household as a member, foreign national subscribers can register only their spouse and underage children as members of their household covered by the national health insurance.

Moreover, the report said that the disadvantage for the failure to pay or delayed payment is excessively harsh for foreign nationals. While Koreans are still eligible for insurance benefits even if they fail to pay the monthly premiums, foreign nationals would immediately lose their insurance coverage in the same situation.

The report noted that the surge in the number foreign national enrollees has improved the fiscal soundness of the NHIS.

In 2020, insurance premiums imposed on foreign national subscribers totaled about 1.54 trillion won ($1.24 billion), up 98.7 percent from 775.6 billion won in 2016. In 2020, their total amount of reimbursements amounted to less than 960 billion won, bringing the NHS a net profit of over 580 billion won. Among the total, 460.9 billion won in insurance premiums was imposed on regional subscribers in 2020, a nearly sixfold increase from 77.2 billion won in 2016.

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