Foreigners’ Korea Health Insurance Balance Posts Record Surplus Above 1 Trillion Won

South Korea’s national health insurance balance for foreign residents posted a surplus of more than 1 trillion won in 2025 for the first time, according to National Health Insurance Service data submitted to ruling-party lawmaker Jeon Jin-sook.

The overall surplus reached about 1.01 trillion won, or roughly $753 million. Foreign nationals paid a combined 2.54 trillion won in insurance premiums, while medical costs covered by the national insurer totaled 1.52 trillion won. The result extended an uninterrupted run of annual surpluses for the foreign-resident account since 2017 and increased from 943.9 billion won a year earlier.

The aggregate figures, however, concealed a reversal in the account for Chinese nationals. That balance recorded a deficit of 40.9 billion won in 2025 after posting a 5.5 billion won surplus the previous year. Premiums collected from Chinese policyholders totaled 956.4 billion won, compared with 997.3 billion won in medical payouts.

The Chinese account had previously remained in deficit for seven consecutive years through 2023 before moving into surplus in 2024. Its return to the red is likely to sharpen political debate over how foreign residents qualify for coverage and how benefits should be structured.

Among other nationalities, Vietnamese residents generated the largest surplus at 160.1 billion won. Nepalese residents followed with 126.2 billion won, while the balance for Indonesian residents stood at 91.8 billion won.

South Korea has tightened enrollment rules in recent years as part of efforts to protect the health insurance system’s finances. Since July 2019, foreigners who stay in the country for at least six months have generally been required to enroll in the national program. A further rule introduced in April 2024 requires foreign nationals and overseas Koreans to reside in South Korea for at least six months before they may be registered as dependents of employees covered by workplace insurance.

Opposition lawmakers have argued for a reciprocity principle that would link insurance eligibility and benefits for foreign nationals to the treatment South Koreans receive in those individuals’ home countries. The latest figures may renew that proposal, although the overall foreign-resident account remained firmly in surplus.