Unpaid Health Insurance Premiums Tied to Foreign Residents Reach 37.5 Billion Won
A National Assembly budget report says overdue state health insurance premiums owed by foreign nationals and overseas Koreans rose sharply between 2021 and 2025, prompting calls for stronger collection and residency monitoring.
Overdue premiums owed by foreign nationals and overseas Koreans enrolled in South Korea’s state health insurance system reached 37.5 billion won, or about $27.9 million, at the end of 2025, according to a government report released Monday.
The National Assembly Budget Office found that the unpaid total had increased 42 percent from 26.4 billion won in 2021. The number of households in arrears rose even faster, climbing 58.1 percent from 21,728 to 34,349 over the same period.
Foreign nationals represented most of the affected accounts. The report said 33,725 foreign households owed a combined 34.4 billion won. The figures indicate that both the value of unpaid contributions and the administrative burden of pursuing them have expanded over four years.
The budget office also highlighted the amount that has ultimately proved impossible to collect. Over the past five years, 134,505 cases worth a combined 47.7 billion won were written off as uncollectible. Such write-offs reduce the likelihood that overdue contributions will ever return to the public insurance system.
South Korean law generally suspends health insurance benefits while an enrolled person is outside the country. The report, however, described instances in which foreign workers allegedly left their foreign registration cards and insurance eligibility with others when returning home or traveling overseas. People remaining in South Korea were then able to use those identities to receive medical care.
Other reported cases involved the use of identities belonging to people who had already departed the country to obtain costly prescription medicines, which were then sent abroad. The report presented those practices as weaknesses in the way eligibility and residency changes are tracked, rather than as a problem limited to premium collection.
The National Assembly Budget Office called for authorities to strengthen collection efforts before foreign nationals and overseas Koreans leave South Korea. It also recommended a monitoring system that can identify changes in residency status and suspend benefits promptly when eligibility changes.
The recommendations are intended to prevent more overdue premiums from being written off after account holders depart. Any policy response will need to combine accurate eligibility controls with fair procedures for residents who remain legally covered, while ensuring that identity misuse does not impose additional costs on the national insurance system.