South Korea has a two-tier health insurance system consisting of public and private health insurance, with a comprehensive national health service providing free at the point of delivery care for around 97% of the country’s citizens. Healthcare in the country is of a very high standard and South Korea is a leader in some aspects of treatment, including skin care. Bloomberg has ranked it as the 4th best healthcare system in the world. You will find a combination of both Eastern and Western medicine on offer in the country.

The South Korean healthcare system is run by the Ministry of Health and Welfare and offers a free at the point of delivery system for the bulk of the country’s population.

Governance is divided into four parts: the Ministry of Health and Welfare (MoHW), which supervises operations and makes policy decisions; the National Health Insurance Service (NHIS), which manages health insurance enrollment, collects contributions, and sets medical fee schedules; the Health Insurance Review and Assessment Service, which reviews fee claims and evaluates care; and finally the healthcare providers that provide healthcare per se.

Health insurance (NHI) in South Korea dates from the 1977 National Health Insurance Act but has undergone substantial reforms since, aiming at a genuinely universal coverage.

In 2000, all insurance schemes were consolidated into a single payer system. The system is funded by contributions, government subsidies, and tobacco surcharges and per capita spending is comparatively high, resulting in a generally excellent standard.

You will need to obtain an Alien Registration Card (ARC) from immigration before you will be entitled to access either public health insurance or private local cover.

As an expat you will be expected to make a small co-payment for any treatment costs.

By law, all hospitals and clinics, whether public or private, as well as pharmacies, are obliged to participate in the NHI system as providers under the NHI and cannot opt out. Healthcare providers are not allowed to deny treatment to NHI patients.

Any company employing more than five foreign personnel must enroll its expat workers in the compulsory health insurance scheme of the NHI. If you are employed in the country, therefore, you will be automatically signed up unless you are working for a very small company, in which case you can still register yourself.

If you are employed, your employer will register you automatically.

If you are self employed you will need to contact your local hospital directly and register yourself. You will require an ARC first, and you will need to take along your passport as well, plus your bank details. You may also need an initial means of payment, such as cash or a card.

You can also enrol yourself if you are a freelancer or unemployed.

You will then be given an insurance passbook.

If you are in the country for six months or more, and have registered with the immigration authorities, you will be automatically enrolled into the NHI.

Most NHI personnel speak at least basic English.

The NHI covers both Eastern and Western medicine, so you may visit either type of primary healthcare provider, or a mixture. NHI coverage includes:

• primary treatment, such as visits to your GP
• hospitalization
• maternity care
• specialist consultations
• rehabilitation
• medically related transport
• prescription costs
• preventive care
• screening (breast cancer, kidney function, etc.)
• check-ups (biannually if you are self employed)
• forms of traditional medicine, such as acupuncture

The state scheme does not, however, cover the costs of full treatment related to chronic illnesses such as cancer, although the state is making an effort to reduce co-payments for this kind of treatment.

How much you have to pay as a co-payment will depend on whether you have gone to a hospital or a smaller clinic: you may need to pay more at a hospital. You will usually have to pay around 5-10% of the total costs and there is a cap on co-payments.

Since you can register yourself with the NHI, you can be covered by national health insurance if you are retired. Korea also has a form of long-term care insurance and you may wish to investigate this possibility with the NHI.

International students must have an insurance plan during their studies in South Korea, but the NHI offers insurance to students and their dependents (spouse and children under 20). You can also take out private cover, including a medical evacuation clause, if you wish.

Your dependents (your spouse and children under the age of 20) will be covered by your national insurance, but they must live at the same address as you.

Basic dental treatment is covered by the NHI, but again you may need to make a co-payment. You can expect to pay around 30% of the cost in a dental hospital but this may rise in a local clinic.

However, dental care is reported by some expats to be of a high standard and comparatively cheap (for example, around US$10 - 16 for de-scaling and a check-up). The cost of a single crown is approximately $450; dentures are approximately $1300; and the dental implant of a single tooth is approximately $1600.

Employed expat personnel are expected to contribute around 5.08% of their income as a deduction from their monthly salary: currently the average is an insurance premium of minimum 103.080 won ($87.07) per month for F-4 visa holders. Your employer will also need to make a contribution.

If you are self employed, the amount of your monthly contributions will be evaluated by considering your income, assets, standard of living and other factors.

You may wish to take out private health insurance for additional peace of mind, particularly if you want cover which includes treatment in other countries, or a medical evacuation clause. The NHI cover, though comprehensive and offering a high standard, will not insure you for travel to other countries.

Although the Korean healthcare system is of a high standard, it is still subject to some strain, including an ageing population and the issue of chronic diseases – pulmonary complaints are particularly prevalent, for example, due to air quality problems in the country. Medical personnel ratios are also lower than some other OECD nations. Over 70% of Korean citizens have some form of private insurance in addition to their NHI cover.

Private health insurance will cover a full range of treatment, although paying out of pocket is also an option. Around a million people are estimated to visit South Korea in 2020 for purposes of medical tourism and this is a rapidly developing sector. Costs of treatment are from 30 – 85% lower than comparable treatments in the US, for example.

As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected.

The main international providers will cover South Korea, including:

• AETNA International
• Allianz
• Cigna
• Pacific Prime

National Health Insurance Service (NHIS) - the main health insurance body in the country