How Korean health insurance premiums are calculated

Who pays and how

Korea's National Health Insurance is a social insurance scheme that in principle covers everyone living in the country, and premiums are collected by the National Health Insurance Service (NHIS). Members fall into two groups: employee subscribers and local subscribers. Employees and business owners with workplaces are employee subscribers; others, such as the self-employed, freelancers and retirees, are local subscribers (sometimes called regional subscribers). Family members who depend on an employee subscriber and whose income and assets are below set thresholds can be registered as dependants and pay no premium of their own. The two groups are charged differently: employee premiums are pay multiplied by a rate, while local premiums look at both income and assets. A long-term care insurance premium is billed alongside the health premium. Knowing this structure makes it easier to see why premiums change when life changes, through a new job, leaving work, a side business or registering a family member as a dependant.

Employees: monthly pay × premium rate

An employee's premium is the monthly pay amount multiplied by the health insurance rate. The monthly pay amount is the average monthly pay over the year, and tax-free pay is generally excluded. The rate is set every year and is 7.19% for 2026. Employer and employee each pay half, so the employee's share is 3.595% of monthly pay. Civil servants and school staff follow the same structure, though who pays the other half can differ. The long-term care premium is calculated separately; for 2026 its rate is 0.9448% of income, also split in half. On the bill it appears as the health premium multiplied by a set ratio, which works out to roughly 13% of the health premium. Premiums have monthly upper and lower limits, so even very high or very low pay is charged within that range. Rates and limits can change each year, so check announcements from the NHIS and the Ministry of Health and Welfare.

• Health premium = monthly pay × 7.19% (2026)
• Employee share is half: 3.595% of monthly pay
• Long-term care = 0.9448% of income, also split (2026)
• Monthly upper and lower limits apply

Income beyond your salary: the extra income-based premium

Even employee subscribers pay more if they have substantial income besides their salary. This is the income-based premium on non-wage income. If non-wage income, such as interest, dividends, business, rental, pension or other income, exceeds KRW 20 million a year, the excess divided by 12 is multiplied by the premium rate. The threshold was lowered in the September 2022 reform. Unlike the pay-based premium, the employer does not pay half of this one; you pay it all. It is based on the previous year's income as reported to the National Tax Service, so premiums billed this year usually reflect last year's income. The share of income counted can differ by type, and some income is excluded from the total. In a year when side-business or rental income rises, it is worth budgeting for a higher premium the following year.

Local subscribers: charged on income and assets

Local subscribers have no employer, so premiums are based on income and assets rather than pay. Income includes business, interest, dividend, pension, wage and other income confirmed through National Tax Service records. Assets include the property tax base of homes and land plus lease deposits, converted into points. The September 2022 reform strengthened the income-centred structure, and from the February 2024 premium the basic deduction for assets rose to KRW 100 million and the premium on cars was abolished. So with the same income, more assets mean a higher premium, while with few assets the premium is set mainly by income. Local premiums are charged per household, including members' income and assets, and billed to the head of household. New income and asset data are applied at set times each year, adjusting the premium. If your income has dropped sharply, there is a procedure to request adjustment with supporting documents, so ask the NHIS.

• Income: various income per National Tax Service records
• Assets: property tax base, lease deposits and so on
• Basic asset deduction KRW 100 million (from February 2024)
• Car premiums abolished from February 2024

Becoming a dependant

Dependants are family members, such as a spouse, parents or children, who mainly rely on an employee subscriber for their living, and they receive coverage without paying their own premium. The requirements are strict accordingly. On income, total annual income from interest, dividends, business, wages, pensions and other sources must be KRW 20 million or less, and anyone with a registered business and business income is generally not accepted. Public pensions count as income, so parents receiving pensions are sometimes removed as dependants because of this threshold. On assets, the property tax base is used: above a certain amount you are excluded regardless of income, and in the band below it a lower income threshold applies. Siblings face stricter tests. Someone removed as a dependant becomes a local subscriber and receives their own bill. Detailed amounts and exceptions can change each year, so check the NHIS guidance on dependant criteria.

Example: premiums on KRW 3 million a month

The following assumptions only show the calculation. Take an employee whose monthly pay amount is KRW 3 million. Applying the 2026 rate of 7.19%, the total health premium is KRW 3 million × 7.19% = KRW 215,700, and the employee's half is KRW 107,850. The long-term care premium is KRW 3 million × 0.9448% = KRW 28,344, with the employee paying about KRW 14,172. Together, the employee pays about KRW 122,000 a month. The actual bill may differ slightly because of rounding rules. Now assume the same person has KRW 26 million a year in deposit interest and dividends. The KRW 6 million above KRW 20 million, divided by 12, is KRW 500,000; multiplied by 7.19% this adds roughly KRW 36,000 a month as an income-based health premium, plus long-term care on top. The employer does not share this part, so the employee bears it all. The real amount can vary with how each income type is counted.

Common misconceptions

Health premiums come with a fair number of myths. First, that if you have a job, premiums apply only to your salary even if you have other income. If non-wage income exceeds the threshold, an income-based premium is added. Second, that leaving a job ends your premiums. You simply switch to being a local subscriber or a dependant; coverage itself continues. Third, that a sudden rise in April is an error. It is usually the settlement reflecting changes in the previous year's pay. Fourth, that parents can always be registered as dependants even if they receive pensions. Pensions count toward the income test.

• Premiums apply only to salary — large non-wage income adds more
• Leaving a job ends premiums — you become local or a dependant
• An April increase is an error — usually last year's pay settlement
• Parents with pensions always qualify — pensions count as income

April settlement and a checking order

Employee premiums are first collected on the previous year's pay, and once the year turns, the difference against pay actually received is settled. After the employer reports total pay for the previous year to the NHIS, the result is usually reflected in the April premium. People whose pay rose or who received bonuses pay extra; those whose pay fell get money back. Large additional amounts can be paid in instalments. So a health premium on the April payslip that looks different from usual is common. If a premium seems wrong, check in this order. First, confirm whether you are an employee or local subscriber, and whether dependant registrations are correct. Next, separate the health and long-term care premiums on the payslip and see whether a settlement amount is included. If you have non-wage income, check for a separate income-based bill. The NHIS premium inquiry and consultation services let you see the underlying data.

• Confirm status (employee or local) and dependant registration
• Look at health and long-term care premiums separately
• In April, check for a settlement amount
• With non-wage income, check for a separate bill
• Use NHIS inquiry and consultation to see the basis

A common case 1: premiums jumped after leaving a job

When you leave a job you lose employee status and, unless you can become a family member's dependant, become a local subscriber. If you own assets or had high income last year, the local premium can be much higher than your former share at work. Voluntary continuation exists for this situation. You can apply if, during the 18 months before leaving, you held employee status for a total of at least one year. If approved, you keep employee status for up to 36 months from the day after leaving and pay a premium at the level of your own former share. You must apply to the NHIS before two months have passed from the payment due date of the first local premium billed after you became a local subscriber. It does not help if the local premium is lower, so compare the two before deciding. If a working family member could take you on as a dependant, that may be the first option to consider. This is separate from applying for unemployment benefits.

A common case 2: a freelancer's premium rises late

Freelancers and the self-employed often become local subscribers. The income part of the local premium is based on income reported to the National Tax Service; global income tax returns are filed in May of the following year and the data is applied to premiums at a set time each year, so there is a lag between the year income rose and the time the premium goes up. Conversely, when work dries up and income falls sharply, the premium may still be based on older income. In that case there is a procedure to request adjustment by submitting proof of business closure, end of a contract or a fall in income, so ask the NHIS. It is also common for a freelancer registered as a working family member's dependant to be switched to local subscriber status once income exceeds the threshold. Remembering that your income tax return carries through to health premiums makes it easier to plan the following year's spending.

Limits and disclaimer

This article is general information to help you understand how Korean health insurance premiums are structured. The health insurance rate of 7.19% and the long-term care rate of 0.9448% are for 2026, and the non-wage income and dependant income thresholds, the basic asset deduction and the voluntary continuation conditions reflect the system at the time of writing. Rates, upper and lower limits, thresholds and timing can change from year to year, so confirm with official guidance from the National Health Insurance Service and the Ministry of Health and Welfare. The pay and income in the example are assumptions to show the method, and actual bills can differ with rounding and with how each income type is counted. Consult a tax accountant on income reporting. This is not legal or tax advice, and an NHIS consultation is the most reliable way to check an individual case. Statutes can be read on the National Law Information Center run by the Ministry of Government Legislation.