The number of foreign health insurance subscribers in the U.S. has surged by approximately 28% over the past three years, exceeding 1.68 million. During this period, the health insurance fund has posted a substantial surplus of over 2.8 trillion KRW (about 1.9 billion USD), with the top five hospitals primarily serving severe illnesses, particularly cancer cases.
According to data obtained by Representative Kim Ye-ji of the People Power Party from the National Health Insurance Service, foreign health insurance enrollment rose from 1,315,474 in 2022 to 1,685,854 in 2025, marking a significant 28% increase in just three years.
As of 2025, Chinese nationals dominated the subscriber base with 726,948 enrollees, accounting for 43% of the total. Vietnamese subscribers followed at 210,214 (12%), with Nepal and Uzbekistan each representing 5% of the total, at 81,136 and 80,975 subscribers respectively.
While the proportion of Chinese subscribers decreased from 52% in 2022 to 43% in 2025, the overall composition of foreign health insurance subscribers has become increasingly diverse, with notable growth from countries like Vietnam.
The foreign health insurance fund has demonstrated robust financial health, accumulating a total surplus of 2.8395 trillion KRW (about 1.9 billion USD) over the past three years. Between 2022 and 2024, premiums collected from foreign subscribers totaled 6.6893 trillion KRW (about 4.5 billion USD), while benefit payments amounted to 3.8498 trillion KRW (about 2.6 billion USD).
The annual surplus showed steady growth, increasing from 544.8 billion KRW (about 368 million USD) in 2022 to 730.8 billion KRW (about 494 million USD) in 2023, and further climbing to 943.9 billion KRW (about 638 million USD) in 2024.
Financial performance varied significantly by country of origin. Over the three-year period, U.S. citizens generated a surplus of 368.6 billion KRW (about 276.5 million USD), while Nepal and Vietnam contributed surpluses of 356.5 billion KRW (about 267.4 million USD) and 342.6 billion KRW (about 256.9 million USD), respectively.
Interestingly, China, despite representing 43% of all foreign health insurance subscribers, maintained a near-equilibrium financial position. With premiums of 4.022 trillion KRW (about 2.7 billion USD) and benefit payments of 4.167 trillion KRW (about 2.8 billion USD), the net difference was a marginal 55 billion KRW (about about 39.2 million USD) over three years.
Foreign patients primarily sought care at the top five hospitals for severe conditions, with a focus on cancer and rare diseases. In 2025, cancer patients constituted the largest group of inpatients across all five institutions, with individual hospitals treating between 153 and 310 cancer inpatients.
Cancer treatment costs varied significantly among hospitals, ranging from 2.377 billion KRW (about 1.6 million USD) to 4.269 billion KRW (about 2.9 million USD), surpassing expenses for other major severe illnesses such as cardiovascular and cerebrovascular diseases.
The most common high-cost treatments were for complex severe conditions including bronchial and lung cancer, liver cancer, breast cancer, leukemia, lymphoma, spinal muscular atrophy (SMA), cardiomyopathy, chronic kidney disease, and congenital heart defects.
Representative Kim emphasized that with foreign health insurance enrollment surging by 28% in just three years to over 1.68 million, we must move beyond simplistic debates about whether foreigners are a burden on our health insurance system.
She added that while the analysis shows an overall surplus of 2.8 trillion KRW (about 1.9 billion USD) in the foreign health insurance system, we’ve identified significant variations by country. It can’t assume the system is flawless just because it’s in the black overall, nor should it labels all foreigners as a drain on resources based on isolated cases.
Kim concluded that the key is to rely on objective data, not vague perceptions or anecdotal evidence. The government must establish a management system that ensures both the long-term viability of the health insurance program and equitable treatment for all subscribers.