The National Health Insurance Corporation of South Korea is moving towards a system where individuals who have persistently neglected to pay their health insurance premiums will have their delinquent payments automatically deducted from any medical expense refunds they are eligible for. This adjustment is part of the corporation's 2026 operational plan and aims to enhance equity within the health insurance system while preventing financial leaks caused by habitual non-payers. A legislative proposal to amend the National Health Insurance Act, spearheaded by Democratic Party lawmaker Seo Mi-hwa, is on the verge of passing through the National Assembly, which would formalize this deduction process.

The legal proposal introduces a provision to prioritize the payment of overdue health insurance premiums when refunding medical expenses covered under the out-of-pocket maximum payment plan. For instance, if a patient is eligible for a refund of 5 million KRW for medical expenses but owes 3 million KRW in unpaid premiums, they would only receive 2 million KRW after the deduction, even if they refuse to accept this condition. This measure addresses criticisms regarding high premium defaulters exploiting the system by claiming refunds without fulfilling their payment obligations, highlighting the need for stricter regulations around health insurance refunds.

Recent statistics indicate a significant issue with non-payment, as 1,926 individuals have received refunds through this plan despite owing over 1 billion KRW in overdue premiums over the last five years. The total overdue amount reached approximately 39 billion KRW, while the refunds accessed by these individuals totalled around 1.8 billion KRW. The Health Insurance Corporation is set to implement the amended regulations in the latter half of this year, streamlining their internal processes and developing new guidelines to effectively enforce these deductions.