▲ National Long-Term Care Insurance
As the number of foreigners staying in South Korea increases, those using the National Long-Term Care Insurance are also growing. However, approximately 80% of these beneficiaries were found to be overseas Koreans with Chinese citizenship.
The financial balance of the long-term care insurance for foreigners recorded a surplus of 132.1 billion won in 2024.
The National Long-Term Care Insurance is a social insurance system that eases the burden on households by providing care services, such as home visits or facility admission, to elderly individuals who have difficulty managing daily life on their own due to advanced age or geriatric diseases like dementia.
It has been implemented since July 2008.
According to the research report titled Study on Foreign Enrollment and Utilization of the National Long-Term Care Insurance released by the National Health Insurance Research Institute on August 14, the number of foreign long-term care recognized beneficiaries stood at 4,790 as of December 2024, accounting for a mere 0.4% of all domestic long-term care recognized beneficiaries (approximately 1.165 million people).
In particular, 85.7% (4,106 people) of the recognized foreign beneficiaries were holders of overseas Korean (F-4) residency status. Combining nationality and residency status, "overseas Koreans with Chinese citizenship" accounted for 78.8% (3,773 people) of all recognized foreign beneficiaries.
This means that ethnic Korean compatriots residing long-term in South Korea make up the majority.
According to the analysis results, these recognized foreign beneficiaries were found to have received long-term care grades only after residing in South Korea and paying insurance premiums for an average of six to seven years following their initial acquisition of residency status.
As of 2024, the average age when acquiring initial residency status was 71.2, and the average age when receiving the initial grade adjudication was 77.6.
Foreigners who actually used long-term care benefits numbered 4,063 in 2024, among whom users who were overseas Koreans with Chinese citizenship accounted for 78.8% with 3,202 people.
The total amount borne by the National Health Insurance Service was 57,145,250,000 won, and the monthly average benefit cost per user was 1,375,742 won.
In terms of utilization patterns, the growth rate of home-care service users receiving care at home outpaced that of facility-care service users entering facilities such as nursing homes.
Home-care users reached 2,901 in 2024, marking a 17.6% increase compared to the previous year and surpassing the facility-care growth rate (11.1%). Among home-care services, home visits (1,972 people) accounted for the largest proportion at 48.5% of all users.
As of 2024, the long-term care insurance financial balance related to foreigners was a surplus of about 132,125,000,000 won.
By country, China recorded a surplus of about 70.753 billion won.
Regarding major overseas countries, Germany automatically applies long-term care insurance to foreigners enrolled in health insurance while requiring a minimum contribution period of two out of the ten years prior to application. Japan mandates nursing care insurance enrollment for foreigners residing for three months or more with resident registration, but provides benefits only for 16 specific geriatric diseases for those aged 40 to 64.
The United States operates enrollment and benefit requirements differently by country, such as restricting Medicare eligibility to permanent residents through a legal amendment in July 2025.
In South Korea, when foreigners residing for six months or more enroll in health insurance, they are automatically enrolled in the National Long-Term Care Insurance and can use benefits upon grade adjudication without a separate minimum contribution period.
The report suggested that in line with the future expansion of the foreign population, it is necessary to establish a systematic monitoring system capable of timely grasping nationalities, residency statuses, and enrollment and utilization patterns, alongside refining enrollment regulations considering entry purposes and supplementing policies based on empirical data such as longitudinal studies.
(Photo: Provided by National Health Insurance Service, Yonhap News)
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