Key points
- Korea runs national health insurance with a single payer: the National Health Insurance Service (NHIS) is the single insurer, covering 97% of the population, with the tax-funded Medical Aid programme covering the remaining 3%.
- Coverage is universal on paper: all of the population is covered for a core set of services, with universal coverage achieved in 1989 and all insurance schemes merged into the NHIS in 2000.
- Care is delivered mainly by private hospitals and clinics, which are obliged to take part in the national health insurance system, alongside public health centres.
- Patients pay a share of the cost of most covered services and the full cost of services outside the benefits package, and households paid 31.8% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database).
- Life expectancy at birth was 83.5 years in 2023, and health spending was 8.4% of GDP in 2024 (OECD Health at a Glance 2025).
Direct answer: Korea runs national health insurance with a single payer: the National Health Insurance Service (NHIS) is the single insurer, covering 97% of the population, with the tax-funded Medical Aid programme covering the remaining 3% — low-income people who cannot pay contributions. Coverage is universal on paper: all of the population is covered for a core set of services (OECD Health at a Glance 2025). Care is delivered mainly by private hospitals and clinics, which are obliged to take part in the insurance system. Patients pay a share of the cost of most covered services and the full cost of services outside the benefits package, and households paid 31.8% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database). Life expectancy at birth was 83.5 years in 2023 — and healthy life expectancy 72.0 years — and health spending was 8.4% of GDP in 2024 (OECD Health at a Glance 2025; WHO Global Health Estimates, October 2026).
At a glance
| Item | Detail |
|---|---|
| Model | National health insurance — single-payer (NHIS) |
| Who pays | Mandatory contributions from employees, employers and the self-employed, plus government subsidies, pooled in the NHIS; the Ministry of Health and Welfare oversees the system and the Health Insurance Review and Assessment Service reviews claims |
| Who delivers | Mainly private hospitals and clinics, all obliged to take part in the national health insurance system, alongside public health centres for preventive care |
| What is free at the point of use | Health check-ups and vaccinations in public health centres; patients pay a share of the cost of most covered services and the full cost of services outside the benefits package |
| Life expectancy at birth | 83.5 years (2023, OECD Health at a Glance 2025) |
| Health spending | 8.4% of GDP (2024, OECD Health at a Glance 2025) |
| Source for the model and coverage | OECD Reviews of Public Health: Korea (2020); WHO Republic of Korea health system review (2015) |
Figures are a snapshot checked 7 November 2026, not a live feed. No country is ranked as best.
How the system works
Korea’s system grew in stages: mandatory social health insurance began in 1977 for industrial workers in large firms, was extended step by step to the self-employed, and covered the entire population by 1989 — through National Health Insurance or the tax-funded Medical Aid programme. In 2000, all the separate insurance schemes were merged into a single payer, the National Health Insurance Service (NHIS). The Ministry of Health and Welfare oversees the system, the NHIS functions as the single insurer, and the Health Insurance Review and Assessment Service (HIRA) reviews claims and evaluates quality.
Contributions are mandatory: employees and employers share payroll contributions, the self-employed pay their own, and government subsidies top up the pool. All hospitals and clinics, whether public or private, are obliged to participate in the national health insurance system as providers and cannot opt out. The benefits package covers curative services — diagnosis, treatment, emergency care, pharmaceuticals and dental care — and includes regular health check-ups, such as cancer screening for people over 40.
Who pays, and what people pay
Mandatory contributions and government subsidies pay for the system, but the public share is thin for a universal system: only 60% of health spending was covered by mandatory prepayment, below the OECD average of 75% (OECD Health at a Glance 2025). What patients pay is substantial: households paid 31.8% of health spending out of pocket in 2023 (WHO Global Health Expenditure Database). Patients pay a share of the cost of most covered services and the full cost of services outside the benefits package — which is why many Koreans also buy supplementary private health insurance to cover what the national scheme does not. From July 2024, patients exceeding 365 outpatient visits a year pay a 90% co-payment on further visits (SBS, 8 September 2026, reporting the Ministry of Health and Welfare).
What is free, and what is not
Free at the point of use: health check-ups and vaccinations provided in public health centres. What is not free is the margin, and it is wide: a share of the cost of most covered services, and the full cost of services outside the benefits package. The benefits package is deliberately narrower than in most OECD countries — population coverage was given higher priority than the scope and depth of service coverage as the system developed — so the bill that falls on households is large even though nobody is uninsured.
How it compares
Korea spends 8.4% of GDP on health — below the OECD average of 9.3% — and $4,797 per person, below the OECD average of $5,967 (USD PPP, 2024). Its life expectancy of 83.5 years is 2.4 years above the OECD average of 81.1 years (OECD Health at a Glance 2025), among the highest in this set, and Korea is one of the nine OECD countries that spend less than the average but achieve higher life expectancy than the average. Its distinguishing feature is capacity: 12.6 hospital beds per 1,000 people, the most in the OECD table — just ahead of Japan (12.5) and three times the OECD average of 4.2 — alongside 87 CT, MRI and PET scanners per million people, against an OECD average of 51. Compare countries side by side in the Health System Comparison tool, or read the other profiles in the country index.
Frequently asked questions
Is Korean healthcare free?
No. Patients pay a share of the cost of most covered services and the full cost of services outside the benefits package — households paid 31.8% of health spending out of pocket in 2023, even though coverage itself is universal.
What is the NHIS?
The National Health Insurance Service: the single insurer that runs Korea's national health insurance, created in 2000 by merging all the separate insurance schemes into one payer. It is overseen by the Ministry of Health and Welfare, and the Health Insurance Review and Assessment Service reviews claims.
Why do Koreans pay so much out of pocket despite universal coverage?
Because only 60% of health spending is covered by mandatory prepayment, below the OECD average of 75%: the benefits package is narrower than in most OECD countries, so co-payments and services outside the package fall on households — and many Koreans also buy supplementary private insurance.