Korea National Health Insurance for International Students: D-2 From Arrival, D-4 Language Trainees Automatically After 6 Months, 2026 Premiums and What Happens If You Fall Behind

International students studying in Korea are automatically enrolled in National Health Insurance (NHI). Premium bills are issued even if you never apply, and if you don't pay, your medical-cost benefits are cut off and your stay permit may also be affected. When coverage begins depends on your status of stay: student (D-2) holders are covered from the day they enter Korea, while general training (D-4) students, such as those at university language institutes, are covered from six months after entry.

Mandatory coverage of foreign nationals as regional subscribers began on July 16, 2019, and international students became subject to mandatory enrollment on March 1, 2021. The current standard is the Ministry of Health and Welfare public notice “Health Insurance Application Standards for Long-Term Resident Overseas Koreans and Foreign Nationals” (amended April 23, 2025). This guide walks through, in order, when coverage begins, 2026 premiums, how to pay, penalties for arrears, and exemption from enrollment and school group insurance. Amounts are given in U.S. dollars first, with won in parentheses (Hana Bank base exchange rate on November 3, 2026: $1 = KRW 1,341.10).

When does coverage start: D-2 on arrival, general D-4 after 6 months

Foreign nationals who are not employee subscribers become regional subscribers, in principle, once they have resided in Korea for six months or more. International students are an exception.

The legal reference date is “the date of entry into Korea.” In practice, the National Health Insurance Service (NHIS) processes enrollment after you complete alien registration, so check that a bill arrives after you register. The alien registration process is explained in our guide to alien registration cards for international students.

In order after arrival, a D-2 student goes through entry, alien registration, receiving an NHIS bill and applying for automatic transfer. Schools such as Seoul National University of Science and Technology and Sungshin Women's University advise that students are enrolled on the date of alien registration upon their first entry. Check which date your first bill was calculated from, and ask the NHIS if it differs. Language institute students (D-4) are enrolled only after six months have passed since entry, and their first bill may arrive around the enrollment date or slightly before it.

For language institute students, the six months are counted from the date of first entry. However, if a student leaves Korea for more than one month at a time during the first six months and then returns, the six months are counted anew from the date of re-entry. Multiple short trips abroad are counted as residence in Korea only up to a combined 30 days over the six months. If the total exceeds 30 days, the starting date is pushed back to the 1st of the next month, then the 1st of the month after that, delaying enrollment accordingly.

Language institute students (D-4) have no National Health Insurance for their first six months. If they fall ill during this period they may have to pay the full cost of treatment, so it is safer to check with the school before enrolling whether school group insurance or private insurance is available.

Monthly premiums for 2026: 50% reduction applied

Premiums for foreign regional subscribers are calculated from income and assets, but if that amount is lower than the average premium of all health insurance subscribers (regional and employee), the average premium is charged instead. The average premium is calculated as of November each year and applied for 12 months from January of the following year.

International students get half of that taken off. If the head of household's status of stay is student (D-2) or general training (D-4) and income and assets are at or below the threshold amounts, premiums have been reduced by 50% since the March 2023 premium. The reduction rate was 70% from the March 2021 premium and 60% from the March 2022 premium before reaching the current 50%. The income and asset thresholds are set out in a separate public notice, so students with income or assets in Korea should check with the NHIS whether they qualify for the reduction.

The 2026 amount is the figure announced by several universities, including Sungshin Women's University and Seoul National University of Science and Technology. The actual amount payable is the amount on your NHIS bill. Over a year, that comes to about $710 (KRW 951,840).

There is an exception. If the head of household is a minor (under 19), they pay not this amount but the larger of the premium calculated on the same basis as Korean nationals and the minimum regional premium. Because a foreign national in principle forms a household alone, elementary, middle and high school students and freshmen under 19 become heads of household themselves. Such students should confirm the amount on their bill with the NHIS.

The 2027 amount has not been released yet. At the Health Insurance Policy Deliberation Committee on September 8, the Ministry of Health and Welfare decided to keep the 2027 health insurance premium rate at 7.19%, the same as in 2026. However, even with an unchanged premium rate, the average premium that sets international students' premiums is recalculated as of November, so check the 2027 amount on the January 2027 bill (the payment due December 25, 2026).

With family: combining households

In principle, each foreign regional subscriber forms a household of one. On the subscriber's application, a foreign spouse (excluding common-law partners) and children under 19 (including the spouse's children) can be combined into the same household. Ask the NHIS how much the household premium would be once family members are added as household members.

By the 25th of each month, pay next month's premium in advance

International students pay each month's premium by the 25th of the preceding month. For example, the December premium is due by November 25. Bills are sent to the residence address on your alien registration, so update your address immediately if you move. To collect the first premium, the NHIS may send a bill in advance, before you obtain coverage. It is not unusual to receive your first bill shortly after arriving.

The main payment methods listed in university guides are:

• Automatic transfer from a bank account or card
• Transfer to the virtual account on the bill
• Payment at a bank counter or ATM

To receive bills by email or text message, apply separately with the NHIS. The NHIS call center number is 1577-1000.

Going home during vacation. A foreign national whose period of stay has not expired loses coverage on the day after departure if they leave Korea and stay abroad for one month or more. On returning to Korea, D-2 holders regain coverage on the day of entry. Language institute (D-4) students are different: if they lose coverage after leaving for one month or more and then return, they must in principle wait another six months. However, if they were previously enrolled and return within six months of the departure date, they can re-enroll immediately by applying to the NHIS on the day of entry and paying premiums that reflect the period abroad. Departures of less than one month leave coverage intact, so premiums continue to be due. Check with the NHIS how the next month's premium already paid before departure will be settled. What to prepare for a trip home during vacation is covered in our winter break home visit and re-entry guide for international students.

What happens if you fall behind: benefits suspended, stay permit penalties

If you don't pay your premiums, the first consequence is that your health insurance benefits stop. If a premium due by the 25th of the preceding month is still unpaid by the 25th of the following month, you cannot receive insurance benefits from the month after that. For example, if the April premium (due March 25) remains unpaid by April 25, you will bear the full cost of medical care yourself from May. Once all overdue premiums are paid, coverage applies again from that day. Check with the NHIS whether medical costs incurred during the suspension can be refunded later. This rule applies to premiums imposed after April 23, 2025. Some university guides still say benefits are “restricted from the 1st of the month after the due date,” but the standard under the current public notice is as described above.

Your stay permit is also affected. When it introduced mandatory enrollment of foreign nationals in 2019, the Ministry of Health and Welfare stated that foreign nationals in arrears on premiums would have their stay permits restricted to no more than six months under a Ministry of Justice system. According to an NHIS collection system notice posted by a university (no year of writing indicated), if arrears reach about $373 (KRW 500,000) or more, the arrears data is provided to the Ministry of Justice and may be used in visa extension reviews. The student (D-2) extension criteria in the Ministry of Justice's current stay manual contain no separate item on health insurance arrears, so detailed criteria by arrears amount are difficult to confirm from public materials.

In the longer term, unpaid health insurance premiums are also treated in permanent residency reviews as a case of having a negative impact on national finances. If you plan to work and live in Korea long term after graduation, it is best not to leave any record of arrears. Visa extension documents are listed in our D-2 and D-4 period of stay extension guide.

If you have foreign insurance: exemption from enrollment and school group insurance

If you receive medical coverage equivalent to Korean health insurance medical care benefits under foreign laws, foreign insurance or a contract with an employer, you can apply for exemption from enrollment. The conditions are:

• To be exempted retroactively to the date of enrollment, you must apply within six months of becoming a regional subscriber.
• An exemption based on foreign insurance or similar grounds lasts up to one year at a time.
• A person who voluntarily re-enrolled while exempted cannot apply again for exemption on the same grounds.

Because the NHIS decides whether foreign insurance provides “coverage equivalent to medical care benefits,” an application may be rejected. If you regain eligibility within one year after an exemption, you must report it to the NHIS within 14 days.

School group insurance for international students is separate from National Health Insurance. Universities describe it as a product that supplements what National Health Insurance does not cover. Having group insurance does not mean you can skip National Health Insurance premiums. Some schools, such as Sogang University, provide group insurance coverage only to students who are not behind on their National Health Insurance premiums.

Benefits you can receive

National Health Insurance subscribers pay only part of their medical costs. Based on university guides, patients pay 30-60% for outpatient care depending on the type of hospital and region, and around 20% for inpatient care. Rates differ for non-covered items, pharmacies and the like. International students who are regional subscribers may be eligible for a free general health checkup once every two years, so check the eligible year and age requirements with the NHIS.

What to ask the NHIS

If your bill differs from what you expected or your circumstances change, check the following with the NHIS call center (1577-1000):

• Whether you qualify for the 50% reduction (if you have income or assets in Korea)
• How much your premium is if you are under 19
• The household premium when adding a spouse or children as household members
• How premiums paid before leaving Korea for one month or more will be settled
• The amount of overdue premiums and late fees
• How your coverage changes after graduation or a change of status of stay

Checklist

• I have checked when my coverage starts based on my status of stay (D-2, or D-4 at a university language institute).
• I have checked that NHIS bills arrive at my address after alien registration.
• I have set up automatic transfer to pay next month's premium by the 25th of each month.
• I understand the loss of coverage when leaving Korea for one month or more and re-enrollment after re-entry.
• I have checked for any arrears before applying for a visa extension.
• If my bill differed from the amount announced by my school, I asked the NHIS why.
• I have asked my school whether insurance is available for my first six months at the language institute.

For how to budget premiums within a year's living costs, see our 2027 Korea study abroad cost guide.

--- Enrollment, reductions, payment and suspension of benefits are based on the Ministry of Health and Welfare public notice (amended April 23, 2025) and its Annexed Table 2; 2026 premiums on guidance from university international offices; and the 2027 premium rate on the Ministry of Health and Welfare's Health Insurance Policy Deliberation Committee (September 8, 2026). Actual amounts are as stated on National Health Insurance Service bills.