Do Foreigners Who Migrated to Korea to Escape Civil War at Age 8 Have to Pay Health Insurance Premiums Upon Turning 19?

Do Foreigners Who Migrated to Korea to Escape Civil War at Age 8 Have to Pay Health Insurance Premiums Upon Turning 19?: KO YONG-CHUL Reporter / Updated : 2026-11-15 09:53:25

"A," a Syrian national, came to South Korea with his family at the age of 8 to escape the civil war.

Although the family obtained humanitarian status, their living conditions were extremely poor as they could not bring any significant property from their home country. Their income shrank even further after A’s father’s health deteriorated due to heart disease. A family of five had to survive on 1.5 million to 2 million won a month.

In this situation, when A turned 19, a notice arrived demanding a separate health insurance premium of around 100,000 won per month. The National Health Insurance Service (NHIS), which had previously classified A as a dependent (household member), now regarded A as an independent head of household and began levying health insurance premiums.

This measure was based on the "Health Insurance Application Criteria for Long-Term Resident Overseas Koreans and Foreigners" notice, which stipulates that insurance premiums for foreign local subscribers are calculated by viewing an individual as a single household, with only children under 19 allowed to be included as household members.

A filed an administrative lawsuit, arguing that imposing separate health insurance premiums simply because he turned 19 violated the principle of equality under the Constitution.

According to the legal profession on the 15th, A argued in the first-instance trial, "The notice in question dictates that the moment a minor child who was a household member of a foreign local subscriber reaches adulthood, they are unconditionally regarded as an independent head of household to pay health insurance premiums separately, without considering their actual job or income status." A added, "This is discriminatory treatment compared to adult children of foreign workplace subscribers or Korean nationals who remain recognized as household members under the same circumstances."

The NHIS countered, "Considering the reality that it is difficult for limited administrative resources to ascertain the specific living, supporting, and income status of foreign local subscriber households, there are reasonable grounds for the discriminatory treatment."

The first instance ruled in favor of A. The court judged that the NHIS's measure placed an excessive burden on low-income foreign local subscriber families, stating it "excessively discriminates without reasonable cause compared to dependents of foreign workplace subscribers and Korean nationals in the same situation."

The court pointed out that to prevent such unconstitutional situations, the notice provision cited by the NHIS as the basis for the disposition should not be viewed as a "conclusive provision" that must always be applied mechanically, but rather as a "presumptive provision" that allows exceptions if there is evidence to the contrary. Mentioning the specific situation faced by A's family, the court noted, "Imposing insurance premiums by considering A as having formed an independent household imposes a burden that is economically difficult to bear, which is practically no different from expelling A from the application of national health insurance."

"Such a disposition is a result that cannot possibly be tolerated under the legal order of the Republic of Korea, and is therefore illegal," the court ruled.

However, the second instance saw errors in the first-instance judgment and recently ruled in favor of the NHIS. The Seoul High Court’s Administrative Division 10-3 (Presiding Judges Won Jong-chan, Oh Hyun-gyu, and Park Hye-seon) held that the notice provision in question should not be interpreted as a "presumptive provision" that allows exceptions.

The court pointed out, "In light of the system of the National Health Insurance laws and related notices, the objective intent of the legislator is to have insurance premiums calculated by fundamentally viewing an individual as a single household for foreign local subscribers, without the need to investigate or verify actual family composition or support relationships." It added, "Interpreting the notice provision in a direction contrary to this is undesirable in terms of the principle of the separation of powers."

The second instance also noted that under the current alien registration system, it is impossible to accurately verify the scope of family members of foreigners, and the administrative power of the NHIS is limited. Considering this, it explained that it is realistically difficult to calculate insurance premiums by grasping the actual income, assets, and support relationships of foreign local subscribers, unlike Korean nationals. Therefore, it judged that the notice provision in question does not discriminate against foreign local subscribers without reasonable cause.

The second instance added, "Declaring the notice provision invalid cannot be an appropriate solution to improve the unstable status and treatment of humanitarian status holders."