Korea will charge 90% after your 300th outpatient visit. Last year that was 7,765 people.

From 1 January, Korea will charge patients 90% of the bill for every outpatient visit after their 300th in a calendar year. The current trigger is the 366th. The cabinet approved the change on 8 September, and it takes effect with the new counting year.

Almost nobody will pay it. On the National Health Insurance Service’s own count, of the roughly 48.4 million people who used outpatient care in 2025, 7,765 went more than 300 times. That is one person in every six thousand.

The people at the far end of the curve

Those 7,765 averaged 344.7 visits each — about six attendances a week, every week, for a year. The ministry also found at least one person who recorded 1,775 visits in twelve months, which works out at just under five a day including weekends.

Children, pregnant women, patients registered under the severe-illness copayment scheme who are being treated for that condition, and registered severely disabled patients are all excluded, as they were under the 365-visit rule that took effect on 1 July 2024. Anyone else can ask the insurance service’s excess-use review committee to certify that the visits were medically necessary, in which case the ordinary rate applies.

Lowering the trigger by 65 visits will not save the fund a meaningful amount of money. Cases at 344 visits a year are clinically strange, and most of them will be exempted on review. Treat the number as a boundary marker rather than a cost-control measure.

The measure that will actually change behaviour arrives in December

The same package sets up something considerably more consequential. From 24 December 2026, the Health Insurance Review and Assessment Service will run a system that lets a doctor see what treatment a patient has already received elsewhere at the moment of prescribing. It starts with CT and MRI scans and expands from there, wired into hospital electronic records so the check happens inside the existing workflow.

This addresses the problem the visit cap does not. Korea’s outpatient volume is not driven by seven thousand outliers. It is driven by everyone. The ministry puts the 2024 figure at 17.9 outpatient visits per person against an OECD average of 6.6 — a ratio of 2.7 to one. In 2021 the comparison was 15.7 against 5.9. The gap is widening, not closing.

Much of that volume is duplicated rather than excessive. A patient who visits three clinics for the same complaint gets scanned three times, because none of the three can see what the others did. Korea has never had a way to stop that at the point of care. Now it will, for the two imaging modalities that cost the most.

The freeze that makes the cost control necessary

The same morning, before the cabinet met, the Health Insurance Policy Deliberation Committee froze the contribution rate for 2027 at 7.19%, and left the property-assessment point value for local subscribers at ₩211.5. It is the third freeze in four years; the rate has moved once since 2023, by a tenth of a percentage point last January. Our guide to what foreign residents actually pay for Korean health insurance sets out how that rate translates into a monthly bill.

The committee’s stated reasons are worth reading closely. Five consecutive years of operating surplus. A reserve of ₩30.2tn at the end of 2025, worth 3.5 months of spending. An extra ₩1.1tn of government support in the 2027 budget. And, listed alongside the rest, expected growth in contribution income from the semiconductor upturn.

That last one is not decoration. Contributions are levied on wages, the chip industry pays some of the highest wages in the country, and Korea’s export boom is concentrated in three product lines of which memory is the largest. A health insurance rate held flat for a year is now partly a bet on DRAM pricing.

And it is expanding coverage substantially. From December the copayment for 1.36 million patients with rare and severe intractable conditions drops from 10% to 7%, and to 5% in the first half of 2028. From January 2027, edentulous over-65s become eligible for two subsidised implants — about 70,000 people, worth roughly ₩2.28m each. The ministry puts the whole package at ₩800bn a year across 1.97 million patients.

Two changes that affect ordinary payroll

Buried in the same decree are two administrative fixes worth knowing about. From 1 October 2026, an employee facing an extra premium bill after the annual reconciliation can spread it over up to twelve months whenever the amount exceeds the minimum monthly premium — ₩10,080 on the 2026 employee share. The old threshold was a full month’s own premium, so a worker paying ₩150,000 a month could not spread a ₩140,000 bill.

Employers get until 31 March, rather than 10 March, to file the remuneration data the reconciliation needs. In the 2025 round, 10.26 million of the 16.56 million people reconciled were handled by direct employer filing — and 7.13 million of those could have been settled from National Tax Service records that simply had not arrived in time.

Figures current as of 9 September 2026, drawn from Ministry of Health and Welfare announcements of 8 September 2026 and 30 June 2024, and the National Health Insurance Service contribution rate table.