Health insurance premiums have emerged as a growing financial burden for Koreans in their 50s and 60s approaching or recently entering retirement. The calculation method for premiums changes dramatically after leaving the workforce.
While employed, workers split insurance premiums equally with their employers. Upon retirement, however, they are reclassified as regional subscribers, triggering a different assessment system. Even as earned income declines, premiums may increase because property holdings including real estate and financial assets factor into the calculation.
This structural gap is particularly pronounced among retirement-age Koreans. According to data released on the 11th by the office of Rep. Jeon Jin-suk of the Democratic Party of Korea on the National Assembly Health and Welfare Committee, 25.28% of those aged 55-59 and 32.18% of those aged 60-64 experienced a change in their health insurance status within one year.
Roughly three in ten middle-aged Koreans see their enrollment type change. Among them, 7.71% and 9.62% respectively converted to regional subscriber status. The insurance premium system shifts significantly in tandem with retirement timing.
Programs exist to ease the burden on retirees. The most notable is the "voluntary continued enrollment" system. When regional premiums would exceed workplace-era levels, retirees can apply to maintain employee-level premiums for up to three years.
However, actual utilization remains extremely low. Only 1.1% of retirees aged 60-64 opted for this program.
The system's structure tends to favor those with greater assets. Subscribers choosing voluntary continued enrollment had average assessed property values of 340 million to 370 million won. This is nearly three times higher than the approximately 120 million won average for those who converted to standard regional subscriber status. Income levels for voluntary continued subscribers were also about 1.5 times higher than standard regional subscribers.
Analysts suggest that those with more assets face steeper premium increases upon becoming regional subscribers, making it advantageous to maintain employee-level premiums.
Meanwhile, regional subscribers who are ineligible for or do not use voluntary continued enrollment bear a relatively heavier burden. Their average monthly income ranges from 890,000 to 1.25 million won—barely enough to cover living expenses.
Despite this, they pay approximately 100,000 won monthly in health insurance premiums because they hold assets averaging around 120 million won. This amounts to roughly 8-11% of their monthly income.
Experts point out that the current property-focused premium system fails to adequately account for the income gap following retirement. Calls are growing for reform toward an income-based premium structure.