The amount of health insurance fraud by foreigners and overseas Koreans increased by nearly 30% last year.
On the 4th, according to materials received from the National Health Insurance Service by representative Kim Mi-ae of the People Power Party's Health and Welfare Committee, the number of detected cases of fraud by foreigners and overseas Koreans last year was 17,087, an increase of 16.8% compared to 2023 (14,630). The number of detected fraud cases peaked at 40,265 in 2021, then decreased to 18,491 in 2022, and 14,630 in 2023, but has turned back to an increasing trend last year.
The number and amount of fraudulent claims have also switched to an increasing trend. Last year, the number of fraud cases was 45,909, which is an increase of 14.7% compared to 2023 (40,020), and the amount of fraud was 2.558 billion won, an increase of 28.5% compared to 2023 (1.991 billion won).
In terms of the types of fraud, the majority involved receiving health benefits even after losing health insurance eligibility. The number of individuals detected for fraud after losing health insurance eligibility last year was 17,011, with cases totaling 44,943, and the amount involved was valued at 2.506 billion won.
The nationality of those detected was mostly Chinese, with 12,033 individuals, followed by the United States with 679 and Vietnam with 605. A total of 41 individuals were detected for improperly receiving health benefits through the lending or unauthorized use of health insurance cards, with 845 cases amounting to 47 million won.
The number of individuals detected for receiving health insurance during the suspension period was 35, with 121 cases totaling 5 million won. Representative Kim Mi-ae noted, “The fraudulent receipt of health insurance by some foreigners seriously threatens the sustainability of health insurance finances, and the government needs to strengthen measures such as punishment for fraudsters and consider the introduction of mutuality in health insurance coverage, as well as develop multifaceted system improvement measures.”