Why Korean Health Insurance Changes in November (2026)

Every year, a lot of people open their November health insurance bill and wonder what happened. Their work has not changed, yet the amount went up. Sometimes it drops without warning. This is especially common for freelancers, the self-employed, people who recently left a company job, and retirees living on a pension.

The reason is simple. For regional subscribers of Korea's National Health Insurance (NHIS), the premium is recalculated with new data every year, starting with the November bill. From November 2026, the premium is based on your income for calendar year 2025 and the property you held on June 1, 2026, and that basis stays in place through the October 2027 bill. So if you want to understand a change, start with two questions: what was my income last year, and what was registered in my name on June 1 this year?

This guide covers regional subscribers, the people who are not covered through an employer. If you are an employee, the part of your premium tied to your salary is set by your monthly pay instead and follows different timing.

How the regional premium is calculated

The regional premium is calculated per household and has two parts.

Income part — your annual income divided by twelve, multiplied by the premium rate of 7.19%.

Property part — your real estate and similar assets are converted into points, and each point is charged at 211.5 won.

Income here means business, employment, interest, dividend, pension and other income, excluding tax-exempt income. For property, the household's property tax bases are added up, a basic deduction of 100 million won is subtracted, and the remainder is converted into points. Households that do not own a home have their rental deposit and monthly rent counted as property instead.

The separate premium that used to be charged on cars was abolished from the February 2024 bill, so you do not need to look for a car item anymore.

What changes in November

The timing is written into the Enforcement Decree. Using 2026 as the example:

January to October 2026 bills — income from 2024 (two years earlier), except pension income, which uses 2025 data.

November and December 2026 bills — income from 2025 (the previous year).

January to October 2027 bills — again two years earlier, which is 2025. Only pension income switches to 2026 data in January.

Property — the property tax data as of June 1 each year is applied from the November bill through the following October.

In other words, November is the month when income and property switch to new data at the same time. A freelancer who had a busy 2025 will see the premium rise from November, and someone whose work slowed down in 2025 will see it fall. If your home's assessed value went up this year, the property part can rise. Pensioners may see the amount change twice: once in November, and again in January when pension income is updated.

Three things to check when the bill arrives

Does the income match your 2025 income? Check the income and property figures used for your premium through the NHIS website, the NHIS mobile app, or the call center, and compare them with your 2025 income certificate from Hometax.

Is anything listed that you no longer own? Common examples are a home sold after June 1, land passed on through inheritance, or a rental amount that does not match your actual lease.

Is your income this year clearly lower than in 2025? If so, the income adjustment below is worth considering.

Situation 1: Your income dropped this year — request an income adjustment

Your premium is based on 2025 income, but if you closed a business, retired, or lost freelance contracts this year, that basis may no longer fit your situation. You can ask NHIS to recalculate the premium using your current income.

Who can apply — regional subscribers whose income fell because of closing or suspending a business, retirement, contract termination, or a drop in business performance. Not only business and employment income but also interest, dividend, pension and other income qualify.

Documents — a consent form for income-based settlement plus proof of the reason, such as a certificate of business closure, a certificate of retirement, or a withholding tax receipt. For freelancers, if the paying company filed a simplified payment statement with the tax office, that filing can stand in for the proof.

How — online applications through the NHIS website and app are accepted only when income has decreased. You can also apply in person, by mail or by fax.

When it applies — from the bill for the month after you apply, through December of that year. If you apply on the 1st of a month, it applies from that month. Applying earlier helps.

The settlement you need to know about

This is not a discount. It is a system where you pay based on your current income first, and the amount is reconciled with your actual income later. Each November, NHIS recalculates the previous year's January–December premiums using the income confirmed by the National Tax Service, then charges or refunds the difference.

If your actual income turns out higher than expected, you pay the shortfall. Large amounts can be split into up to twelve installments.

If your actual income was lower, the overpayment is refunded.

If new income arises later in the same year after the adjustment, you must report it to NHIS within the following month.

An application can be withdrawn within 90 days, and only before the settlement amount is calculated. Settled premiums cannot be adjusted again.

Depending on the settlement result, benefits such as dependent status, premium reductions or the out-of-pocket ceiling may change or be reclaimed.

So this request makes sense when you are confident your income this year is clearly below the current basis. If you expect a lot of work at the end of the year, think it through first.

Situation 2: You sold a home or land after June 1 — property adjustment

Because property is charged for a full year based on June 1 data, a home you sold afterward may still appear on the bill. If ownership changed through a sale, inheritance or expropriation, apply for an adjustment with the property registration certificate or building and land ledgers. The change applies from the month after the month in which it happened.

Situation 3: Your rent or deposit is recorded incorrectly — submit the lease

For households without a home, the deposit and monthly rent are counted as property, and the figures NHIS received may not match your actual contract. Submitting your lease agreement lets NHIS correct it. If you live in someone else's home free of charge, you submit a confirmation of rent-free residence instead.

Situation 4: You took out a loan to buy or rent your home — report it

A loan taken for the home you actually live in can be partly deducted from your property once you report it. NHIS does not know about it automatically.

Single-home households — a mortgage first taken within three months before or after acquiring the home. The deduction is capped at 50 million won.

Households with no home — a loan secured on your rental deposit, first taken within three months before or after the earlier of your move-in date and resident registration date. Up to 30% of the loan is deducted, but not more than 30% of the deposit.

There are separate conditions on home value and deposit size, so confirm eligibility with NHIS.

Situation 5: Your first regional bill after leaving a job — compare voluntary continued enrollment

When you leave a company, you become a regional subscriber, and the first bill is often higher than what you paid as an employee. In that case you can apply for voluntary continued enrollment and keep employee-subscriber status.

Eligibility — you were an employee subscriber for a combined total of at least one year (365 days) during the 18 months before leaving the job.

Deadline — before two months have passed since the payment due date on your first regional premium bill. After that, you cannot apply.

Duration — up to 36 months from the day after you left the job.

Premium — based on the average of your monthly wage over the last 12 months before leaving, and you pay the whole amount yourself with no employer share. The law allows part of it to be reduced.

Dependents — as with employee subscribers, family members can be registered as dependents.

Which option is cheaper differs from person to person. Use the calculators on the NHIS website to compare the regional premium and the continued-enrollment premium. If you do not pay the first continued-enrollment premium within two months of its due date, the status lapses and you return to being a regional subscriber. And if your income has dropped enough that the regional premium will come out low, the income adjustment in Situation 1 may be the better route.

Situation 6: You were a dependent and received a bill — check the requirements

If you were registered as a family member's dependent and a premium bill arrived, you have most likely exceeded either the income or the property requirement. The requirements are:

Income — total income of 20 million won or less per year.

Business income — none at all if you have a business registration; 5 million won or less per year if you do not. If you have rental income from housing, the 5 million won allowance does not apply even without a business registration.

Property — a combined property tax base of 540 million won or less. If it is above 540 million won and up to 900 million won, annual income must be 10 million won or less.

Married couples — both spouses must meet the requirements.

You can check which requirement applies to you with the dependent eligibility check on the NHIS website. If the cause was a one-off spike in income and this year's income is lower, ask NHIS about re-registering as a dependent along with the income adjustment in Situation 1.

Due date and where to ask

Due date — each month's premium is due by the 10th of the following month, so the November bill is due December 10. Regional premiums can also be paid quarterly.

Contact — NHIS call center 1577-1000. The NHIS website offers a regional premium calculator, a dependent eligibility check, and online income adjustment requests.

A note for foreign residents: foreign residents who are regional subscribers are covered by separate premium rules under the Enforcement Decree, except for marriage migrants (F-6), permanent residents (F-5) and other statuses the Ministry designates. The timing described above may not apply to you in the same way, so confirm your own case with NHIS.

The November bill is a signal that the basis for a full year of premiums has changed. If the amount moved, start by checking the two lines, income and property, against your actual situation. Where they do not match, there is usually a way to fix it.

This guide reflects the National Health Insurance Act, its Enforcement Decree and NHIS guidance as of November 4, 2026. Confirm your individual premium and eligibility for adjustments with NHIS.