Korean Silson 2026: Keep the 4th Generation or Switch to the 5th? 5 Tables on Premiums, Copays and Non-Covered Care

Photo: Kelly Sikkema, free to use under the Unsplash License.

Short answer: As of October 2026, the decision facing a silson policyholder is "keep my current contract (one of the 1st to 4th generations) or move to the 5th generation launched on 6 May 2026." The 5th generation has premiums about 30% lower than the 4th generation, but the copay on non-covered care is higher and the limit for non-severe non-covered care is smaller. Put the monthly premium difference and your own yearly non-covered medical spending side by side on one sheet. Also check the safety net that lets you withdraw within 6 months if you have not received any insurance payout since switching.

If you decide only because "the new product is cheaper," you end up comparing two numbers, premiums and hospital bills, as if they belonged to different days. This article lays out the order in which someone who already holds silson insurance can weigh keeping the current contract against switching to the 5th generation. The right answer depends on when you joined and how you use hospitals, so it does not claim that either side is better.

There are two source documents. The structure and premium level of the 5th generation follow the Financial Services Commission's announcement of the 5th-generation launch (press release of 6 May 2026), and the copay structure of the 4th generation follows the General Insurance Association of Korea's guide to switching to 4th-generation silson. The example amounts in this article are assumptions meant to show the comparison method; they are not an invitation to buy a policy or a promise of any payout.

Which generation is my silson, and what exactly do I have to decide?

First, check the date you joined on your policy certificate. Silson insurance is divided into the 1st to 4th generations by joining date, and the copay structure differs by generation. According to the Financial Services Commission, the 5th generation launched on 6 May 2026 at 16 insurers (7 life insurers and 9 non-life insurers), and existing 1st-to-4th-generation policyholders can switch to the 5th generation of the insurer they already hold a policy with. No separate underwriting review is required for the switch. However, a review does apply if you widen the coverage categories, or if you switch again after withdrawing from an earlier switch.

So today's decision is not "old contract versus 4th generation" but "keep versus switch to the 5th generation." If you hold a 4th-generation plan, leaving it as it is means keeping; if you hold a 1st-to-3rd-generation plan, leaving the older contract as it is means keeping.

Even if you keep it, the premium can change at renewal. For the 4th generation, the non-covered rider premium is discounted or surcharged across 5 grades according to the non-covered benefits paid out in the previous year. Confirm the exact size of each grade in the insurer's notice and on your certificate.

The 5th generation divides coverage into a base contract, a severe non-covered rider (Rider 1), and a non-severe non-covered rider (Rider 2). "Severe" means conditions that qualify for the national health insurance special calculation exemption, such as cancer, cerebrovascular and heart disease, and rare or intractable diseases. The design lowers the premium by raising the copay on the commonly used non-severe non-covered care.

How does the money I pay at the hospital change under the 5th generation?

Placing the copay structures side by side gives the table below. The 4th-generation column shows only the rates that can be confirmed from the General Insurance Association's guide. Terms for the 1st to 3rd generations differ by joining period, so write in the copay clauses of your own certificate yourself.

The notable changes are that the copay for non-severe non-covered inpatient care rises from 30% to 50%, the non-severe benefit limit falls from 50 million won a year to 10 million won a year, and severe non-covered inpatient care gains an annual copay cap of 5 million won.

How the covered outpatient copay is calculated

The covered outpatient copay is the largest of the national health insurance copay rate, 20%, and 10,000/20,000 won. Let us work through the Financial Services Commission's example. If the covered out-of-pocket amount for an outpatient visit is 200,000 won and the national health insurance copay rate is 40%, then 40% of 200,000 won, which is 80,000 won, is your copay and the insurance payout is 120,000 won. 200,000 won × 0.4 = 80,000 won, and 200,000 won − 80,000 won = 120,000 won, so the numbers add up. Check the table in the product description to see which of the minimum amounts (10,000/20,000 won) applies to you.

Non-severe non-covered items that may not be covered

As examples excluded from the non-severe rider (Rider 2), the Financial Services Commission named musculoskeletal physical therapy, extracorporeal shock wave therapy, and non-covered injectable drugs. If you often receive manual-therapy-type treatments, whether they are excluded may matter more than the premium difference. Confirm this in the product description and in a written reply from the insurer.

How much lower is the premium really, and what happens once hospital bills are added?

The Financial Services Commission stated that 5th-generation premiums are about 30% cheaper than the 4th generation and at least 50% cheaper than the 1st and 2nd generations. It also explains that holding only the base contract and Rider 1 comes to about 50% of the 4th-generation premium. Actual premiums vary with age, insurer, renewal timing and the riders you choose, so get your own quote directly from the insurer or from Bohum Damoa (the industry insurance comparison site).

What follows is a hypothetical calculation and not real figures. Assume a 4th-generation monthly premium of 40,000 won and a 5th-generation quote of 28,000 won (about 30% lower), and assume you receive the same non-covered treatment under both.

The arithmetic is simple. 12,000 won × 12 months = 144,000 won saved, while the same treatment costs 300,000 won (30%) under one plan and 500,000 won (50%) under the other, so you pay 200,000 won more. If the item is excluded, you pay the full 1,000,000 won, which is 700,000 won more.

If you receive no non-covered care, the full 144,000 won saving stays with you. Under this assumption, the break-even point at which the 5th generation comes out ahead is non-severe non-covered spending of 720,000 won a year or less, because 144,000 won ÷ 0.2 (the gap between 50% and 30%) equals 720,000 won. This is a simplification that ignores outpatient deductibles, visit-count limits and excluded items.

Holding only the base contract and Rider 1 is said to be about 50% of the 4th-generation premium, which under the same assumption is 20,000 won a month (a saving of 240,000 won a year). In exchange, there is no non-severe non-covered coverage.

Who leans toward keeping, and who leans toward switching?

This choice depends heavily on how often you receive non-severe non-covered care. What follows is only a starting point for thinking and not a personal conclusion.

Keeping is closer to the mark if you regularly receive treatment that may be excluded from Rider 2, or already have a treatment plan. Keeping can also be reasonable if the coverage of a 1st-to-3rd-generation contract fits your usage pattern well. Switching is closer to the mark if you rarely receive non-covered non-severe care, you genuinely feel the burden of the premium, and you judge that a design centered on major-illness coverage is enough. For 1st- and 2nd-generation holders the premium gap is large enough that getting a quote is worthwhile, but the coverage structure is different, so switching on premium alone can cost you something.

Why your claim history matters to the decision

The history of benefits you have received matters in two places. If you keep the 4th generation, your non-covered benefit history feeds into the discount or surcharge grade at the next renewal, and if you switch, the withdrawal conditions below depend on that history. Start by checking your own claim and payout record in the insurer's app. There is no need to write sensitive information such as a diagnosis into the table; it is enough to note only what the cost decision needs, such as "non-covered treatment planned once a month."

If I change my mind after switching, can I go back?

Withdrawal is the safeguard that eases the worry about switching. If you have not received any insurance payout since the switch, you can withdraw within 6 months and return to your previous product. Within 3 months of the switch, you can withdraw even if a payout event has occurred.

However, if you want to switch again after withdrawing, you go through a review. Confirm in writing whether the start date of the period is the contract date or the date of the first premium payment. Do not switch lightly on the strength of withdrawal alone; go through the checking order below first.

What should I check before applying, and in what order?

You can look into switching through an insurer branch, an agent, Bohum Damoa (the industry insurance comparison site), or a call center.

If comparing premiums feels unfamiliar, the "fix the inputs and look only at the price" approach in how to compare car insurance quotes on identical terms is a useful reference. To see the reduced premium within your living costs, how to calculate the 12-month total cost of an MVNO plan helps; when you weigh the burden of health insurance contributions together, the order for calculating health insurance premiums helps; and for reviewing long-term cash flow, a comparison of loan repayment methods helps.

💡 Practical insight: convert the saving into "one treatment bill"

The most common mistake in insurance comparison is to feel the monthly premium gap as large and the hospital bill gap as small. 12,000 won a month is an easy number to notice, yet even added up over a year it is only 144,000 won. A non-covered treatment costing 1,000,000 won, on the other hand, exceeds the saving through the copay-rate difference alone. That is why I suggest turning the saving into the question "how many tens of thousands of won of extra non-covered treatment cost can I take on before I merely break even?" Under the earlier assumption, the 5th generation turned unfavorable once non-severe non-covered spending passed 720,000 won a year. The break-even point is found by dividing the yearly premium difference by the copay-rate difference (20 percentage points). Add up the non-severe non-covered medical bills you actually paid over the past 12 months and check only whether the total sits above or below the break-even point. If below, there is a reason to consider switching; if above, keeping may be reasonable. If excluded items are included, the break-even point drops considerably. If you have treatment scheduled, add it in and calculate again.

• □ I confirmed which generation my silson is from the joining date on my policy certificate.
• □ I wrote down the current monthly and yearly premium and the 5th-generation quote as of the same date.
• □ I wrote down the covered and non-covered copay rates and the outpatient deductible for both the current contract and the switch option.
• □ I added up my non-severe non-covered medical bills for the past 12 months and compared the total with the break-even point.
• □ I asked the insurer whether the treatments I often receive are Rider 2 exclusions (musculoskeletal physical therapy, extracorporeal shock wave therapy, non-covered injectable drugs, and so on).
• □ I confirmed in writing my recent claim and payout history and the start dates of the withdrawal windows (6 months and 3 months).

Frequently asked questions

Q1. How much does the premium fall if I switch to the 5th generation? The Financial Services Commission stated that it is about 30% cheaper than the 4th generation and at least 50% cheaper than the 1st and 2nd generations. The actual amount differs by age, insurer and renewal timing, so get your own quote directly.

Q2. Is there a disadvantage if I simply keep my 4th-generation plan? Switching is not mandatory, and if you keep your plan the contract continues under its terms. However, the premium can change at renewal, and for the 4th generation the non-covered rider premium is discounted or surcharged across 5 grades according to the non-covered benefits paid in the previous year.

Q3. Is there a review when I switch to the 5th generation? According to the Financial Services Commission, existing 1st-to-4th-generation policyholders who switch to the 5th generation of the insurer they already hold a policy with face no separate review. A review applies if you widen the coverage categories, or if you switch again after withdrawing from a switch.

Q4. Can I go back if I regret switching? If you have not received any insurance payout since the switch, you can withdraw within 6 months and return to the previous product. Within 3 months of the switch, you can withdraw even if a payout event has occurred.

Q5. I am receiving manual therapy. Is it fine to switch? The Financial Services Commission named musculoskeletal physical therapy, extracorporeal shock wave therapy and non-covered injectable drugs as examples excluded from the non-severe rider (Rider 2). First check whether your treatment falls under them, and if it does, recalculate the extra yearly burden.

Q6. Where do I ask about switching? You can choose whichever route is convenient: an insurer branch, an agent, Bohum Damoa (the industry insurance comparison site), or a call center. Get your current contract and the 5th-generation option on the same items and keep them in writing.

Checked: 2026-10-22. This article is not an insurance sale, medical advice or a promise of any payout. Before switching, read your current policy certificate, the switching guide, the product description and the terms, and confirm your personal circumstances with the insurer concerned. The amounts in the tables are assumptions.