1st Gen vs. 4th Gen Korean Health Insurance (Silson): Your Optimal Choice for 2026 – Coverage, Costs, and Conversion Guide

In 2026, the hottest topic in the Korean insurance market is undeniably ‘Silson (actual expense) insurance conversion.’ If you are a subscriber of 1st generation Silson insurance, in particular, now is the time to deeply consider whether or not to convert to 4th generation Silson insurance. Making a hasty decision simply because the premiums are cheaper might lead to regrets later. This post will meticulously analyze two key factors: the robust coverage of 1st generation Silson insurance and the overwhelming cost savings of 4th generation Silson insurance. We will provide a comprehensive standard for making the optimal choice in 2026. Through figures and case studies, we will help you make a wise decision.

📊 Real Cost Analysis by Maintenance Stage (as of 2026)

Silson insurance is broadly categorized into 1st generation (old Silson), 2nd generation (standardized Silson), 3rd generation (good Silson), and 4th generation (new Silson), depending on the subscription period and conditions. In 2026, the difference between the oldest form, 1st generation Silson, and the newest form, 4th generation Silson, is starkly evident. According to 2023 data from the Health Insurance Review & Assessment Service, the average premium for 1st generation Silson insurance for a 50-year-old exceeds ₩120,000 (approx. $90 USD) per month, posing a significant burden on subscribers. In contrast, 4th generation Silson insurance offers reasonable premiums of around ₩30,000 (approx. $22 USD) per month for the same age group, drawing significant attention. However, simply looking at premiums is not enough; one must consider the complex coverage structure, deductibles, and surcharge system.

💸 Real Money Simulation for Conversion: What’s the Right Choice for Me?

As mentioned earlier, if a 1st generation Silson insurance subscriber converts to 4th generation Silson insurance, there is an average monthly premium difference of approximately ₩90,000 (₩120,000 – ₩30,000 or approx. $67 USD). Let’s assume you simply save this amount. If you consistently deposit ₩90,000 (approx. $67 USD) each month into a savings product with an annual interest rate of 5% for 10 years, your principal of ₩10,800,000 (approx. $8,000 USD) plus approximately ₩2,700,000 (approx. $2,000 USD) in interest would accumulate to an asset value of approximately ₩13,500,000 (approx. $10,000 USD). This is a significant opportunity cost that cannot be ignored. This can be a great help, especially when nearing retirement or at a time when financial flexibility is needed.

However, this simulation is valid under the premise that you are very healthy and rarely use medical services. The situation changes if you frequently visit the hospital or regularly require expensive non-covered treatments (such as manual therapy, non-covered injections, MRI, etc.). The deductibles and non-covered surcharges of 4th generation Silson insurance could lead to unexpectedly large expenses.

📌 Case Study: Mr. Kim Cheol-soo’s Choice (50s)

• If maintaining 1st generation Silson: Monthly premium ₩120,000 (approx. $90 USD). Total annual expense ₩1,440,000 (approx. $1,065 USD). Almost no deductible when medical expenses occur. (e.g., If annual medical expenses total ₩3,000,000 (approx. $2,220 USD), actual expenditure is ₩1,440,000 + ~₩50,000 (approx. $37 USD)).
• If converting to 4th generation Silson – Healthy case: Monthly premium ₩30,000 (approx. $22 USD). Total annual expense ₩360,000 (approx. $267 USD). Rarely visits the hospital, so minimal deductibles and no non-covered surcharges. (e.g., If annual medical expenses total ₩300,000 (approx. $222 USD) (assuming covered ₩200,000 + non-covered ₩100,000), a deductible of approximately 20% (around ₩60,000 / approx. $44 USD) occurs. Total expenditure ₩360,000 + ₩60,000 = ₩420,000 (approx. $310 USD)). → Annual saving of ₩1,020,000 (approx. $755 USD) (₩1,440,000 – ₩420,000).
• If converting to 4th generation Silson – Frequent non-covered use case: Monthly premium ₩30,000 (approx. $22 USD). Total annual expense ₩360,000 (approx. $267 USD). Suppose annual non-covered treatment costs ₩3,000,000 (approx. $2,220 USD) (e.g., manual therapy ₩2,000,000 (approx. $1,480 USD) annually, non-covered injections ₩1,000,000 (approx. $740 USD)).
  • Deductible: 30% of ₩3,000,000, which is ₩900,000 (approx. $665 USD).
  • Surcharge: If ₩3,000,000 in non-covered services is used, next year’s premium is likely to be surcharged by 200%. (₩30,000 (approx. $22 USD) / month → ₩60,000 (approx. $44 USD) / month). Annual premium ₩720,000 (approx. $533 USD).
  • Total expenditure: ₩360,000 (current premium) + ₩900,000 (deductible) + ₩360,000 (increased premium) = total annual ₩1,620,000 (approx. $1,200 USD). → Annual additional expenditure of ₩180,000 (approx. $133 USD) compared to maintaining 1st gen (₩1,620,000 – ₩1,440,000).

Thus, even for the same illness, the deductibles and surcharges of 4th generation Silson can lead to unexpected expenses. Especially with the potential for an increase in overall medical costs due to strengthened non-covered treatment management from 2026, meticulous review is essential.

💡 Conversion Decision Guide: Which Silson Insurance is Right for Me?

The decision to convert Silson insurance must be made carefully, considering various factors such as personal health status, hospital usage habits, and financial situation. Use the following checklist to gauge which option might be more favorable for you.

• Presence of chronic diseases: If you are currently receiving continuous hospital treatment for chronic diseases such as diabetes or high blood pressure, consider maintaining 1st generation.
• Preference for non-covered treatments: If you frequently use or plan to use non-covered treatments like manual therapy, non-covered injections, or MRI, consider maintaining 1st generation or carefully reviewing a 4th generation conversion.
• Number of hospital visits: If you are healthy and visit the hospital less than 1-2 times a year, 4th generation is advantageous.
• Financial余裕 (leeway): Determine whether saving tens of thousands of won (tens of USD) per month in premiums is more important, or minimizing the burden of potentially high medical costs.
• Preparation for old age: As people age, medical expenses tend to increase, so choose an option that will be advantageous in the long term.

📢 2026 Silson Insurance Conversion FAQ

We’ve collected common questions about Silson insurance conversion, which many people are curious about. Find more information here!

1. Q1: Is it true that 1st generation Silson insurance will be discontinued?
   A1: 1st generation Silson insurance itself is not being discontinued. Existing subscribers can continue to be covered through renewals as long as they maintain their contract. However, due to very high loss ratios, insurers may significantly increase renewal premiums or encourage some special term changes. New subscriptions are only possible for 4th generation Silson insurance.
2. Q2: Can I go back to 1st generation after converting to 4th generation Silson insurance?
   A2: Unfortunately, once you convert to 4th generation Silson insurance, you cannot revert to 1st generation Silson. Therefore, the conversion must be decided very carefully. Especially since the broad coverage of 1st generation is no longer available for new subscriptions, careful judgment is required.
3. Q3: What if I convert to 4th generation when healthy and then get sick later?
   A3: If you convert to 4th generation when healthy and pay lower premiums, but later develop an illness and receive many non-covered treatments, your premiums may be surcharged. In particular, if non-covered medical expenses exceed ₩1,000,000 (approx. $740 USD) annually, the surcharge stages begin to apply, and premiums can be surcharged by up to 300%. You must fully understand this point before making a conversion decision.
4. Q4: What items must be considered when converting Silson insurance?
   A4: The most important factors are your health status and future medical utilization plans. You should comprehensively consider the presence of chronic diseases, the necessity of expensive non-covered treatments (manual therapy, MRI, etc.), and the number of annual hospital visits. Furthermore, it’s crucial to meticulously calculate whether the monthly premium savings are greater than the estimated non-covered deductibles and surcharges. If necessary, we recommend consulting with an insurance expert to receive a personalized analysis optimized for your situation. Access expert consultation now →

🎯 Conclusion: Smart Silson Insurance Conversion – The Data Holds the Answer

It’s impossible to definitively say whether 1st generation or 4th generation Silson insurance is the best option. This is a complex issue where the answer varies depending on an individual’s health status and financial goals. However, what is certain is that the data for 2026 provides clear criteria.

• If you rarely use medical services, have no underlying conditions, and have low reliance on non-covered treatments, you should actively consider converting to 4th generation. A monthly saving of approximately ₩90,000 (approx. $67 USD), or an annual saving of around ₩1,080,000 (approx. $800 USD), can lead to a substantial asset value of about ₩13,500,000 (approx. $10,000 USD) over 10 years. This can be viewed not just as saving money, but as an investment for the future.
• Conversely, if you already suffer from chronic diseases or regularly require expensive non-covered treatments (e.g., annual manual therapy worth millions of won, periodic non-covered injections, MRI scans), maintaining the ‘invincible coverage’ of 1st generation Silson insurance is much wiser. Although you might pay a relatively higher premium, it will be the best risk management strategy to prevent unpredictable expenses due to deductibles and surcharges, ensuring stable medical services. Especially the non-covered surcharge system of 4th generation Silson can dramatically escalate the financial burden as medical expenses increase.

The key is to accurately diagnose ‘your medical usage patterns’ and objectively simulate the ‘estimated costs’ accordingly. Rather than making a hasty decision just because others are converting or because premiums are cheaper, we strongly recommend consulting an expert or using a Silson insurance calculator to make the optimal choice for your situation. Your wise judgment will determine your stable medical life in the future.