When You Must Rest Because of Illness, the Sickness Benefit Is Paid Only in Pilot Regions: 49,540 Won a Day After a 7-Day Wait, Up to 150 Days, and the Nationwide Rollout Is Pushed Back to 2027

The sickness benefit replaces part of your income while you cannot work

It partly makes up your income when an illness or injury unrelated to work forces you to stop working.
An accident on the commute or an injury on the job belongs to industrial accident insurance instead. You cannot be paid twice for the same period by both programs, so first sort out how you were hurt.
If your employer gives paid sick leave, you are already receiving pay for that period, so it is hard to treat it as eligible. Ask the NHIS about the detailed exclusions.

It is paid only in pilot regions, not nationwide

The Ministry says it is running the pilot on an extended basis with the aim of introducing a full system. Since 2025 it has been testing a universal, rate-based model alongside the earlier selective, flat-amount model to compare the effects.
As of 2026 the announced pilot regions are Anyang, Yongin, Daegu Dalseo-gu and Iksan (phase 2), and Chungju, Hongseong, Jeonju and Wonju (phase 3). Regions can change or be added, so first check on the NHIS website whether your area is covered right now.
You need one of two things. Either you live in a pilot region or you work at a workplace located there. The guidance generally targets employed people aged 15 and over and under 65.

The first 7 days after you stop working are not paid

The benefit has a 7-day waiting period. The first 7 days you could not work are not counted, and payment starts from the following days.
That means if the time off is short, you may receive almost nothing. The medical certificate states the period you need to rest according to the doctor's judgment, so whether that period exceeds 7 days is the first hurdle.
There is also a payment cap: the program covers up to 150 days within the pilot period.

The base is 49,540 won a day, or 60% of average pay in rate-based regions

In flat-amount regions it pays 49,540 won a day, based on 60% of the 2026 minimum wage. It is the figure you get by assuming 8 hours at the hourly minimum wage of 10,320 won and multiplying by 60%.
For employee insureds in regions using the rate-based model, the base is 60% of average pay over the previous 3 months, with a floor and a ceiling. Guidance materials put the ceiling at around 68,100 won a day, but the amount actually applied is set in the NHIS review.
For example, if you receive 20 days at the flat amount after the 7-day wait, 20 days times 49,540 won is about 990,000 won. Taxes and adjustments against other benefits need to be checked separately.

Income and asset conditions depend on each region's model

Regions run on the selective model have applied household income and asset tests, while regions on the universal model look at employment status and enrollment conditions without such tests.
Which region uses which model, and whether this year's criteria are unchanged, can vary from year to year. It means the same illness can lead to different results depending on where you live, so do not rely on the numbers alone and read the notice for your own region.
Types other than employee insureds, such as the self-employed and daily workers, have their own conditions, so it is more accurate to confirm the conditions for your enrollment type through an NHIS consultation.

The application starts with a certificate from a participating medical institution

The order is as follows. You see a doctor at a participating medical institution and get the certificate designed for the sickness benefit. Then you gather documents showing you stopped working and apply through the NHIS website, app or a branch office.
Not just any hospital's certificate will do. Ask first whether it is a participating institution before getting the certificate, to avoid a wasted trip.
The application deadline may be limited to a set period from the date of the certificate. Do not put off the paperwork while you rest, and ask the NHIS about the deadline.

Nationwide introduction has been pushed back to 2027

The Ministry has said the full launch was postponed from the original 2025 to 2027. It says it will review issues such as who is covered, how it is funded and the level of protection using pilot data, and then go through public discussion.
Press reports talk of pushing for a nationwide expansion in the second half of next year, but whether the law and the start date are final must be checked in Ministry announcements.
Until then, remember that people living outside the pilot regions are not covered.

Order of steps and related guides

1) Check whether your home or workplace is in a pilot region, 2) talk with your doctor about whether the rest period exceeds 7 days, 3) get the dedicated certificate from a participating institution, 4) apply to the NHIS, 5) check that it does not overlap with industrial accident benefits or paid sick leave.
If hospital bills are the heavy part, read our guides on catastrophic medical expense support and refunds under the copay cap. If you were hurt on the job, our first steps for an industrial accident claim applies, and if you have left your job, see voluntary continued enrollment in health insurance.
Questions can go to the NHIS call center and the Ministry's Health Insurance Policy Division (044-202-2729). This is general information and does not replace diagnosis or advice for an individual case.