Do you know what the most talked-about topic in group chats these days is, along with pictures of autumn leaves? It's the plan to go back to Korea at the end of the year to get a health checkup. Honestly, I was considering going myself, so I spent quite a while browsing hospital websites.

However, the more I looked into it, the more I realized it wasn't just about being cheaper and faster. So, I organized what I found step by step.

First, let's look at the situation in Korea. Starting April 3, 2024, overseas citizens must reside in Korea for at least six months to be listed as dependents of a workplace subscriber. Spouses and children under 19 are exceptions.

The rules for regional subscribers are similar. Overseas citizens can only become regional subscribers after six months of entering the country.

If you spend more than 30 consecutive days abroad during those six months, you must start a new six-month period from the day you re-enter. This means that if you enter Korea for a two-week vacation just to get a checkup, you can't expect to benefit from Korean health insurance.

Of course, comprehensive checkup packages often include many non-covered items that are not eligible for insurance, so you often end up paying the full price regardless of insurance. Prices can vary significantly between hospitals and programs, so be sure to compare the listed prices from each hospital.

Now, let's look at the situation in the US. Surprisingly, many people overlook something important.

If you have insurance that follows ACA guidelines, unless it's a grandfathered plan, you should receive specified preventive services at in-network hospitals without any out-of-pocket costs. This means no copays or deductibles.

This provision has been challenged in court before. However, on June 27, 2025, the Supreme Court ruled in favor of maintaining this structure in the Kennedy v. Braidwood case.

However, the ruling also confirmed that the Secretary of Health and Human Services has the authority to accept recommendations from the preventive services task force or replace its members. Therefore, there is a perspective that the covered items may change in the future.

Specifically, what does this include? In 2021, the US Preventive Services Task Force lowered the recommended starting age for colorectal cancer screening to 45.

When a stool test comes back positive, follow-up colonoscopy is also considered an extension of the screening and is covered without out-of-pocket costs, according to federal guidelines. This applies to plan years starting on or after May 31, 2022.

The task force also changed its recommendation in 2024 for mammograms to be performed every two years for women aged 40 to 74. Blood pressure, diabetes, and depression screenings are also included in this list.

I was surprised to learn this. While I diligently pay my insurance premiums every year, I wasn't taking advantage of the free services available to me.

So, what is the real advantage of getting a checkup in Korea? It's the ability to complete multiple tests in one building in just a day or two, and the results come back quickly.

In the US, you have to schedule an appointment with your primary care physician, get a referral, and then wait for an appointment with a specialist. This process can take a long time.

And if you want to get tests that are not on the free preventive list in the US, the packages in Korea that bundle multiple tests together are definitely more convenient. In the US, you often need a doctor's recommendation to get the same tests done individually.

However, there is a catch. If something abnormal comes up in Korea, you often have to return to the US to confirm it.

At that point, it may be classified as diagnostic testing rather than preventive, which means deductibles and coinsurance could apply, so it's best to check with your insurance company in advance.

Additionally, it can be difficult to get reimbursed by US insurance for elective tests done abroad. Since each plan has different regulations regarding overseas treatment, be sure to check the out-of-network provisions in your policy.

If you decide to get tested in Korea, ask when making your appointment whether you can receive the results in English. If you bring imaging tests on a CD or file, it makes it much easier for a US doctor to interpret them.

A friend of mine had a checkup in Korea a few years ago and only brought back the results in Korean, and she had a tough time explaining them to her primary care physician here. Hearing that story felt all too relatable.

In summary, the criteria for comparison are threefold: whether the tests are already free under my insurance, whether they can only be easily obtained in Korea, and whether I can follow up on any abnormal findings in the US.

My conclusion is this: first, take advantage of the free preventive checkups covered by US insurance, and then choose Korea for any additional tests you really want.

What tests are necessary for me, and what should I get done earlier due to family history? This varies from person to person. Be sure to discuss it with your doctor or pharmacist.

You can check which preventive services are free under your insurance on the HealthCare.gov preventive services page or through your insurance company's member portal. You can also call the number on the back of your card and ask by providing the CPT code.

It would be nice to get a checkup while going to Korea. However, when you factor in the cost of the plane ticket, you might find that there isn't much savings after all.

Looking out the window at the leaves piling up, I realize that this year is coming to an end. Before my deductible resets, I'll make an appointment with my primary care physician this week.