May 28, 2024
SEOUL – Starting July, the government will start charging extra medical fees for those who use the medical services an “excessive” amount.
The recent revision of the National Health Insurance Act will kick in on July 1, which means that the current coverage of the state-run health insurance program will be limited to 365 outpatient treatments in a year.
Those visiting the hospital more frequently will still be covered by the National Insurance, but will have to pay 90 percent of the medical bill rather than the usual 20-30 percent.
One example reported by Yonhap News was of a 60-something-year-old person, who received 3,779 medical treatments in 2021. The treatments included visits to multiple hospitals, as many as eight hospitals in a day, and were to treat back pain.
Legal minors and people with valid medical reasons for frequent hospital visits are exempted from the new measure. This includes pregnant women, people with disabilities, and those with rare incurable diseases or advanced diseases.
According to the Ministry of Health and Welfare, the revision is to prevent unnecessary overuse of the medical service. Health officials said that 2,550 people in South Korea received outpatient treatments more than 365 times a day, which cost the National Health Insurance Service an extra 25.1 billion won ($18.4 million) from its budget.
The annual state insurance coverage for these people was nearly 10 million won on average, well over six times the average insurance coverage for all subscribers of the state insurance in 2021.
The Health Ministry plans to introduce services that can alert each subscriber of the National Health Insurance of information such as how many times they have visited the hospital, how many days they have been admitted, and how much of the medical bill they have to pay for. The service is expected to be available via Kakao Talk messenger, online portal Naver, and the NHIS mobile application.