The fifth-generation indemnity health insurance, which reduces coverage for nonreimbursable services and is reorganized to focus on essential and severe conditions, is set to launch next month. Premiums are expected to drop to about 40% of those for the second-generation product, which has the most existing policyholders.
According to financial authorities and the insurance industry on the 26th, major non-life insurers are preparing to launch fifth-generation indemnity health insurance products in early May. Premiums for the fifth generation are expected to fall to about 17,000 won for men in their 40s and 40,000 won for women in their 60s. According to disclosures on indemnity insurance by non-life insurers, the second generation costs about 45,000 won for men in their 40s and about 112,000 won for women in their 60s. Policyholders with second-generation products account for about 43%.
The fifth generation was revamped to focus on severe conditions. Compared with existing products, it provides the same coverage for severe nonreimbursable services while reducing the limits and reimbursement ratios for non-severe nonreimbursable services.
Services such as manual therapy or new medical technologies not yet listed are not covered, and the coinsurance rate for non-severe nonreimbursable services will be raised to as high as 50%. The goal is to curb excessive use of nonreimbursable care and normalize medical costs. For reimbursable items, inpatient treatment will keep the current 20% coinsurance, while outpatient treatment will be partially increased in line with the National Health Insurance coinsurance rate.