Starting this year, the government will increase the number of rare diseases eligible for medical cost support to 1,388 and will ease the income criteria for eligibility. This is expected to reduce the financial burden on patients by allowing them to receive treatment without out-of-pocket costs for nursing care.
The Korea Disease Control and Prevention Agency noted on the 6th that it is expanding the target diseases of the ‘medical cost support project for patients with rare diseases’ and relaxing the household income criteria for patients to strengthen the guarantee of medical cost support. The application process has also been improved to enhance convenience.
The medical cost support project for patients with rare diseases aims to reduce the excessive medical expenses burden on patients and their families by supporting the out-of-pocket costs and other expenses of low-income health insurance subscribers among those registered under the special treatment for rare diseases. This includes costs related to treatment, out-of-pocket costs for nursing care, special dietary purchases, and caregiver expenses. Through this, 90% support is provided under the special treatment (health insurance finances) in addition to the 10% from the medical cost support project (government support), allowing patients to receive treatment without out-of-pocket costs.
This year, the number of diseases eligible for support will increase from the existing 1,272 to 1,338 with the addition of 66 diseases. Included in the support target disease group are congenital glaucoma, polycystic kidney disease, autosomal dominant disorders, Blume syndrome, and familial thoracic aortic aneurysms and dissections.
Additionally, the criteria for medical cost support for adult and pediatric patients with rare diseases have been uniformly relaxed to below 140% of the median income, regardless of age, starting this year. Previously, the criteria were below 120% of the median income for adults and below 130% for children.
The application process has also been refined. Previously, only diagnostic certificates explicitly naming the condition as the main diagnosis were accepted when applying for medical cost support; however, in the future, applications can be submitted using the final diagnosis without distinguishing between primary and secondary diagnoses. If medical expenses are not automatically reduced when using medical institutions, patients or guardians will be able to submit claims for out-of-pocket costs for nursing care and other specific items to the National Health Insurance Service office via mail or fax.
Korea Disease Control and Prevention Agency Commissioner Ji Young-mi said, “I hope that the expansion of medical cost support for patients with rare diseases will provide practical help to patients and their families,” and added, “We will continue to discover and designate rare diseases under national management and link them to the support system while continuously striving to create a better treatment environment.”