It was investigated that the non-covered medical expenses, such as physical therapy, dental implants, and herbal medicine prescriptions, amount to 22.64 trillion won annually.
The Ministry of Health and Welfare and the National Health Insurance Corporation noted on 6th that the reported non-covered medical expenses, based on 1,068 items for non-covered reporting as of March 2024, totaled 1.8869 trillion won. This is estimated to be approximately 22.6425 trillion won annually.
This analysis is the first statistical data analyzing the status of non-covered medical expenses across all medical institutions after the implementation of the non-covered reporting system. The non-covered reporting system is a system where medical institutions report details of non-covered treatments to ascertain the status of non-covered services and guarantee the public's right to know and the right to medical choice. It was first implemented in September 2023 for hospital-level medical institutions, and in March of last year, the reporting target institutions were expanded to include all medical institutions, including clinics. The number of reporting items also increased from 594 last year to 1,068.
When examining the non-covered medical expenses by type last March, dental clinics accounted for the largest medical expense with 741.4 billion won (39.3%). This was followed by clinics with 431.6 billion won (22.9%), hospitals with 261.6 billion won (13.9%), and Oriental medicine clinics with 141.7 billion won (7.5%).
By item, in the medical field, physical therapy had the largest medical expense at 120.8 billion won (13%). This was followed by extracorporeal shockwave therapy for musculoskeletal disorders at 70 billion won (7.5%), and single room rates for higher-level hospital rooms at 52.3 billion won (5.6%). Physical therapy accounted for the largest amounts in both hospital and clinic levels, with 51.6 billion won and 69.2 billion won, respectively.
In the dental field, dental implants (per tooth) using zirconia were the highest at 272.2 billion won (34%). Zirconia is a ceramic material similar in color to teeth, known for its high strength and durability among dental prosthetics. This was followed by crown zirconia at 161 billion won (20.1%), and orthodontics and other fixed comprehensive orthodontics for malocclusion at 41.9 billion won (5.2%). The top item lists were the same for both dental hospitals and dental clinics.
In the Oriental medicine field, herbal medicine prescriptions accounted for the largest expense at 120.9 billion won (76.7%). This was followed by acupuncture and acupoint treatments at 15.1 billion won (9.6%), and others at 12.8 billion won (8.1%).
The government plans to comprehensively provide various non-covered related information, including the analysis results of these non-covered reporting data, prices by non-covered item, total medical expenses, and evaluations of the safety and efficacy of non-covered medical practices through a 'tentative name' integrated non-covered portal. The portal site is expected to be opened at the end of this month. Additionally, plans will be announced to include focused management measures for excessive non-covered services that burden public medical expenses and health insurance finances in the second medical reform execution plan.
Kwon Byeong-gi, an essential medical support officer at the Ministry of Health and Welfare, said, 'The non-covered reporting system, which was first implemented last year, is being stabilized with the active cooperation of all medical institutions.' He also noted, 'We are discussing with experts, including those in the medical field, about expanding the non-covered reporting system and management measures for non-covered services, and we will prepare reform measures that can harmonize with a medical system that strengthens essential medical services.'