Last year, 2,135,776 patients whose hospital expenses exceeded their out-of-pocket maximum will receive a total of 2.79 trillion won. Each person will receive an average of 1.31 million won. The Ministry of Health and Welfare and the National Health Insurance Service noted on the 27th that they would begin procedures to pay the excess out-of-pocket expenses starting on the 28th.
The government has been implementing the out-of-pocket maximum system since 2004. It is a program that refunds some medical expenses to health insurance beneficiaries whose medical expenses exceed the maximum based on income. It helps alleviate the medical costs for low-income individuals, the elderly, and socially vulnerable groups. However, it excludes non-covered treatments, 2-3 person private hospital room fees, dental implants, and others.
The maximum varies by income bracket. Based on last year's figures, the lowest is 870,000 won per year, and the highest is 10.5 million won. The structure means that those with lower incomes receive more in refunds. Of those in the bottom 50% of income earners, 1,900,287 people will receive 2.1352 trillion won, accounting for 89% of the total recipients and 76.5% of the distributed amount. By age group, 1,211,616 individuals aged 65 and older will receive 1.884 trillion won.
The National Health Insurance Service will sequentially send payment application notifications to the eligible individuals starting on the 28th. Those who receive the notification can apply for their refunds through the National Health Insurance Service website (www.nhis.or.kr), the app 'The Health Insurance', fax, mail, or phone. A spokesperson from the National Health Insurance Service said, "I hope this will serve as a support for citizens who are struggling with unexpected medical expenses."