Out-of-pocket medical expenses that occurred over a month at hospital-level institutions reached 749.9 billion won. A simple annualized calculation puts it at about 9 trillion won. The out-of-pocket items on which patients had the highest expenditure were higher-grade room fees (single rooms) and manual therapy.
The Ministry of Health and Welfare and the National Health Insurance Service on the 9th released the results of an analysis of out-of-pocket reporting data conducted in the second half of 2025 for hospital-level medical institutions.
In this survey, the out-of-pocket expenses in Sept. 2025 for 1,251 items reported by 4,098 hospital-level institutions totaled 749.9 billion won. That was 63.5 billion won more than the 686.4 billion won in out-of-pocket expenses for the same items in Mar. 2025. The increase reflects both a rise in participating institutions from 4,000 to 4,098 and higher average out-of-pocket expenses per institution.
Out-of-pocket items are medical services not covered by health insurance, for which patients bear the full cost. The out-of-pocket reporting system was introduced in Sept. 2023 to require medical institutions to report out-of-pocket treatment details to the government, identify the status of out-of-pocket care, and enhance patients' medical choices. The number of items subject to reporting in 2025 is 1,251, up 183 from the previous year.
A simple annualization of 749.9 billion won over 12 months is about 8.9986 trillion won. However, this is an estimate that multiplies the treatment costs reported for the single month of September by 12, and it may differ from the actual annual out-of-pocket total.
By type of institution, hospitals recorded 312.2 billion won in out-of-pocket expenses, the largest share at 41.6% of the total. General hospitals posted 158.7 billion won (21.2%), tertiary general hospitals 108.4 billion won (14.5%), and dental hospitals 65.9 billion won (8.8%).
By item, in the medical sector, higher-grade room fees for single rooms were the highest at 56.1 billion won. Manual therapy followed at 55.2 billion won. Out-of-pocket expenses for just these two items exceeded 110 billion won. Soft-tissue reconstruction materials were also sizable at 28.1 billion won.
By medical specialty, orthopedics had the highest out-of-pocket expenses at 202.4 billion won, accounting for 27.0% of the total. Neurosurgery followed with 100.5 billion won (13.4%), internal medicine 81.6 billion won (10.9%), general surgery 55.6 billion won (7.4%), and obstetrics and gynecology 37.2 billion won (5.0%). The top 10 specialties accounted for 81.1% of all out-of-pocket expenses.
In dentistry, implants accounted for 35.2 billion won, or 48.4% of out-of-pocket expenses in the dental sector. Crowns followed with 19.4 billion won (26.6%), and orthodontics with 7.3 billion won (10.0%). In Korean medicine, decocted herbal medicines and traditional herbal preparations accounted for 14.4 billion won, or 73.9% of out-of-pocket expenses in the Korean medicine sector.
The government is strengthening oversight with a focus on items with high out-of-pocket costs. Starting in July this year, manual therapy has been subject to "managed benefits," which set fees and clinical criteria for oversight. For extracorporeal shock wave therapy, the medical community's self-correction has laid the groundwork to manage treatment frequency and intervals, as well as indications. The government plans to expand managed benefits and continuously monitor the status of out-of-pocket care.
The government also plans to expand information services using this out-of-pocket reporting data so patients can compare and choose out-of-pocket care. Prices by out-of-pocket item and treatment costs for covered and uncovered care by disease and surgery are available on the National Health Insurance Service's out-of-pocket information portal.