건강보험 환급National Health Insurance Corporation building in Mapo-gu, Seoul (file photo)
Reimbursement for medical expenses exceeding the health insurance out-of-pocket limit: 538.6 billion won paid to 280,000 people starting from the 13th
(Seoul = Yonhap News) Reporter Lee Joo-yeon = Among the out-of-pocket expenses paid by health insurance subscribers last year while using hospitals and clinics, the amount exceeding the upper limit (2 to 4 million won) will be refunded to the patient.
The Ministry of Health and Welfare and the National Health Insurance Corporation announced on the 11th that they will refund the amount exceeding the individual out-of-pocket limit set through last year’s health insurance premium settlement starting from the 13th.
Last year, there were 280,000 subscribers who were eligible for a refund whose out-of-pocket expenses paid while using hospitals and clinics exceeded the upper limit, and the refund amount was 538.6 billion won. Compared to 2010, the number of beneficiaries increased by 23,000 and the amount paid increased by 85.4 billion won.
This appears to be due to an increase in elderly medical expenses due to the increase in the population of people aged 65 or older and an increase in cases of expensive treatment exceeding 3 million won.
In fact, when the out-of-pocket reimbursement amount was broken down by age group, those aged 65 or older accounted for the largest amount at 65.6% of the total amount paid. Next, those aged between 40 and under 65 accounted for 27.2%.
The out-of-pocket out-of-pocket cap system is a system to prevent people with high-cost or serious illnesses from placing an excessive burden on their families due to out-of-pocket expenses. If the total out-of-pocket cost of health insurance benefits paid while using a medical institution for one year exceeds 2 to 4 million won, the excess amount is paid by health insurance.
The Corporation will send out notices to those eligible for refunds starting on the 11th, and subscribers who receive the notices can apply for refunds to the Corporation via the Internet (www.nhic.or.kr) or phone (1577-1000).
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