Go to Contents Directly Go to Main menu Directly Go to Footer Directly

National health insurance service


Health Insurance Guide

National Health Insurance Corporation

Insurance Benefit


Home > Health Insurance Guide > Insurance Benefit

Types of Insurance Benefits

Insurance benefits feature the manner in which NHIS provides service benefits (health care benefits, health check-ups) or cash benefits (care expense, co-payment ceiling system, compensation for excessive co-payment, appliance expenses for the disabled, pregnancy & childbirth examination expense) under the following cases according to the law:

  • Preventing, diagnosing, treating, or rehabilitating the insured or their dependents’ diseases or injuries
  • In childbirth, death, and health promotion
  1. Benefits in Cash
    1. Appliance expense for the disabled

      Insurance benefits of supportive equipment for the disabled When the insured (a registered disabled person) or their dependents purchase appliances for a physically challenged person, NHIS pays part of the appliance price as insurance benefits

      Payment Amount

      • When the product price is below the maximum subsidy amount for the product, the corporation pays 90% of the price.
      • When the product price exceeds the maximum subsidy amount for the product, the corporation pays 90% of the product’s maximum subsidy amount.
    2. Childbirth Expense

      When the insured or their dependents deliver babies at home, etc. instead of care institutions (hospital, clinic, maternity nurse), NHIS pays the childbirth expenses

      • ※ Exception: Childbirth in a foreign country (Article 49 of the National Health Insurance Act – Suspension of Benefits)

      Subsidy Amount

      NHIS pays KRW 250,000 for childbirth (regardless of the number of children)

    3. Medical resources for chronic renal failure

      if a patient of chronic renal failure purchased the peritoneum perfusate and consumables for automated peritoneal dialysis in any other places instead of an institution, a part of expenses is returned

    4. Oxygen recovery service (home oxygen and portable oxygen)

      if a patient is provided oxygen recovery service at home or outdoors, a part of expenses is returned

      * standard of the amount : Home oxygen-120,000 (provided monthly), portable oxygen-200,000/month(KRW100,000 within 15 days of rental, KRW200,000 per month more than 16 days of rental)

    5. Consumables for diabetics

      if a diabetic patient purchases consumables for insulin injection and test of blood sugar, a part of expenses is returned.

      * Amount can be varied from ₩900 to 2,500 by the types of diabetes

    6. Consumable for self-catheterization

      if a patient having neurogenic bladder purchases consumables for self-catheterization, a part of expenses is returned.

      * (applicable amount : ₩9,000 per day, up to 6 items)

    7. Respirator

      if a patient having rare incurable diseases requires and rents a respirator and purchases consumables by the prescription of a doctor, a part of expenses is returned

      * mixed type : 535,000 per a month, pressure type·volume type : 356,000 per a month, basic consumables 60,000~80,000 / optional consumables (connector 14,000~29,000 per a month/facial mask within 400,000 a year)

    8. Mechanical In-Exsufflator

      If a respirator user rents mechanical in-exsufflator for central nervous system diseases, a part of expenses is returned (160,000 per a month, including consumables)

    9. Support Business for Pregnancy & Child Birth Medical Expenses

      NHIS supports a part of the co-payment of benefit or non-benefit medical expenses received by the insured (their dependents) for pregnancy or childbirth. (Implementation: 2008.12.15)

  2. Lease Program of Care Aids and Appliances

    Objectives

    • Ensure convenience of living for the insured who need appliances temporarily during treatment and rehabilitation.
    • Ease the insured’s financial burden by enabling use of appliances at a lower price.
    • Prevent resource loss through NHIS’s purchase and lease of appliances, as it is often used a short period, at the national level.

    Rental Item

    WheelchairWalkerStickCrutchesBathing Device
  3. Limitation of health care costs, refund of individual cost

    Rank of average insurance premiums in a year
    year The number
    of days of
    hospitalization
    Rank of average insurance premiums in a year (low income > high income)
    Rank 1 Rank 2~3 Rank 4~5 Rank 6~7 Rank 8 Rank 9 Rank 10
    2016 1,210,000 1,520,000 2,030,000 2,540,000 3,050,000 4,070,000 5,090,000
    2017 1220,000 1,530,000 2,050,000 2,560,000 3,083,333 4,110,000 5,140,000
    2018 Less than
    120 days
    800,000 1,000,000 1,500,000 2,600,000 3,130,000 4,180,000 5,230,000
    More than
    120 days
    1,240,000 1,550,000 2,080,000