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National health insurance service


COMMUNITY

National Health Insurance Corporation

FAQ



  • Could you explain the reimbursement process for the purchase of the assistive appliances for the disable?
    To apply for the insurance benefits on supportive equipment for the disabled, submit the following request forms : a copy of “Application for Claims of Insurance Benefits on Supportive Equipment for the Disabled”, a copy of prescription and examination verification on supportive equipment, respectively, and tax invoice issued by the manufacturer(merchandiser) of the equipment or medical institutions.

    such as cane, crutches, white cane, and wheelchair (In cases of reception of insurance benefit from NHIS twice or more).

    It is not necessary to submit the appliance prescription and test confirmation sheet to the NHIS for getting additional benefits, such as cane, crutches, white cane and wheelchair (In cases of reception of insurance benefit from NHIS twice or more).

    It is not necessary to submit the verification on examination identification to the NHIS for electronic wheelchairs and scooter that are purchased with a prescription issued dafter September 30th, 2011.

    It is not necessary to submit the confirmation document to the NHIS. to get a bedsore prevention mattress, bedsore prevention mat, electric lift, walker,
  • “What is the pre-application or post-reimbursement process of co-payment ceiling?”
    This policy basically means that if you see the same doctors several times and hospitalization, you only have to pay up to 5,230,000 Won. And if the expense is more than 5,230,000 won (for year 2018), you only have to pay 5,230,000 won and the rest of the expense will be paid by NHIS. Yet the non-benefit items for the insurance, selection payment and cost that you are all responsible for are all exclusive(applicable for the visits to doctor since January 1, 2009).

    Post-reimbursement on co-payment ceiling is when you have to pay more than the limit of payment (5,230,000 for the year 2018 and not applicable with the services not covered by the insurance), the rest of the expense that you have to pay will be reimbursed additionally in next year according to the level of annual average insurance premium.
  • If I get a surgery for illness while I am traveling in abroad, can I get the reimbursement of the medical expenses when I get back to Korea?
    If a patient had surgery overseas, the cost is not reimbursed pursuant to Clause 2, Article 39 and Article 49 of the national health insurance act . If the patient received the subsequent medical treatments at a domestic care institute, however, such expenses may be reimbursed.
  • “I want to know whether the examination for identifying the cause of sterility is covered by insurance benefits. Likewise, is “artificial insemination” covered by insurance benefits?”
    If a person entitled to care benefits is not pregnant for a certain period (usually 1 year) due to sterility, the examination for identifying the cause and use of fertility drugs for pregnancy promotion are covered by insurance benefits.

    However, “expenses incurred in Assisted Reproductive Technology (including internal and external artificial insemination)” run counter to the principle of health insurance benefit. In short, this treatment is not covered by insurance benefits. The treatment of complications after artificial insemination is covered by insurance benefits, however.
  • Is it available to get diabetes treatment medicine for 6 months in advance if a person who takes it regularly is going on a business trip to abroad?
    The period of prescribing medicine for a patient is determined by a doctor’s medical judgment after referring to the status of the patient’s disease, treatment condition, etc. When a patient is in a foreign country, however, insurance benefit is suspended as per Article 49 of the health insurance act in relation to insurance qualification. If a patient is traveling in a foreign country after being prescribed medicine in the country, insurance benefit is available. During travel outside Korea, however, insurance benefit is suspended.