건강보험 환급With the confirmation of the individual out-of-pocket limit, 2.386 trillion won will be refunded to 1,749,831 people who spent medical expenses exceeding the out-of-pocket limit. Individuals will receive an average of 1.36 million won in benefits per person.
The Ministry of Health and Welfare and the National Health Insurance Corporation announced on the 23rd that the ‘2021 individual out-of-pocket maximum amount’ has been confirmed and that the process of paying the amount in excess of the maximum amount will begin from the 24th.
The National Health Insurance Corporation will sequentially send notices to those eligible for payment starting from the 24th. Those eligible for payment can apply to the National Health Insurance Corporation for payment to an account in their name.
The out-of-pocket cap system is a system designed to alleviate the financial burden on people due to excessive medical expenses.
If the total annual out-of-pocket cost exceeds the individual maximum amount, the National Health Insurance Corporation will cover the excess amount and return it to the subscriber and dependents. The number of beneficiaries and payments is steadily increasing.
This year, the out-of-pocket limit will be determined for each individual, and the excess amount will be paid to those who have spent more on medical expenses than the out-of-pocket limit.
Prior to this, the government already exceeded the maximum out-of-pocket amount of 5.84 million won and paid 641.8 billion won in advance to 231,563 people who needed to pay the excess even before the individual maximum amount was determined according to their income level.
This time, 1,518,268 people, KRW 1,744.2 billion, which were decided to be paid by confirming the maximum amount of out-of-pocket expenses for each individual, will be paid upon individual application.
The number of people subject to the out-of-pocket cap system in 2021 increased by 89,188 (5.4%) compared to 2020, and the amount paid increased by 138.9 billion won (6.2%) compared to 2020.
However, due to the impact of the decrease in use of mild and outpatient medical care due to the prolonged COVID-19, the growth rate of the cap payment amount slowed slightly from 12.2% the previous year.
Looking at the beneficiaries of the out-of-pocket cap system in detail, it was revealed that the bottom 50% of income earners and the elderly over 65 years of age benefited the most.
The number of people in the bottom 50% of income bracket and the amount paid was 1,467,741 and KRW 1.634 trillion, respectively, accounting for 83.9% of all subjects and 68.5% of the amount paid, confirming that the out-of-pocket cap system reduced the burden of medical expenses on the lower income class.
By age, 920,197 people aged 65 or older received 1.5386 trillion won in excess of the out-of-pocket limit, accounting for 52.6% of all recipients and 64.5% of the payment amount.
Kang Jun, head of the Medical Security Management Department at the Ministry of Health and Welfare, said, “Amid difficult economic conditions such as the prolonged COVID-19 outbreak and high inflation, the burden of medical expenses for low-income people is expected to increase further.” He added, “We will continue to maintain the system to further strengthen the medical safety net function of the vulnerable groups under the out-of-pocket cap system.” “We plan to improve,” he said.
☞ Application: NHIS website (www.nhis.or.kr), The Health Insurance App, ☎ 1577-1000
Inquiries: Ministry of Health and Welfare Medical Security Management Department (044-202-2681), National Health Insurance Corporation Disaster Cap Management Department (033-736-4636)
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