Health Insurance Refund of 2.8 Trillion Won Begins for 2.13 Million People

The National Health Insurance Service announced yesterday (the 27th) that it will start refunding 2.8 trillion won, which is the excess amount over the health care expenses ceiling, to over 2.13 million health insurance subscribers and dependents starting from the 28th.

This refund is based on the out-of-pocket expenditure cap system, which returns the difference to patients when the total amount of health care expenses covered by health insurance exceeds the individual ceiling amount.

As of 2024, the individual ceiling amount will vary based on income levels, ranging from 870,000 won to 10.5 million won.

Low-Income and Elderly People Are the Main Recipients

A total of 2,135,776 people are eligible for this refund, totaling 2.792 trillion won. The average refund amount per person has been calculated at approximately 1.31 million won.

Notably, 89% of the recipients, or 1,900,287 people, belong to the low-income group, which falls within the bottom 50% of income earners.

The amount to be refunded to this group reaches 2.1352 trillion won, accounting for 76.5% of the total. Among the refund recipients, 1,211,616 people aged 65 or older make up 56.7% of the total, indicating that the elderly, who face significant medical expenses, are the main beneficiaries of this system.

Refund Payment Methods and Application Procedures

The National Health Insurance Service explained that for 25,703 of the eligible recipients, their out-of-pocket payment at the same medical institution has already exceeded the maximum ceiling amount, so they have pre-paid a total of 160.7 billion won in refunds to those institutions.

For the remaining beneficiaries, refund amounts will be automatically deposited into their pre-registered accounts.

Those who have not pre-registered their accounts will receive a notification for refund application. They can apply for the refund through various methods including the official website (www.nhis.or.kr), mobile app (The Health Insurance), phone (1577-1000), mail, and in-person visits.

Ongoing Increase in Out-of-Pocket Expenditure Cap Refunds

According to data from the National Health Insurance Service, the number of recipients of the out-of-pocket expenditure cap refund has increased from 1,660,643 in 2020 to 2,135,776 last year, reflecting an average annual growth rate of 6.5% over the past five years.

During the same period, the total refund amount also grew from 2.2471 trillion won to 2.792 trillion won, showing an average annual increase of 5.6%.

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