South Korea to freeze health insurance premiums and expand coverage

South Korea's Ministry of Health and Welfare has announced significant changes to the National Health Insurance system for the upcoming year. The government has decided to freeze health insurance premium rates at 7.19% for employees, citing a surplus in the insurance fund and increased government subsidies.

To expand medical coverage, the government will gradually reduce out-of-pocket expenses for approximately 1.97 million patients with severe or rare incurable diseases. For these patients, the co-payment rate will be lowered from 10% to 7% by December, eventually reaching 5% by the first half of 2028. Additionally, coverage will expand to include severe type 2 diabetes patients, dental implants for edentulous seniors aged 65 and older, and composite resin treatments for children aged 5 to 13.

However, new measures will be introduced to curb excessive medical use. Starting January 1, individuals who exceed 300 outpatient visits per year will face a 90% out-of-pocket co-payment rate, starting from their 301st visit. This policy excludes children, pregnant women, and patients with severe or rare diseases. To support this, a new system will be established to allow medical institutions to verify a patient's medical history across different providers, beginning with CT and MRI scans in December.