[DiaryPoint = Reporter Park Bo-young] A proposed revision to South Korea’s enforcement decree would lower the health insurance copay rate for covered care for people registered under the country’s special coverage program for rare and severe intractable diseases from 10% to 7%. Public comments can be submitted through November 16, and the change is being planned for care received from December 1 onward.
The Ministry of Health and Welfare is accepting comments from November 4 through 16 on a partial revision to the National Health Insurance Act Enforcement Decree. Organizations and individuals can submit comments through the National Participation Legislation Center or the ministry’s Insurance Policy Division. Details are available on the ministry’s website under Information, Laws and Regulations, Legislative and Administrative Notices, and the electronic public hearing section.
The change would cover about 1.36 million people registered for special coverage for rare or severe intractable diseases. If adopted, the patient share for health insurance-covered services related to those conditions would fall from the current 10% to 7%.
Non-covered care and inpatient meal costs are excluded from the reduction. Patients will continue to pay the full cost of non-covered care and 50% of inpatient meal expenses.
The ministry estimates that the reduction would bring the average annual out-of-pocket cost per person down from about 750,000 won to about 530,000 won. Actual costs may vary depending on how much covered care each patient uses.
The proposed revision is the first step in a phased reduction plan approved by the Health Insurance Policy Deliberative Committee in September. The ministry has proposed lowering the rate to 7% in December and then to 5% in the first half of 2028.
Following the public comment period, the ministry plans to complete review by the Ministry of Government Legislation and approval by the Cabinet, with the decree taking effect on December 1. The director general of the ministry’s Health Insurance Policy Bureau said, “We will quickly complete the remaining procedures to ensure implementation proceeds as planned.”