South Korea’s Ministry of Health and Welfare has proposed lowering the health insurance copayment rate for people registered under the special coverage program for rare and severe intractable diseases. The rate would fall from 10 percent to 7 percent, potentially benefiting an estimated 1.36 million people. The change has not yet taken effect.
Under the proposal, a patient receiving 1 million won in covered medical services would pay 70,000 won instead of 100,000 won. The ministry estimates that the average annual copayment per person would decline from about 750,000 won to 530,000 won, a reduction of roughly 220,000 won.
Coverage limits and approval steps
The reduction would apply only to treatment covered by national health insurance. It would not lower charges for non-covered services, and patients would continue to pay the existing 50 percent share of hospital meal costs. The proposal also does not directly compensate families for income lost while providing care or for transportation expenses associated with outpatient visits.
The ministry opened the proposed amendment to the Enforcement Decree of the National Health Insurance Act for public comment from November 4 through November 16. It plans to complete the remaining review process, including examination by the Ministry of Government Legislation and approval by the Cabinet, before applying the lower rate to treatment provided from the first day of the following month. That timetable remains a target while the amendment is under review.
This is the first stage of a reduction plan approved by the Health Insurance Policy Deliberation Committee in September. The government intends to lower the rate initially to 7 percent and then reduce it to 5 percent in the first half of 2028, matching the level applied to conditions including cancer and cardiovascular or cerebrovascular diseases. Until the amendment is finalized and its effective date confirmed, registered patients remain subject to the current 10 percent copayment rate.