Today we will learn about health insurance premium refund. This is a system that refunds a portion of insurance premiums to citizens who have spent more than their income supported by the government. It corresponds to the difference between the amount paid by the subscriber and the amount of medical expenses used during the period of health insurance subscription.
Health insurance premium refunds are paid by the National Health Insurance Corporation, and you must apply by submitting an application form and required documents. Refunds will be paid based on the results of the application. Detailed information on medical expense reimbursement can be found on the National Health Insurance Corporation’s official website.
How to apply for health insurance premium refund
Applications for National Health Insurance refunds can be made within a certain period of time from the date of receipt of the payment application form. If this period is exceeded, the application will expire, so applications must be made within the period.
Required documents: National Health Insurance refund application form, copy of ID card, copy of health insurance card, bank account number
How to apply
National Health Insurance Corporation website
‘The Health Insurance’ App
Phone (1577-1000)
👇 Go to The Health Insurance (Android)
👇Go to The Health Insurance (iPhone)
Fill out and submit application form: Submit application form and required documents
Check application results
You can check the results within approximately 2 weeks after submitting the application, or within 7 days from the application date for online applications.
Out-of-pocket reimbursement
If you have high medical expenses, you may be eligible for health insurance premium reimbursement. You can check inquiries and applications at the National Health Insurance Corporation.
Out-of-pocket reimbursement is a system in which the Corporation collects overpaid out-of-pocket expenses from medical institutions and returns them to subscribers, etc., if the medical expenses claimed by the medical institution exceed the legal standards or were received in error.
Exceeding the maximum amount of out-of-pocket expenses
Double payment of insurance premiums, retroactive in case of error
Other levy refunds
Delinquent insurance premiums, cancellation of advance benefit restrictions, and refund of public corporation contributions
Subsidy for the difference in portion of drug costs (patients with severe illness, etc.)
Out-of-pocket limit system
In order to relieve the household burden caused by excessive medical expenses, the NHIS covers the annual health insurance out-of-pocket cost paid by the subscriber if it exceeds the out-of-pocket maximum amount.
Category of application of ceiling system
The upper limit system is divided into advance payment and post-refund depending on the application method.
For advance payment, if the total annual health insurance out-of-pocket cost at the same health care institution exceeds the maximum amount, the excess amount is paid by the health care institution to the NHIS instead of receiving it from the patient.
Post-refund is a system in which, if the total amount of health insurance contribution paid by the person exceeds the upper limit, the Corporation confirms this and returns the excess amount to the person who received the treatment.
Payment method
Advance salary
When the annual out-of-pocket amount for hospitalization at the same medical institution exceeds 5.84 million won, the medical institution directly bills the National Health Insurance Corporation for the excess amount.
Regardless of income, if you only receive treatment covered by health insurance premiums, you will only pay a maximum of 5.84 million won in medical expenses.
Post refund
Calculate health insurance premiums for each individual every year to determine the maximum out-of-pocket amount and standard insurance premium
Afterwards, the Corporation will cover the amount exceeding the out-of-pocket maximum amount through an individual application, and the excess amount will be paid directly to the patient.
finish
We have learned about how to apply for health insurance premium refund. The maximum amount of out-of-pocket expenses is adjusted every year, and the refund amount changes depending on the income level. Please check once and apply for a refund if possible.
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