Amendment to National Health Insurance Act enforcement decree open for public comment

About 1.36 million patients to benefit; average annual out-of-pocket cost to fall from about 750,000 won to about 530,000 won per person

[123RF]
[123RF]

The national health insurance co-payment rate for patients with rare and severe intractable diseases will be lowered from 10 percent to 7 percent, with about 1.36 million patients set to benefit and average annual out-of-pocket costs falling by 180,000 won ($134) per person.

The Ministry of Health and Welfare announced Wednesday that it will open a public comment period on the proposed amendment to the enforcement decree of the National Health Insurance Act, running through Nov. 16.

Once the amendment takes effect, the average annual out-of-pocket medical cost for the roughly 1.36 million patients with rare and severe intractable diseases is expected to drop from about 750,000 won to about 530,000 won per person.

Rare and severe intractable diseases are difficult to cure and require prolonged treatment, placing a heavy financial burden on patients and their families. The government has applied special calculation exceptions to ease that burden, but the current 10 percent co-pay rate for these patients remains higher than the 5 percent rate applied to other serious conditions such as cancer and cardiovascular disease.

The amendment implements the first step of a phased reduction — from 10 percent to 7 percent to 5 percent — approved by the Health Insurance Policy Deliberative Committee in September. The government plans to lower the rate to 7 percent in December, then further to 5 percent in the first half of 2028.

Organizations or individuals wishing to submit comments on the amendment may do so through the Public Participation Legislative Center or the Ministry of Health and Welfare's Insurance Policy Division by Nov. 16.

After collecting feedback during the public comment period, the ministry plans to complete a review by the Ministry of Government Legislation and secure Cabinet approval, with the amendment set to take effect Dec. 1.

"This amendment is the first step toward bringing the co-payment burden on patients with rare and severe intractable diseases in line with that of other serious conditions," said Yoo Ju-heon, director general of the ministry's Health Insurance Policy Bureau. "We will move swiftly through the remaining procedures to ensure a smooth Dec. 1 implementation."

The full text of the amendment is available on the Ministry of Health and Welfare website under Information → Legislation → Legislative/Administrative Pre-announcement and Public Hearings.


thlee@heraldcorp.com