"2.4% Decrease in Indemnity Insurance Payments Due to Strengthened Health Insurance Coverage"

[Asia Economy Reporter Oh Hyung-gil] Due to the strengthening of health insurance coverage, indemnity health insurance has gained a side benefit with a 2.42% decrease in insurance claim payout rates.

Reflecting this side benefit, indemnity insurance premiums are expected to rise by up to 17% next year. The industry is demanding a 20% increase, leading to a final tug-of-war.

On the 24th, the Financial Services Commission and the Ministry of Health and Welfare held a 'Public-Private Insurance Policy Council' via video conference and reported that the effect of reduced indemnity insurance payouts due to strengthened health insurance coverage this year was 2.42%. The side benefit was 0.6% in 2018.

In this regard, the government plans to announce a 'Comprehensive Plan to Strengthen Non-Covered Service Management' this month to alleviate the burden of non-covered expenses. The main content includes expanding the disclosure of non-covered medical costs from hospital-level to clinic-level medical institutions starting January next year.

A prior notification system, where medical staff explain the items and prices before non-covered treatment, will also be implemented from January next year. The number of disclosed non-covered medical cost items will increase from the existing 564 to 615, including non-invasive prenatal tests and tartar removal.

Major health insurance coverage enhancement items include ▲ coverage for lower abdomen, urinary system, and male reproductive organ ultrasounds ▲ coverage for 2- and 3-person rooms in hospital-level medical institutions ▲ coverage for cerebrovascular and head and neck MRI ▲ reduction of outpatient co-payments for children under 1 year old ▲ coverage for polysomnography, among others.

Additionally, the 4th generation indemnity insurance, reflecting the reform plan, is scheduled to be launched on July 1 next year after revisions to supervisory regulations and standard terms and conditions.

The insurance industry demanded a 20% increase in indemnity insurance premiums next year. However, the government conveyed its opinion to reduce the increase to 15?17% for 'old indemnity insurance premiums' and 10?12% for 'standardized indemnity insurance' based on these side benefits. The new indemnity insurance introduced in 2017 is expected to remain frozen.

Do Gyu-sang, Vice Chairman of the Financial Services Commission, stated, "Strengthening the linkage between public and private insurance for mutual cooperation and systematic role sharing is more important than ever," adding, "Since the indemnity insurance claim digitization bill was first discussed in the National Assembly, we plan to alleviate medical community concerns about the bill and actively communicate with consumer groups and others."

This content was produced with the assistance of AI translation services.