Government Support to Increase for 'Catastrophic Medical Expenses' Caused by Cancer and Rare Diseases

[Asia Economy Reporter Lee Chun-hee] The scope of support for 'catastrophic medical expenses,' which assists with the treatment of cancer, cerebrovascular diseases, rare and intractable diseases, and other conditions that impose excessive medical costs, will be expanded.

The Ministry of Health and Welfare announced on the 27th that the agenda to expand support for catastrophic medical expenses was approved at the 'Catastrophic Medical Expense Support Policy Deliberation Committee' held that morning.

Catastrophic medical expenses is a support system designed to prevent household bankruptcy by providing partial assistance when medical expenses are excessive relative to income level. Support is available if the medical expense burden exceeds 15% of annual income for those with income at or below 100% of the median income. For those with income between 100% and 200% of the median income, support eligibility can be determined through individual review if the burden exceeds 20% of annual income.

Inpatient treatment is supported for all diseases, while outpatient treatment support is provided for severe diseases such as cancer, cerebrovascular diseases, heart diseases, rare diseases, severe intractable diseases, and severe burn diseases. Non-reimbursable items excluding cosmetic, plastic surgery, and nursing care costs, as well as preliminary reimbursement and selective reimbursement items, are supported up to 50% of the patient's out-of-pocket medical expenses within an annual limit of 20 million KRW. Through individual review, support can be extended up to a maximum of 30 million KRW.

This expansion of catastrophic medical expense support was decided to further strengthen the medical safety net for vulnerable groups, based on the assessment that household incomes have declined since the COVID-19 pandemic began last year.

The previous uniform support level of 50% for all eligible recipients will now have 50% as the minimum support rate for the 100-200% median income bracket, with higher rates provided for lower income levels. Additionally, in cases where high medical expenses exceed the support limit, and additional support for the excess amount is not granted through individual review, the current annual support limit of 20 million KRW will be increased to 30 million KRW.

This expansion will be implemented starting November after revisions to related enforcement ordinances and notifications.

Meanwhile, as a proactive response to the impact of the COVID-19 pandemic on household income, the out-of-pocket medical expense threshold for low-income groups was lowered starting January this year. Consequently, the support amount for low-income groups in the first half of the year increased by 26.5%, from 6.251 billion KRW last year to 7.97 billion KRW.

Kang Do-tae, Vice Minister of Health and Welfare, stated at the meeting, “It has been three years since we began full-scale implementation of the catastrophic medical expense support project, which serves as a medical safety net to alleviate economic burdens caused by excessive medical expenses from non-reimbursable treatments, alongside the expansion of health insurance coverage.” He added, “With this expansion, we plan to provide stronger support to vulnerable groups and ensure that this project firmly establishes itself as a reliable and comprehensive medical safety net.”

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