Starting Today, Health Insurance Covers Korean Herbal Medicine for Rhinitis, Indigestion, and Disc Issues

Expansion of Covered Diseases for Herbal Medicine under National Health Insurance from 3 to 6 Types

From the 29th, health insurance coverage will also apply to herbal decoctions for the treatment of allergic rhinitis and functional dyspepsia.

The Ministry of Health and Welfare announced that with the implementation of the second phase of the herbal decoction health insurance pilot project, the number of diseases covered by health insurance for herbal decoctions will expand from the existing three to six. Accordingly, the diseases covered by the pilot project include dysmenorrhea, facial nerve palsy, and sequelae of cerebrovascular disease, as well as allergic rhinitis, functional dyspepsia, and lumbar intervertebral disc herniation.

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The scope and duration of health insurance coverage, as well as participating medical institutions, have also been significantly expanded.

First, the target patients for herbal decoctions for sequelae of cerebrovascular disease, which previously only applied to those aged 65 and older, have been expanded to all age groups. The eligible institutions have been expanded from Korean medicine clinics to include Korean medicine hospitals and hospitals/general hospitals operating Korean medicine departments. Additionally, whereas health insurance coverage was previously limited to 10 days per year for one disease per patient, it will now cover up to 20 days each for two diseases, allowing patients to receive prescriptions for herbal decoctions accordingly.

The patient co-payment rate, which was uniformly applied at 50%, has been improved to 30% for Korean medicine clinics, 40% for Korean medicine hospitals and hospitals, and 50% for general hospitals. This improvement enhances patients’ accessibility and coverage under the pilot project, enabling them to take herbal decoctions at a cost of approximately 40,000 to 80,000 KRW per 10 days. However, if the annual usage exceeds 20 days per disease, it will be applied at the health insurance fee rate but will be fully borne by the patient.

The number of participating medical institutions in this pilot project is 5,955 nationwide, and the government plans to recruit additional institutions during the first half of the year. Participating institutions can be checked on the Ministry of Health and Welfare or Health Insurance Review & Assessment Service websites.

The herbal decoction health insurance pilot project began on November 20, 2020, applying health insurance pilot fees to herbal decoctions, which have the highest demand for health insurance coverage among Korean medicine treatments. It has been evaluated as reducing patients’ economic burden and improving access to herbal decoctions, but there have been calls for improvements regarding the target diseases and medication periods.

Minister of Health and Welfare Cho Kyu-hong stated, "Through the second phase of the pilot project, which expands participating institutions and improves health insurance coverage criteria, we expect that patients will be able to use Korean medicine and herbal decoctions more widely at reduced costs closer to their homes, contributing to the management of public health."

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