South Korea's Catastrophic Medical Expense Support program for Korean NHI members whose annual out-of-pocket medical cost is severe relative to income. 2026: up to 50M KRW/year, 50–80% of covered+non-covered co-pays — overseen by Korean MOHW and paid by Korean NHIS.
| Korean Income Tier | Min Korean Med-Cost | Korean Support Rate |
|---|---|---|
| Basic Livelihood / Near-Poor | Co-pay > 800k KRW | 80% |
| ≤ 50% median | > 1.2M KRW | 70% |
| ≤ 100% median | > 1.6M KRW | 60% |
| 100–200% median | > 10% of annual income | 50% |
| Inpatient | All Korean diseases (outpatient is limited to major illnesses) |
| Outpatient (severe) | Cancer, heart disease, cerebrovascular, rare / intractable severe illness, severe burns, severe trauma, post-transplant care |
| Covered items | Korean NHI co-payments + some non-covered items (excluding premium room, meals, caregiver, 선택진료) |
| Excluded | Cosmetic surgery, Korean health-promotion procedures, routine vaccinations, Korean nursing-hospital base fees |
| Korean property rule | Total assets ≤ 700M KRW after housing deduction (540M for low-income Korean), varies by Korean municipality |
| Korean income rule | NHI premium ≤ 200% Korean median or med-cost ≥ 10% of Korean income |
| Korean annual cap | 50M KRW (combined across a Korean year) |
| Korean stacking | Net of Korean out-of-pocket cap refund, Korean private indemnity, and other Korean subsidies |
| Korean NHIS call center | 1577-1000 |
| Korean Health & Welfare Hotline | 129 |
| Korean Social Service Voucher | 1566-0133 |
| Korean NHIS branch | Varies by region |
This is a South Korea–only summary of the Korean Catastrophic Medical Expense Support Act and Korean NHIS / MOHW notices as of April 2026. Korean income, asset, support rates, and caps are re-announced annually. Actual Korean eligibility and amount follow Korean NHIS case review and may differ even when criteria appear met. Netting applies to Korean out-of-pocket cap refunds, Korean private indemnity insurance, and other Korean subsidies. This is NOT medical or legal advice and has no legal effect. Always consult Korean NHIS 1577-1000 or your Korean NHIS branch.
South Korea's Catastrophic Medical Expense Support is a public Korean program under the Korean Catastrophic Medical Expense Support Act, overseen by the Korean Ministry of Health & Welfare and administered by the Korean NHIS, that helps Korean NHI members whose annual medical out-of-pocket cost is severe relative to Korean household income. Since 2024 the Korean annual cap is 50,000,000 KRW (up from 30M). Korean support rates: Basic Livelihood and Near-Poor 80%, ≤ 50% median 70%, ≤ 100% median 60%, 100–200% median 50%. Korean inpatient care covers all diseases; Korean outpatient care covers only major illnesses (cancer, heart, cerebrovascular, rare/severe intractable, burns, trauma, post-transplant). Korean covered items include Korean NHI co-payments and some non-covered items, but exclude Korean premium-room upcharges, 선택진료, meals, and caregiver fees. Korean applicants file within 180 days of treatment at any Korean NHIS branch with receipts, diagnosis, and income/property papers. Korean amounts from Korean out-of-pocket cap refund, Korean private indemnity (실손), or other Korean subsidies are netted from the Korean payout.
The Korean Out-of-Pocket Cap auto-refunds Korean NHI-covered co-pays exceeding an income-tier cap. Catastrophic Medical Expense Support is a separate Korean case-reviewed program covering both Korean covered and non-covered costs when Korean income-vs-medical-cost ratio is severe. Both can apply; the Korean cap refund is netted.
Korean private indemnity payouts are netted from the Korean Catastrophic support amount. Typically file private first, then apply for Korean catastrophic on the residual co-pay.
Nominally ineligible, but Korean case-by-case review can grant support based on Korean medical urgency or Korean asset-to-cost ratio — consult a Korean NHIS branch.
Only Korean major illnesses (cancer, heart, cerebrovascular, rare/intractable, severe burns/trauma, post-transplant). Korean routine outpatient care is not covered; Korean inpatient covers all diseases.
Korean applications after 180 days are generally denied. If a Korean hospitalization or family emergency prevented timely filing, consult a Korean NHIS branch for exceptional review.
Korean NHI members and dependents including foreign residents with valid Korean registration are eligible. Korean short-term visitors and undocumented persons are ineligible; ask a Korean NHIS branch about alternate Korean foreign-resident programs.
South Korea's 2026 Catastrophic Medical Expense Support, governed by the Korean Catastrophic Medical Expense Support Act and administered by the Korean NHIS under MOHW oversight, helps Korean NHI members facing severe out-of-pocket medical costs. Since 2024 the Korean annual cap is 50M KRW (up from 30M), with Korean support rates of 80% (Basic Livelihood / Near-Poor), 70% (≤ 50% median), 60% (≤ 100% median), 50% (100–200% median). Korean inpatient care covers all diseases; Korean outpatient care covers only major illnesses (cancer, heart, cerebrovascular, rare intractable, severe burns, severe trauma, post-transplant). Korean non-covered items such as premium rooms, meals, caregiver fees, and 선택진료 are excluded. Korean assets must typically stay below 700M KRW after Korean housing deduction (540M for low-income Korean). Korean applications are filed within 180 days of treatment at any Korean NHIS branch with Korean receipts, diagnosis, and income/asset papers. Korean amounts from the out-of-pocket cap refund, private indemnity, and other Korean programs are netted. Korean reviews typically take 30–60 days and the program is case-by-case, so near-threshold Korean applicants may still be denied. Korean contacts: NHIS 1577-1000, Health & Welfare Hotline 129.