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Insurance coverage rate for severe disease such as cancer is 71.4%, 3.6 % p up from the previous year and the total coverage rate is 62.7%, 1.3% p down from the previous year

  • Date : 2012-02-09
  • Hit : 4772

Insurance coverage rate for severe disease such as cancer is 71.4%, 3.6 % p up from the previous year and the total coverage rate is 62.7%, 1.3% p down from the previous year

National Health Insurance Corporation (President Kim, Jong Dae) disclosed the result of the survey on status of the health insurance patients’ medical expenses for 2010

According to the survey result, the insurance coverage ratio for severe diseases (cancer, heart disease, neurovascular disease, rare and incurable disease) is 71.4%, 3.6% up from the previous year (67.8%)..

- This seems to have resulted from reinforcing the insurance coverage for severe diseases (cancer, heart disease and neurovascular disease) such as reduction of the portion of medical expenses to be paid by individuals (10->5%).

(Unit: %, %p)

Health insurance coverage rate for diseases subject to the specially reduced partial payment by individuals

Category

All the diseases subject to the special payment benefit

Cancer

Neurovascular disease

Heart disease

Rare and incurable disease

2010 (A)

71.4

70.4

66.1

69.2

74.6

2009 (B)

67.8

67.9

60.9

63.8

68.4

Increase/decrease rate (A-B)

3.6

2.5

5.2

5.4

6.2

However, the entire coverage rate has turned out to be 62.7%, 1.3% down from 2009 (64.0%).

- It is because the ratio to be paid by individuals and not covered by the insurance has more radically increased

although the health insurance benefit coverage rate has increased along with the reinforcement of the coverage.

* Health Insurance Benefit Coverage Rate: 73.5%(‘09) → 74.5%('10)

(Unit: %,%p)

Health Insurance Coverage Rate

2009 (A)

2010 (B)

Increase/decrease (B-A)

Health Insurance Coverage Rate

Legal

Ratio to be paid by individuals

Non-benefit coverage

Ratio to be paid by individuals

Health Insurance Coverage Rate

Legal

Ratio to be paid by individuals

Non-benefit coverage

Ratio to be paid by individuals

Health Insurance Coverage Rate

Legal

Ratio to be paid by individuals

Non-benefit coverage

Ratio to be paid by individuals

64.0

22.7

13.3

62.7

21.3

16.0

1.3

1.4

3.1

- It is assumed that the increase of the non-coverage ratio is caused by an increase of expenses for exams and medical

materials for treatment resulting from a drastic rise in outpatient surgery (16.7% up from the previous year.)

* Major outpatient surgeries include urologic surgeries such as ureterolithotomy, ENT surgeries such as tonsillectomy

and eye surgeries such as cataract surgery, etc.

(Unit: %, %p)

Status of Increase of Expenses by Non-Coverage Item

Category

Entire non-benefit coverage to be paid by individual

Exam

Ultrasonic

Waves

Treatment

Material

MRI

Meals

Etc

2010(A)

16.0

8.4

11.0

8.8

6.0

0.3

13.5

2009(B)

13.3

7.0

9.7

7.6

5.2

0.2

12.1

Increase/decrease rate (A-B)

2.7

1.4

1.3

1.2

0.8

0.1

1.4

In the meantime, National Health Insurance Corporation said that the 2010 coverage rate (62.7%) remains within the

range of 62~64% which are the rates for the past five years and compared with the rate of the previous year, it is within

the margin of error. Therefore, there is no significant statistical difference.

Health Insurance Coverage Rate (Lower limit˜ Upper limit, 95% of the confidence interval)

: 64.0%(63.3˜64.7) in 2009, 62.7%(61.9˜63.4) in 2010

It added that instead of giving much weight to 12% of the coverage rate change, just recognizing the health insurance

coverage rate as around 62~64% will be better and safer.

It also said that a new index for the insurance coverage needs to be developed given that the current index for the

insurance coverage is not suitable for international comparison and is not used as index for policy objectives as there is

no means for management of non-coverage.

- It additionally mentioned that coming up with another index such as the proportion of the health insurance coverage to

the coverage for essential medical service or the entire medical expenses (supplement cost, cost for packs of herb

medicine and general medicine, etc) needs to be considered.

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