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Health Insurance Premiums will be Raised by 2.8 % Next Year

  • Date : 2011-11-17
  • Hit : 4807

Health Insurance Premiums will be Raised by 2.8 % Next Year

-Coverage for dentures for senior citizens expanded and medical insurance fees raised by 2.2% on average -

Health insurance premium rates, increased by 2.8%

○ 5.64% of monthly wages (2011) → 5.80% of monthly wages (2012)

Coverage, expanded

○ The insurance coverage expanded to the dentures for the senior aged 75 and over

○ Support for maternal care cost expanded(40→500 thousand won)

Medical insurance fees : 2.2% increased on average

○ Hospital 1.7%, clinic 2.8%, dental clinic 2.6%, oriental medical clinic 2.6%, pharmacy 2.5%, maternity clinic 4.2%, healthcare institution 2.0%

Ministry of Health and Welfare determined the health insurance premium rates, the plan for expansion of the insurance coverage and the increase rate of the medical insurance fees for next year by convening the Health Insurance Policy Review Committee (chair: Vice Minister of Health and Welfare) on 15 Nov. (Tue.).

The employment health insurance premium rate will increase from 5.64% of monthly wages to 5.80% and the amount that regional subscribers have to pay for points upon which the insurance premiums are imposed will rise by 2.8% from 165.4 won to 170.0 won.

Due to this adjustment in the insurance premium rates, the monthly average insurance premium for the employment insurance holder (per household) is anticipated to grow by 2,355 won from 84,105 won to 86,460 won, and for the regional subscriber, from 74,821 won this year to 76,916 won next year by 2.095 won.

Particularly, at a meeting held on 15 Nov. (Tue.), it was finally decided that the insurance premium rate would be raised by 2.8% given that the premium rate increase should be kept at a minimum level taking into account of the burden on the public and businesses, an increase in medical demand resulting from population aging and income growth should be addressed and the coverage should be expanded to the dentures for the senior citizens, etc.

The growth rate of 2.8% for next year is greatly low compared to 5.9% of this year’s increase rate because it reflects effects of the improvement of systems such as this year’s action for financial stabilization and drug price reductions for next year, etc.

Next year, the coverage for seniors’ dentures and maternal care will be expanded.

The coverage for the dentures will be subject to the seniors aged 75 and older in accordance with the “2009~13 Coverage Expansion Plan (announced in June 2009),” and 50% of the cost will be paid by individuals.

From July next year, full dentures which have relatively higher urgency will be covered by the insurance first and starting from 2013, the coverage will be expanded to the partial dentures eventually. This is to consider the financial burden on the side of the health insurance and lessen any confusion resulting from an abrupt rise in demand.

The coverage for seniors’ dentures is expected to cost about 328.8 billion won in 2012.

* Estimated price for dentures (medical insurance fee): full dentures; 950 thousand won, partial dentures (based on two abutment teeth); 1.64 million won

☞ These are tentatively estimated figures and these are subject to change according to the standards for medical insurance fees and benefits next year.

The amount of aid for maternal care cost will also increase from 400 thousand won this year to 500 thousand won next year.

The support for maternal care cost has been provided from 2008 in an effort to create a childbirth-friendly environment.

* This aid is provided in the form of an electronic voucher (called “Go-un Mom Card”) and it can be used at 2,093 designated maternal care institutions. Out of pregnancy- and childbirth-related treatment costs, the portion which an individual is responsible for (including the non-benefit portion) is supported (maximum of 60 thousand won at a time).

In the meantime, the Committee decided to raise the medical insurance fees by 1.7% for hospital-level medical institutions(representative group: Korean Hospital Association) that fail to make a contract with the National Health Insurance Corporation under some conditions such as an expanded introduction of 7 DRGs, etc. In this regard, the medical insurance fee will increase by 2.2% on average next year.

In the medical insurance fee agreement that was negotiated until 17 Oct. between the National Health Insurance Corporation and a medical and pharmaceutical group for next year, all types of medical institutions (clinic 2.8%, dental clinic 2.6%, oriental medicine clinic 2.6%, pharmacy 2.5%, and healthcare center 4.2%) except for hospital-level institutions agreed upon medical insurance fee increase rates.

This year, the health insurance finance is running a surplus of 804.4 billion won as of Oct., and is expected to record a surplus of around 200 billion won by the end of this year (1.2 trillion won in accumulated amount).

The health insurance finance is anticipated to post a deficit of 177.2 billion won in 2012 due to the coverage expansion, the increase of medical insurance fees and the adjustment of insurance premium rates for next year (1.18 trillion won in accumulated amount).

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