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If you are a National Health Insurance subscriber, such as an office worker, business owner, or housewife, there is something you must check, especially if you have recently spent a lot of money on hospital bills. This is ‘health insurance premium refund’.
There are two main cases in which refunds occur: ■ When more health insurance premiums have been paid by mistake; When qualifications have changed, such as changing from a local health insurance subscriber to an employer subscriber; or when charging data such as income or assets have changed. Refunds occur when the Corporation fails to reflect this and incorrectly charges insurance premiums. ■ When medical expenses in the previous year exceed the out-of-pocket maximum amount, the ‘out-of-pocket maximum amount’ for health insurance subscribers is determined according to their income level. The maximum amount that a person receiving treatment must pay is set. If the total amount of medical expenses I paid in the previous year is more than this, the excess amount will be refunded. It is a system that aims to ease the burden on households.
You can receive it if you have a history of overpaying or mispaying your health insurance premiums. You can also receive benefits if you spent more on medical expenses than the out-of-pocket limit in the previous year. (However, non-benefit items, selected benefits, hospitalization expenses for 2-3 people, etc. are excluded from the calculation.) For example, as of 2022, the maximum out-of-pocket amount for the 6th to 7th income decile is 2.89 million won. If you spent 4 million won on medical expenses in 2021, you can receive 1.11 million won back.
In both cases, if you are eligible for payment, the Corporation will send you a payment application notice. You must apply within 3 years of receiving the notice, and you cannot receive it after this period. If you are a subscriber who has received a refund due to the out-of-pocket limit system, you can receive it at the end of August when the maximum amount is set. If you did not receive the notice due to moving, etc., you must check individually. The confirmation method is as follows.
National Health Insurance website > Login (simple authentication possible) > Refund (subsidy) inquiry/application
The Health Insurance App > Login (simple authentication available) > All menu > Click here for complaints > Inquiry > Refund (subsidy) inquiry/application
Want to know more? Please contact the National Health Insurance app or customer center (1577-1000).
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