Health insurance
Do you need private insurance if you already have National Health Insurance?
Having National Health Insurance does not always reduce a hospital bill to zero. The patient may pay part of an insured service, and National Health Insurance does not apply to non-benefit items. This does not automatically mean that everyone needs private insurance.
National Health Insurance includes mechanisms intended to reduce the burden of medical costs. Under the ceiling on out-of-pocket payments, for example, the National Health Insurance Service pays the amount by which a person’s eligible out-of-pocket costs during a defined period exceed their individual ceiling. Certain costs, including non-benefit items, selective benefits and items paid fully by the patient, are excluded from this calculation.
Private health insurance may supplement some costs left after National Health Insurance, subject to its policy terms. It also requires continuing premium payments and may have out-of-pocket amounts, exclusions, coverage limits and underwriting. Medical-expense insurance does not pay every hospital cost in full, and its structure differs according to when the policy was purchased and its product generation.
Consider questions such as these when deciding whether you need private insurance:
- Which costs do you currently pay beyond National Health Insurance?
- Do you have employer group insurance or another personal policy?
- Do you have emergency savings for an unexpected medical expense?
- How long do you expect to live in Korea?
- Can you maintain the premium over the long term?
- What out-of-pocket amounts and exclusions apply to the proposed product?
- Would a pre-existing condition or another enrollment term restrict coverage?
Private insurance is a separate contract, not a replacement for the public health system. It may help some people reduce medical-cost risk, while for others existing coverage and savings may be sufficient. An information site cannot responsibly decide that it is “necessary” or “unnecessary” without knowing the individual situation.
Practical conclusion
National Health Insurance and private insurance have different roles. Decide whether additional insurance is appropriate only after considering your current coverage, expected medical costs, emergency savings, premium burden and plans for staying in Korea.
Claims to avoid
- “National Health Insurance is insufficient, so private insurance is essential.”
- “Private insurance reimburses every hospital expense.”
- “Young, healthy people never need private insurance.”