Korean Ministry of Health and Welfare (MOHW) manages and supervises the operation of the NHI program through formulation and implementation of policies.
Korean NHI system works in the following way:
- When patients get hurt or need to have any procedures/surgeries done, they go to a provider of their choice. They are responsible for paying any co-payments applicable to receive medical services.
- Providers then submit a claim to the insurer (National Health Insurance Corporation [NHIC]). NHIC evaluates these claims and pay the providers accordingly.
- To be able to receive insurance benefits, insured must pay contributions to NHIC.
The Single Public Insurer
- InsurerNational Health Insurance
- Health Insurance Review and
Assessment Service, HIRA
- Ministry of Health & Welfare
- InsuredContributionto InsurerCo-paymentto Providers
- ProvidersClaimto InsurerMedical serviceto Insured
As a result of implementing this NHI system, 96.3% of Korean population has been insured. The remaining 3.7%, whom belongs to the low income group, is covered by medical aid financed through taxation. NHI system not only has resulted in outstanding health outcomes for Korea (long life expectancy, low infant mortality rates, etc.) but it has enabled low healthcare expenditures as well. Healthcare expenditures of Korea stands at 6.8% of its GDP, which is lower compared to other advanced countries.
- Medical aid3.7%
- Employees Insured (51.5%)
- Self-employed Insured (44.8%)
- Medical aid (3.7%, low income)
Korea has achieved universal health insurance in the shortest amount of time when compared with other countries worldwide. Following the implementation of NHI system in 1977, universal health insurance was achieved in 1989; merely 12 years after.
Universal coverage system for the whole nation achieved in only 12 years!
Source : National Health Insurance Corporation