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The recent revision of the National Health Insurance Act cuts the state-run health insurance coverage after 365 visits. Starting with their 366th outpatient visit, these individuals will have to shoulder 90 percent of their medical costs themselves, instead of the usual 20 to 30 percent. The remaining costs will continue to be covered by the health insurance system.
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With the reform in place, the Health Ministry also plans to launch informational services to notify each National Health Insurance subscriber about the number of hospital visits they have made and the associated medical costs.
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As of 2021, it recorded the highest average number of outpatient visits per person at 15.7 a year among the Organization for Economic Cooperation and Development's member countries, whose average was 5.9 visits.
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The Ministry of Health and Welfare data, obtained by the minor Rebuilding Korea Party Rep. Kim Sun-min, revealed that the number of patients who made more than 365 outpatient visits a year was 2,561 in 2021, 2,488 in 2022 and 2,448 in 2023. In each of these years, more than half of them were aged 70 or older.
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The cap on yearly outpatient visits, however, does not apply to pregnant women, individuals with severe disabilities, patients with incurable diseases and legal minors.
The Korean government wants to put a brake on what it sees as excessive access to treatment by some patients, reasoning that it puts unnecessary strain on the country's health care system and hampers efforts to keep it affordable and accessible for all.
In 2023, for example, the highest number of patients, 838 (34.2 percent), were in their 70s and 16.6 percent were in their 80s. There were 579 (23.6 percent) in their 60s.
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Approximately 2,500 Koreans, mostly elderly people, received more than 365 outpatient treatments a year over the past few years, data showed Thursday.