1. Reasons for Proposal

The National Health Insurance Act was amended (Act No. 19527; promulgated on January 2, 2024; to be enforced on April 3, 2024) to add requirements for foreigners residing in Korea, etc. to acquire eligibility as dependents and this Amendment modifies the Decree accordingly. It also prevents misuse of medical services caused by the moral hazard effect, etc. by increasing the co-payment rate to 90% for persons who use outpatient services more than 365 times a year, and otherwise addresses and improves upon a number of weaknesses in the current system.

2. Major Provisions

A. Prescribe regulations to vary the co-payment rate according to the frequency of use of outpatient services

Prescribe a co-payment rate of 90% of the total amount of health care benefits upon outpatient treatment of any person who has received more than 365 outpatient treatments a year (Article 19, attached Table 2)

B. Adjust the timing of acquisition of eligibility for dependents who are foreigners

Adjust the timing of acquisition of eligibility as dependents for foreigners, etc. in accordance with Article 109 (4) 3 of the amended National Health Insurance Act, which requires any foreigners residing in Korea, etc. to satisfy requirements regarding the period of residence or reasons for residence pursuant to Article 109 (3) 1 of the Act in order to acquire eligibility as a dependent (Article 76-3)