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Health Insurance Refund for Exceeding Self-Pay Maximum

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Created: 2024-11-19

Created: 2024-11-19 08:17

Out-of-Pocket Maximum Reimbursementis a system that returns money to National Health Insurance subscribers who have spent a lot on medical expenses in a year. In short, if your medical expenses exceed a certain limit, you get the excess amount back.

Why should I receive a refund?

  • Easing the Burden of Medical Expenses: Reduces the significant financial burden caused by unexpected illnesses or injuries.
  • Strengthening National Health Coverage: Prevents situations where people forgo treatment due to medical expenses and supports maintaining a healthy life.

Who is eligible for a refund?

  • All National Health Insurance Subscribers: This includes regionally enrolled individuals, those enrolled through their workplaces, and dependents.
  • Those Who Have Incurred High Medical Expenses: Anyone who has exceeded the out-of-pocket maximum limit for medical expenses is eligible for a refund.

What is the refund procedure?

Refund for exceeding the self-pay maximum

Refund for exceeding the self-pay maximum

1. Notification from the National Health Insurance Service: Around August each year, a notification is sent to eligible recipients.
2. Application: Apply according to the instructions in the notification. Applications can be submitted through various methods, including online, fax, phone, and mail.
3. Payment: Payment is made within one week of application.

Frequently Asked Questions

  • Relationship with Private Medical Insurance: The out-of-pocket maximum reimbursement is separate from private medical insurance. Private medical insurance reimburses actual medical expenses, while the out-of-pocket maximum reimbursement is a payment made within the National Health Insurance system.
  • What if I missed the application deadline? Contact the National Health Insurance Service to confirm and apply if necessary.
  • What happens if the applicant dies? The heir can apply and inherit the reimbursement.

Don't Miss Out!

The out-of-pocket maximum reimbursement system is a valuable system that reduces the burden of medical expenses. Carefully check the notification each year, and if eligible, be sure to apply to receive the benefits.

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