National Health Insurance System (NHIS) in South Korea

South Korea's National Health Insurance Service (NHIS) provides universal coverage to all residents through a single-payer system. The standard copayment rate is approximately 30% for outpatient hospital visits, though this varies by facility type: 30% at general hospitals, 40% at hospitals, 50% at clinics for outpatient care, and 20% for inpatient stays. Premiums are income-based at approximately 7.09% of income (split between employer and employee for workers).

The NHIS covers a comprehensive range of services including physician visits, hospitalization, surgery, diagnostic tests, prescription drugs, and traditional Korean medicine (hanbang). The Moon Jae-in Care reforms starting in 2017 significantly expanded coverage by moving many previously non-covered items such as MRI scans and ultrasounds into the covered benefit package. Out-of-pocket spending as a share of total health expenditure has declined but remains relatively high at approximately 28%.

A catastrophic medical expense protection system caps annual out-of-pocket costs based on income level. For the lowest income bracket, the annual cap is approximately ₩810,000, while the highest bracket caps at ₩5,800,000. Medical Aid (uiryo geubyo) provides near-free coverage for approximately 3% of the population living in poverty. The system achieves remarkable cost efficiency, with total health spending at approximately 8.4% of GDP, below the OECD average, while maintaining high-quality outcomes.