Starting next year, the period for reduced out-of-pocket expenses for preterm infants’ outpatient care will be extended to a maximum of 5 years and 4 months, and the maximum reward for reporting fraudulent health insurance claims will be increased to 3 billion KRW. The Ministry of Health and Welfare announced on the 16th that the Cabinet had approved a partial amendment to the Enforcement Decree of the National Health Insurance Act.
This amendment aims to alleviate the medical expenses burden for preterm infants, prevent financial leakage in health insurance, and strengthen post-management of health checkups to enhance public convenience. Previously, all preterm infants were given the same reduction in out-of-pocket expenses for up to 5 years from birth, but now the period will be extended up to 5 years and 4 months based on the gestational age at birth.
The reward system for reporting fraudulent health insurance claims will also be improved. The amended decree standardizes the criteria for calculating rewards regardless of the type of informant and raises the maximum reward from 2 billion KRW to 3 billion KRW. This aims to encourage more reports of fraudulent claims and prevent financial leakage in health insurance, thereby enhancing the sustainability of the system.
The period for exemption from out-of-pocket expenses for additional consultations and tests following general health checkups will also be extended. Previously, the exemption was valid until January 31 of the following year, but it will now be extended by two months to March 31 of the following year to strengthen the connection between health checkups and subsequent treatment and management, and to improve convenience for examinees.