1.36 Million Rare and Severe Disease Patients to See Annual Out-of-Pocket Costs Reduced from 750,000 to 530,000 Won

The out-of-pocket cost ratio for national health insurance coverage of patients with rare and severe chronic diseases will be reduced in stages to match that of other severe diseases.

The Ministry of Health and Welfare (Minister Jeong Eun-kyung) announced a legislative proposal to amend the "National Health Insurance Act Enforcement Decree" that lowers the out-of-pocket cost ratio for patients with rare and severe chronic diseases from 10% to 7% from November 4 to November 16.

Until now, the burden of medical costs for patients and families with rare and severe chronic diseases has been substantial due to the difficulty of achieving complete cures and the resulting long treatment periods.

Currently, the out-of-pocket cost ratio for patients with rare and severe chronic diseases (10%) is set higher than for other severe diseases such as cancer and cardiovascular and cerebrovascular diseases (5%). The Ministry of Health and Welfare plans to lower the out-of-pocket cost ratio to 5% by 2028, matching that of other severe diseases.

According to the Ministry's analysis, if the amendment is implemented, approximately 1.36 million patients with rare and severe chronic diseases will see their annual average out-of-pocket medical costs reduced from approximately 750,000 won to approximately 530,000 won per person.

This amendment is intended to implement the first phase of the phased reduction in out-of-pocket cost ratios (10%→7%→5%) approved by the Health Insurance Policy Review Committee in September. The government plans to implement the 7% reduction in December of this year, followed by a further reduction to 5% in the first half of 2028.

The Ministry of Health and Welfare plans to broadly collect public opinions during the legislative proposal period, followed by review by the Ministry of Government Legislation and cabinet approval, with implementation scheduled for December 1.

Yu Ju-heon, Director General of the Health Insurance Policy Bureau, said, "This amendment represents the first step in reducing the out-of-pocket costs of patients with rare and severe chronic diseases to the level of other severe diseases."