2026 건강보험료 병원비 환급 지급안내서

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About this app

Did you spend a lot on medical expenses last year? This is an easy-to-understand guide app explaining the 'Co-payment Ceiling System,' a system where the National Health Insurance Service refunds the excess amount if your annual co-payments exceed the ceiling limit.

According to announcements by the Ministry of Health and Welfare and the National Health Insurance Service, a total of 3.076 trillion won in refunds for medical expenses in 2025 will be paid to 2,262,605 people, averaging approximately 1.36 million won per person.

[What is the Co-payment Ceiling System?]

It is a system that refunds the excess amount if the total sum of health insurance co-payments (covered items) paid at hospitals and pharmacies from January to December exceeds the income-based ceiling limit (890,000 won to 10.74 million won in 2025). Non-covered items, selective benefits, full co-payments, and premium room differentials are not included in the calculation.

** [Payment Schedule for 2025 Medical Expenses]

· Notification letters will be sent sequentially to eligible recipients starting August 31, 2026 (via electronic documents on Naver, PASS, and KakaoTalk; mail will be sent if not viewed).

· 1.31 million people who pre-registered their payment consent accounts will receive automatic payments without application starting September 2.

· The remaining recipients can apply directly after receiving the notification letter to receive payment.

· Starting October 8, 2026, payments will be made after deducting any outstanding insurance premiums.

[How to Apply]

National Health Insurance Service website, official app (The Health Insurance), phone [phone]), fax, mail, or visit a branch office.

■ Content Available in the App

· A quick overview of the 2025 medical expense refund amount and payment schedule.

· Calculation method for the Co-payment Ceiling System, and the difference between advance benefits and post-refunds.

· 6 ways to apply upon receiving the notification letter and payment consent accounts.

· Insurance premiums received when overpaying. Refund Information

· How to distinguish fraudulent refund text messages (smishing) and FAQ

· Large font easy to read for those in their 40s to 60s

· Notifications on health insurance and welfare policy news

※ This app is for informational purposes only and does not assist with refund inquiries or applications. Please make actual applications through the National Health Insurance Service website, official app, or Customer Center.

**Refund Information** [Information Sources]

- Ministry of Health and Welfare (Press Release on Refund of Excess Co-payment Ceilings for Medical Treatment in 2025, Aug. 30, 2026) : https://mohw.go.kr/board.es?act=view&bid=0027&list_no=1491727&mid=a10503010100&nPage=1&tag=

- National Health Insurance Service (Guide to the Co-payment Ceiling System) : https://www.nhis.or.kr/nhis/minwon/wbhapa01000m01.do?mode=view&articleNo=10946900

- National Law Information Center (National Health Insurance Act) : https://www.law.go.kr

- Republic of Korea Policy Briefing (Official Government Policy Portal) : https://www.korea.kr

※ Note (Notice): In South Korea, official government websites use the domain ".go.kr, .kr", not ".gov".

korea.kr is Korea Policy Briefing (대한민국정책반핑), the official government policy portal operated by the Ministry of Culture, Sports and Tourism. nhis.or.kr is the official website of the National Health Insurance Service, a public institution under the Ministry of Health and Welfare.

Examples: https://www.mohw.go.kr (Ministry of Health and Welfare), https://www.nhis.or.kr (National Health Insurance Service), https://www.korea.kr (대한민국정책반핑)

[Privacy Policy]

- https://www.picktheprice.io/privacy_return.html

[Disclaimer]

- This app has no affiliation or cooperative relationship with any government or political agency or the National Health Insurance Service, and is not an official app. It does not represent any government agency and does not directly provide government services, such as checking or applying for refunds.

- This app was created by an individual for the purpose of providing information to users, and it organizes and provides information based on the aforementioned official government data.

While we strive to maintain the accuracy and up-to-date nature of the information provided, it does not have legal force. Please be sure to verify payment criteria and schedules with the National Health Insurance Service Customer Center (1577-1000).

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