National Health Insurance Act (Gungmin Geongang Boheom Beop)

The National Health Insurance Act governs South Korea’s national health insurance system. The Act established the framework for universal health coverage, covering all residents through a single-payer system. The National Health Insurance Service (NHIS) administers the system, and benefits include medical, hospital, and pharmaceutical services. The system is funded through premiums, government subsidies, and co-payments.

Legal area: Law governing the provision of medical services and healthcare institutions.

Year enacted: 1999

Full text: https://elaw.klri.re.kr/eng_service/law_view.do?hseq=south-korea-national-health-insurance-act

Key Provisions

• Chapter I: General provisions (insured persons, coverage)
• Chapter II: Benefits (medical, hospital, pharmaceutical services)
• Chapter III: Premium contributions (income-based)
• Chapter IV: Health care providers (contracts, reimbursement)
• Chapter V: Supervision and administration
• Chapter VI: Medical fee schedule (HIRA role)

Significance

South Korea’s national health insurance system provides universal coverage to all residents, achieving good health outcomes at relatively low cost. The system is administered by the National Health Insurance Service and the Health Insurance Review and Assessment Service. The Act has been amended to address rising healthcare costs, ageing population, and to expand coverage for rare diseases and catastrophic illnesses. South Korea’s healthcare system has been praised for its efficiency and accessibility.