Eligibility for Coverage of Pregnancy, Delivery, and Miscarriage and How to Apply
Eligibility for Coverage of Pregnancy, Delivery, Etc.
- A employer-sponsored insurance subscriber or his/her dependent who is pregnant or who has made a delivery (miscarriage and stillbirth included) can have medical expenses associated with pregnancy, and delivery covered by national health insurance by submitting proof of pregnancy or delivery (Article 50 of the National Health Insurance Act, Paragraph 1 of Article 23 of the Enforcement Decree of the National Health Insurance Act, and Paragraph 1 of Article 24 of the Enforcement Regulations of the National Health Insurance Act).
How to Apply for Coverage of Pregnancy, Delivery, Etc.
- A pregnant woman or thelegal representative of an infant who is less than twoyears old (hereinafter referred to as a “Pregnant Woman, Etc.”) seekingto apply for coverage of medical expenses associated with pregnancy anddelivery must submit an application for coverage of pregnancy/delivery byhealth insurance to the Service, a financial institution, or an appropriategovernment office (Article 23(4) of theEnforcement Decree of the National Health Insurance Act, Article 24(1) and subparagraph 1 of Article 64(3) of the Enforcement Regulations of the NationalHealth Insurance Act, and Article 3(1) and subparagraph 1 of the Attached Table 1 of the Standardsfor the Payment of the Treatment for Pregnancy and Childbirth, Etc.).
Coverage of Medical Expenses Associated with Pregnancy, Delivery, and Miscarriage
What is a Voucher (Kookmin Haengbok Card)?
- “Voucher” refers to a certificate provided as a credit card or debit card by electronically recording the amount to ensure that the costs associated with the treatment of pregnant women and the purchase of medicines and treatment materials, and the costs associated with the treatment of National Health Insurance Service subscribers or their dependents less than two years of age and the purchase of prescribed medicines and treatment materials are paid (subparagraph 2 of Article 2 of the Standards for the Payment of the Treatment for Pregnancy and Childbirth, Etc.)
Issuance of a Voucher (Kookmin Haengbok Card)
- Following an application made by an employer-sponsored insurance subscriber or his/her dependent who is pregnant or has made a delivery, the Service must verify the eligibility of the applicant and the pregnancy/delivery and issues a voucher (Kookmin Haengbok Card) to the applicant (Paragraph 5 of Article 23 of the Enforcement Decree of the National Health Insurance Act).
Value of Coverage
- The upper limits of amount payable with a voucher (Kookmin Haengbok Gard) shall be as follows: Provided, That, if deemed necessary and publicly notified by the Minister of Health and Welfare, the payable amount may exceed the following upper limits (Paragraph 7 of Article 23 of the Enforcement Decree of the National Health Insurance Act).
· For pregnancy of one child: 1 million won
· For pregnancy of two or morechildren: 1.4 million won
Use and Valid Period of a Voucher (Kookmin Haengbok Card)
- An employer-sponsored insurance subscriber or his/her dependent who is pregnant or has made a delivery can have medical expenses associated with pregnancy, and delivery covered by national health insurance by submitting a voucher to the medical institution (Paragraphs 2 of Article 24 of the Enforcement Regulations of the National Health Insurance Act).
- The issued voucher will beavailable for use until two years pass from the date of childbirth by the employeeinsured who has been pregnant or given birth or her dependent (for miscarriageor stillbirth, the relevant date) or from the date of childbirth an infant ageless than two years (Article 23(6) of the Enforcement Decree of the National HealthInsurance Act).