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National Health Insurance (Employer-sponsored Insurance)

Coverage of Health Examinations

Coverage of Health Examinations

Execution of Health Examinations

- The Service carried out health examinations of employer-sponsored insurance subscribers and dependents to support the early detection of illnesses and provide the necessary benefits (Paragraph 1 of Article 52 of the National Health Insurance Act).

- Health examination shall take place at a health examination institution (hereinafter referred to as "examination institutions") defined by the Framework Act on Health Examination (Paragraph 2 of Article 25 of the Enforcement Decree of the National Health Insurance Act).

Features of Health Examinations by Type

- Scheduled examinees, examination frequency, and individuals notified of a scheduled health examination according to the type of health examination are as follows (Paragraphs 3, 4, and 5 of Article 25 of the Enforcement Decree of the National Health Insurance Act, Attached Table 1 of the Enforcement Decree of the Cancer Control Act, and Subparagraph 1 of Paragraph 2 of Article 8 and Paragraph 1 of Article 9 of the Health Examination Execution Standards).

Types of health checkups		Eligibility	Health checkup cycle	Notification of the Implementation of health checkups
General health checkup		Self-employed insured who is the head of a household and aged 20 or older	Once every two years	Notified to the person who underwent medical checkup (notified through an insurance premium notice sent to each household)
Cancer diagnosis	Stomach cancer	Male and female adults aged 40 or older	2 years
	Liver cancer	High-risk group for liver cancer among male and female adults aged 40 or older (patients with cirrhosis, antigen-positive for hepatitis B, antibody-positive for hepatitis C, chronic liver disease caused by hepatitis B or C virus)	6 months
	Colorectal cancer	Male and female adults aged 50 or older	1 year
	Breast cancer	Female adults aged 40 or older	2 years
	Cervical cancer	Female adults aged 20 or older	2 years
	Lung cancer	High-risk groups for lung cancer among men and women aged between 54 and 74 [current smokers with a smoking history of 30 pack-years (average daily number of cigarettes consumed × smoking duration) or those who are in great need of lung cancer screening]	2 years
Health checkup for infants	Self-employed insured under the age of 6	Aged 14-35 days	Once at the time of checkup	Notified to the head of the relevant household (notified through an insurance premium notice sent to each household)
		Aged 4-6 months
		Aged 9-12 months
		Aged 18-24 months
		Aged 30-36 months
		Aged 42-48 months
		Aged 54-60 months
		Aged 66-71 months

Coverage of Health Examination Expenses

- Expenses associated with general health examinations, health examination at transitional ages, and health examination of young children are fully covered by the Service (Paragraph 1 of Article 12 of the Health Examination Execution Standards).

- Cancer screening expenses of employer-sponsored insurance subscribers and dependents whose monthly premium is lower than the median premium paid by health insurance subscribers scheduled for examination in the current year as of November of the previous year are covered by the central government, local government, and the Service at a ratio of 5%/5%/90% (3%/7%/90% for Seoul residents), respectively (Subparagraph 2 of Article 10 and Paragraph 2 of Article 11 of the Cancer Screening Execution Standards).

· Cervical cancer screening expenses of employer-sponsored insurance subscribers are fully covered by the Service.