ENGLISH

National Health Insurance (Self-Employed Insured)

Support for health checkups

Support for health checkups

Provision of health checkups

- The National Health Insurance Service (hereinafter referred to as the “NHIS”) provides health checkups for self-employed insured for the early detection of any diseases and provision of health care benefits therefor (Article 52 (1) of the “National Health Insurance Act”).

- A health checkup must be provided at a health checkup institution specified under the Framework “Act on Health Examinations” (Article 25 (2) of the “Enforcement Decree of the National Health Insurance Act”).

Characteristics of each type of health checkup

- Those who are eligible to receive health checkups according to the type of health checkup, health checkup cycle, and those who are notified of the implementation of health checkups are as follows [Article 52 (2) of the “National Health Insurance Act”, Article 25 (3) through (5) of the “Enforcement Decree of the National Health Insurance Act”, attached Table 1 of the “Enforcement Decree of the Cancer Control Act”, and Article 8 (2) 1 and Article 9 (1) of the “Health Checkup Implementation 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

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

Payment of expenses for health checkup

- Expenses associated with general health checkup, medical benefits for health checkup at the turning point in life, and health checkup for infants will be entirely payable by the NHIS (Article 12 (1) of the “Health Checkup Implementation Standards”).

- As of November of the immediately preceding year, in relation to the cost of cancer screening for self-employed insured whose monthly premiums fall below the bottom 50% of health insurance policyholders scheduled for the relevant year, the State and local governments will each pay 5/100 (provided that for Seoul Metropolitan Government, the State will pay 3/100 and the local government will pay 7/100) and the NHIS will pay 90/100 of the amount [Article 10, subparagraph 2 and Article 11 (2) of the “Health Checkup Implementation Standards”].

· However, the cost of cervical cancer and colorectal cancer screening for self-employed insured will be entirely payable by the NHIS.