The 2025 Revision of Indemnity Health Insurance

Among the insurance products many people are interested in is indemnity health insurance (silson insurance).
This product is insurance under which the insurer reimburses part of the medical expenses you paid yourself when receiving treatment at a hospital.
In 2025, a revision to this indemnity health insurance was announced and has been applied since April 1.

[Details of the revision]
1. Higher out-of-pocket costs for non-covered items
- For manual therapy, extracorporeal shock wave therapy, prolotherapy (muscle strengthening and pain relief treatment), etc., out-of-pocket costs increase by up to 90~95% compared to the amount previously paid.
- Outpatient treatment costs for minor conditions are limited to a daily coverage cap of 200,000 won
- For inpatient treatment, limited to a cap of 3,000,000 won per instance
2. Premium increases
- Subscribers who use a large amount of non-covered services may see their premiums increase by up to 30%.
3. Higher co-payment rate
- The out-of-pocket share may be raised from the previous 30% up to 50%
- For example, if treatment costs 100,000 won, the previous structure had the patient paying 30,000 won and the insurer 70,000 won; with this revision, it changes to a structure in which the patient must pay up to 50,000 won.
4. Expanded enrollment age for indemnity health insurance for seniors
- Previously possible up to age 75, enrollment in indemnity health insurance will be possible up to age 90, and the coverage age will also be extended from 100 to 110.

The most important part of this revision is the increase in out-of-pocket costs for non-covered items.
Since many people have been using these services, it seems necessary to look closely at the insurance benefits when renewing indemnity health insurance.

[Non-covered items]
:Medical services not covered by the National Health Insurance, for which the patient must pay the full medical cost
1. Non-covered examinations
- MRI·CT scans, ultrasound, endoscopy (including biopsy)
2. Non-covered treatments
- Manual therapy (orthopedic, spine·joint treatment), extracorporeal shock wave therapy, prolotherapy (ligament·cartilage strengthening injections)
3. Non-covered surgeries and procedures
- Cataract surgery, vision correction surgery such as LASIK·LASEK, cosmetic plastic surgery, dermatology procedures (Botox, fillers)
4. Non-covered dental and traditional Korean medicine
Implants (outside National Health Insurance coverage criteria), prosthetic treatment (crowns, bridges, etc.), traditional Korean medicine treatments (Chuna therapy, pharmacopuncture)