Out-of-Pocket Cap Refunds 2026: Arrears Deduction Rules

An older man rests his braced leg on a footstool and looks at a smartphone on a table beside the window.

This content applies specifically to South Korea.

If you have overdue health insurance payments, arrears deductions apply to excess amounts notified on or after October 8, 2026. The notice date determines whether the new rule applies; the deposit date alone does not.

Understand the amount available for payment

When annual qualifying out-of-pocket payments exceed the individual maximum, the excess qualifies for a refund. Arrears deductions cover overdue insurance premiums and other amounts owed under the law. A remaining balance can be paid, but a deduction covering the entire payable amount may leave no deposit.

On the National Health Insurance Service website, verify your identity and check Refund Inquiry and Application. Review the treatment year, payable amount, notice date and deduction details together.

A middle-aged woman makes a phone call beside an elderly woman's hospital bed, with paperwork on the table.A middle-aged woman makes a phone call beside an elderly woman's hospital bed, with paperwork on the table.

Find the refund checks in one place

In the original article on OnBinder, you can compare annual maximums, follow the application steps and check document requirements for a family member's account. (verified value For 2025 treatment refunded in 2026, individual annual maximums range from KRW 890,000 to KRW 10,740,000. · source m.korea.kr · checked 2026-08-30) Its explanation of notice dates helps distinguish refund eligibility from the amount left after deductions.

Read the full article on OnBinder

Match the inquiry to the difference

If the calculated refund differs from your estimate, check qualifying expenses, the maximum applied and amounts already handled by the hospital. If only the deposit differs, check the arrears deduction and final payment details.

Before contacting the Service, you can note which of these two amounts needs explaining. That distinction can save time rechecking receipts when the difference arose at payment.

Check the treatment year and claim period

Insured members and dependents may qualify. For treatment received in 2025 and refunded in 2026, the 2025 maximum applies. Individual maximums depend on health insurance premiums and other factors for the treatment year.

The announcement for 2025 treatment gives no single nationwide application deadline. The right to claim insurance benefits expires if not exercised for 3 years. Check your notice or contact the Service for the individual claim deadline.

What else needs checking?

Is another application needed for automatic payment?

No, if eligible for automatic payment to an account registered with payment consent. Check the registered account and payment status.

Do non-covered medical costs count?

No. Non-covered services, selectively covered services and amounts paid entirely by the patient are excluded.

Where can an online application problem be resolved?

Contact 1577-1000 or a local Service branch. Applications are also accepted by telephone, fax, mail or in person.

Check the treatment year and payable amount in the Service's Refund Inquiry and Application service.

Read the full article on OnBinder

This post was written with assistance and published on a channel run by OnBinder (onbinder.com). The original article and its sources are at the link above.

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