Outpatient visits above 300 a year to incur 90% patient payment from next year

Patients in South Korea who make more than 300 outpatient visits in a year will face a 90% co-payment from their 301st visit under rules approved by the Cabinet.

The Ministry of Health and Welfare said the change will take effect on Jan. 1. The current threshold is 365 visits, meaning the government will apply the higher payment rate to a broader group of frequent users. Three hundred visits amounts to roughly six visits a week.

The rules retain protections for patients whose conditions require frequent care. Children, pregnant women, people with severe disabilities covered by special calculation rules, and patients receiving treatment for severe, rare or severe intractable diseases will be excluded. Others may seek an exception through the National Health Insurance Service’s review committee for excessive medical use, which will assess medical necessity.

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This amendment aims to reduce patient safety risks and support more appropriate use of medical services by the public.

The ministry said 7,765 of about 48.4 million outpatient users in 2025 had exceeded 300 visits as of June 30. They averaged 344.7 visits, while the highest recorded total was 1,775. South Korea’s average was 17.9 outpatient visits per person in 2024, compared with an OECD average of 6.6.

From Dec. 24, medical institutions will also gain access to a system showing patients’ covered treatment at other institutions. The system will initially cover CT and MRI examinations, addressing the difficulty of identifying repeated or similar tests and treatments across hospitals. Separately, from Oct. 1, employees will be able to request installment payments for additional year-end health insurance charges when the amount reaches the legal monthly minimum, 10,080 won under this year’s figure, with payments spread over up to 12 installments.

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Because the implementation dates differ by amendment, we will strengthen advance guidance so that health insurance subscribers and medical institutions are fully informed.