If you paid more than the statutory standard for medical treatment at a hospital or pharmacy, the excess amount can be refunded through the National Health Insurance Service (NHIS). This is known as the 'health insurance co-payment refund' system.

How Refunds Are Determined

Refunds are processed when it is confirmed during the review of medical fees by the Health Insurance Review and Assessment Service (HIRA) or on-site investigations of healthcare institutions by the Ministry of Health and Welfare that a patient paid co-payments exceeding statutory standards. The NHIS deducts the excess amount from the medical fees payable to the healthcare institution and then pays that amount to the patient who received treatment or to the enrollee. This system is designed to retrospectively correct overbilling by hospitals.

Simple Application Process

When a refund is due, the NHIS mails a payment application form to the eligible individual. After filling in the bank account and personal information on the form, it can be submitted through any of the following methods:

• Visit a nearby NHIS branch in person, by mail, or by fax
• Apply by phone via the NHIS customer center
• Apply online by logging in with a joint public certificate on the NHIS website

In principle, the refund is transferred to the designated account within seven days from the date of submission.

Eligible Individuals and Application Period

The eligible applicant is, in principle, the individual who received the medical treatment. However, if the individual has difficulty applying directly, an employee enrollee or family member may apply on their behalf. The application period is a critical point to note. If three years have passed since receiving the payment application form, the statute of limitations expires and the refund can no longer be claimed, so it is important not to ignore the notification.

Automatic Deposit Also Available

If you have already applied once and registered an account, subsequent refunds can be automatically deposited into the same account without a separate application. If you wish to use a different account or do not want automatic deposits, you must notify the relevant branch separately.

[※ This article is based on official guidance materials from the National Health Insurance Service. Please be sure to verify eligibility and procedures through the official NHIS channels. Policy details are subject to change. This article was produced with the assistance of AI.]