If hospital costs became a burden last year due to repeated inpatient and outpatient treatment, you can receive a refund from the National Health Insurance Service (NHIS) for the portion of your out-of-pocket health insurance payments over a one-year period that exceeded the cap set according to your income level. However, if you have delayed applying while defaulting on health insurance premiums, the situation changes. For payments made after October 8, 2026, overdue premiums will first be deducted, and only the remaining amount will be deposited into your account.

■ Legal Basis for the Change: Revised Article 44, Paragraph 3 of the National Health Insurance Act Once this provision takes effect, the NHIS may deduct the amount of any overdue premiums or collections under the same Act before paying out amounts exceeding the out-of-pocket maximum. The Ministry of Health and Welfare advised those with arrears to take note of this point when it began the payment process for excess amounts from last year's treatments.

• ■ Payments Proceed Along Two Tracks
• With the enforcement date approaching, payments are currently proceeding along two tracks.
• Those who pre-registered a payment consent account: paid sequentially without a separate application
• Other recipients: must apply directly after receiving a notice in order to receive payment
• Among these, it is not known how many people have not yet applied, or how many of them are in arrears on their premiums, as these figures have not been disclosed.

■ Refund Amounts Vary by Income-Based Cap and Out-of-Pocket Payments Individual refund amounts vary depending on the cap for each income bracket and the out-of-pocket payments actually made. If the arrears exceed the refund amount, there may be nothing left after the deduction.

■ Timing of Application Remains Unclear The official announcement only stated that the deduction applies to payments made after the enforcement date. Whether a deduction applies if an application was completed before the enforcement date but the actual deposit occurs afterward has not been confirmed.

■ How to Apply and Check Arrears Applications can be made via the NHIS website, mobile app, phone, fax, mail, or by visiting a branch office. Those with arrears should check both their outstanding amount and the applicable criteria through the NHIS customer service center.

■ Remaining Uncertainties It is not yet known whether the NHIS will provide additional guidance on whether the application date or the payment date after enforcement will serve as the standard, or whether it will disclose the actual number and amount of deductions. Note also that missing the application deadline may result in forfeiting the payment.

[This article on checking National Health Insurance refunds is intended to provide information for better understanding. Details and applicability should be verified through the relevant agencies and official sources. Artificial intelligence (AI) assistance was partially used.]