Catastrophic Medical Expense Support Calculator

Check eligibility for the Korean catastrophic medical expense support program and estimate the support amount and remaining out-of-pocket cost by income bracket.

Korea-related planning note

This English page is a planning estimate. If the topic involves Korean taxes, pensions, insurance, loans, or public programs, confirm the current Korean rules, limits, and eligibility before acting.

Scenario inputs

Adjust the assumptions to compare gross value, cost drag, tax drag, and downside value.

Net ending value

$6,973,239,713

Gross value before drag

$6,973,239,713

Estimated tax

$0

Fee and tax drag

$0

Total contributions

$45,000,000

Net gain

$6,928,239,713

15,396.1%

Downside value

$5,578,591,771

Scenario readout

Tax drag is included in net value

This calculator is based on Korean rules (2026). The interactive fields above are a simplified English planning model; use the Korean page for the full income-bracket eligibility and support logic.

Related calculators

What is the Catastrophic Medical Expense Support?

Korea’s Catastrophic Medical Expense Support program helps households when illness or injury creates medical bills beyond what they can afford. The state covers part of the out-of-pocket costs that national health insurance does not, to prevent families from falling into financial ruin.

This calculator is based on Korean rules (2026) under the Act on Support for Catastrophic Medical Expenses and the Ministry of Health and Welfare notification, administered by the National Health Insurance Service (NHIS). If a sudden cancer diagnosis, serious illness, or major surgery produces bills of several million to tens of millions of won, you should first check the three eligibility requirements: income, property, and medical burden.

Enter household size, annual income, property tax base, and total out-of-pocket medical expense, and the calculator shows whether you qualify, your income-bracket support rate, the estimated support amount, and your remaining out-of-pocket cost after support — all on the 2026 basis.

Who needs this

  • • Cancer or serious-illness patients and their families facing large bills
  • • People with heavy non-covered (uninsured) costs not fully reimbursed by private insurance
  • • Basic Livelihood recipients and near-poor households needing medical help
  • • Middle-income households checking their individual-review chances (median income 100–200%)
  • • Anyone wanting to confirm in advance whether they exceed the income or property limits

The three eligibility requirements (2026)

You must satisfy all three requirements — income, property, and medical burden. Missing any one excludes you, so understanding each is essential.

1. Income — at or below 100% of the standard median income

A household at or below 100% of the standard median income (the bottom 50% of incomes) is eligible for basic support. Households above 100% but at or below 200% are not immediately excluded — they can be supported selectively through an individual review. Above 200%, you are excluded.

  • • At or below median 100%: basic eligibility
  • • 100–200%: individual review (selective support)
  • • Above 200%: excluded

2. Property — tax base of KRW 700 million or less

The combined property tax base of the household’s housing, buildings, and land must be KRW 700 million or less. This figure is the property tax assessment base, not the market price, so it corresponds to a fairly high market value — most households clear this test. The property limit was eased from KRW 540 million to KRW 700 million in 2023.

3. Medical burden — exceeding the bracket threshold

Your total out-of-pocket medical expense must exceed a starting threshold set by income bracket. This threshold is not a deductible subtracted from the support — it is a gate that decides whether support can begin at all.

  • • Basic Livelihood / near-poor: over KRW 800,000
  • • Median 50% or below: over KRW 1.6 million
  • • Median 50–100%: over 10% of annual income
  • • Median 100–200%: over 20% of annual income (individual review)

Support rates and the annual cap

Lower incomes receive higher support rates. Since 2019 the program moved from a flat 50% for everyone to a graduated rate that protects vulnerable households more heavily.

Support rate by income bracket

  • • Basic Livelihood / near-poor: 80%
  • • Median 50% or below: 70%
  • • Median 50–100%: 60%
  • • Median 100–200% (individual review): 50%

Annual cap — up to KRW 50 million

The annual cap is KRW 50 million per household. It was raised sharply from KRW 30 million to KRW 50 million in 2024. Individual-review cases in the median 100–200% band can receive up to an extra KRW 10 million depending on the review, for a total of up to KRW 60 million.

How the support amount is calculated

The support subtracts any other public support and insurance payouts from your eligible out-of-pocket expense, then multiplies by the bracket support rate.

The formula

Eligible base = out-of-pocket medical expense
  − state / local support
  − private (indemnity) insurance payout
  − expected out-of-pocket cap refund

Estimated support = eligible base × rate (80–50%)
Final support = min(estimated support, KRW 50M)

Example: a median 50–100% household (60% rate) spends KRW 15 million out of pocket and receives KRW 3 million from private insurance. The eligible base is KRW 12 million and the estimated support is KRW 7.2 million, cutting the real burden to KRW 4.8 million.

Note that the bracket thresholds (KRW 800,000 / KRW 1.6 million / 10% / 20% of income) are eligibility gates, not deductibles. Once you clear the gate, the support rate applies to the entire eligible base.

How to use the calculator

Step 1: Household information

Enter household size and annual income. If you are a Basic Livelihood recipient or near-poor, turn on that toggle to apply the 80% rate.

Step 2: Out-of-pocket medical expense

Enter the eligible total (covered co-payments plus non-covered costs), excluding cosmetic surgery, upgraded room fees, and caregiver costs.

Step 3: Property and deductions

Enter the property tax base, and any state/local support, private insurance payout, or expected out-of-pocket cap refund under the deductions section.

Step 4: Read the result

See eligibility, your bracket and rate, the estimated support, and the remaining out-of-pocket cost, along with pass/fail for each of the three requirements.

How to apply

  1. Where: a National Health Insurance Service branch (call center 1577-1000).
  2. When: within 180 days after discharge (the final treatment date). During hospitalization you can apply separately as advance support.
  3. Which expenses: out-of-pocket costs incurred within one year before the final inpatient/outpatient date; expenses from multiple illnesses can be combined.
  4. Documents: itemized bills and receipts, medical certificate, and family/income/property verification documents.
  5. Review and payment: NHIS reviews income, property, and medical requirements before paying; individual-review cases go through a support deliberation.

July 2026 revision — what changed

The support-standard revision effective 1 July 2026 removed several items from coverage. Exclude the following when entering your total out-of-pocket expense.

  • • Managed benefit excluded: the newly created managed benefit within selective benefits is excluded.
  • • Minor illnesses excluded: 105 minor conditions such as hypertension, bronchitis, spinal stenosis, and back pain are excluded.
  • • 2–3 bed room charges excluded: generally excluded, though support is kept for certain diseases.

Frequently asked questions

Q. Can I still get support if I have private insurance?

A. Yes. But any amount reimbursed by private insurance is subtracted from the eligible expense before the rate is applied. If private insurance fully reimburses you, there is no additional support.

Q. Am I automatically excluded above median 100%?

A. No. The 100–200% band is an individual-review category; if medical costs exceed 20% of annual income, you can receive 50% support. Only above 200% are you excluded.

Q. Is the property tax base the same as market value?

A. No. The property test uses the property tax assessment base, not market price. A KRW 700 million tax base corresponds to a fairly high market value.

Q. Can I combine this with the out-of-pocket cap system?

A. Covered co-payments already refunded through the out-of-pocket cap are excluded from the catastrophic-support base. The two programs are complementary; enter the expected cap refund under deductions.

Q. Does the result match the actual amount?

A. This is a 2026 estimate. Actual eligibility and amounts depend on the NHIS income/property verification and individual review, so confirm with the NHIS.

Check your estimated support now

Enter household size, income, property, and medical expense to see the estimated support instantly.

The NHIS review is final; this calculator is a Korea-based (2026) reference estimate.