DTx Telemedicine Coverage Simulator

Estimate digital therapeutics or telemedicine coverage value after reimbursement, fees, tax drag, and adoption stress.

DTx and telemedicine coverage simulator

Estimate Korean digital therapeutics and telemedicine cost, private health insurance generation coverage, copay ceiling refund, and coverage gap.

Monthly total cost

₩108,400

Monthly out-of-pocket

₩65,680

Monthly insurance payout

₩42,720

Total net burden

₩3,898,080

Coverage gap

58.6%

Recommended generation

GEN5

Uses calculateDtxTelemedicineCoverage with condition-specific DTx prices, 2026 telemedicine fees, medicine delivery, private health generation matrix, outpatient limits, copay percentage, copay ceiling brackets, and optimistic/base/pessimistic cost scenarios. This English finance calculator calls the same Korean pure calculation module as the Korean page. KRW amounts, Korean tax rules, insurance terms, statutory limits, and scenario assumptions are preserved instead of the old generic percentage stub.

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DTx and telemedicine coverage simulator guide

This English guide translates the Korean DTx and telemedicine coverage simulator. The calculator calls calculateDtxTelemedicineCoverage and keeps digital therapeutics pricing, telemedicine fee, private health generation, copay ceiling, and coverage matrix logic.

DTx, telemedicine, prescription, and delivery cost

The model covers insomnia, depression, ADHD, diabetes, hypertension, COPD, and cancer rehabilitation. Each condition has representative DTx pricing for prescription purchase, monthly subscription, one-time purchase, recommended sessions, and duration.

Telemedicine fees are condition-specific and include consultation, management, prescription, and delivery base fees. Monthly cost is split into DTx, telemedicine, prescription, delivery, and add-on items, then accumulated over the selected simulation years with medical inflation and DTx price change.

Private health generation coverage matrix

The insurance matrix compares no private health insurance, generation 1, generation 2, generation 3, generation 4, and generation 5. Matrix features include telemedicine coverage, psychiatric outpatient coverage, non-reimbursed drug coverage, DTx consultation coverage, DTx subscription coverage, and delivery coverage.

Generation default parameters preserve outpatient limits and copay percentages. The simulator also tracks psychiatric coverage for depression and ADHD, non-reimbursed drug coverage, and digital health rider availability.

Copay ceiling and coverage gap

The Korean copay ceiling brackets are preserved from income bracket 1 to 10, with annual general limits ranging from KRW 870,000 to KRW 8,080,000 and long-term limits ranging from KRW 1,380,000 to KRW 10,500,000.

The result reports monthly total cost, monthly out-of-pocket, monthly insurance payout, total cumulative burden, total cumulative insurance payout, copay ceiling refund, total net burden, coverage gap percentage, income-ratio grade, recommended generation, and scenario comparisons for optimistic, baseline, and pessimistic costs.

Korea-specific assumptions

DTx reimbursement, telemedicine legality, private health coverage, delivery rules, and copay ceiling application can change. This Korean simulator is for planning around current assumptions, not guaranteed reimbursement.