Insulin Pump and CGM Benefit (Yoyangbi) Calculator
Insulin Pump and CGM Benefit (Yoyangbi) Calculator helps estimate Korea-related assistive device, hearing aid, reimbursement, and maintenance-cost assumptions in English.
Health cost scenario inputs
Enter Korea-related chronic care, eldercare, therapy, procedure, fertility, diagnostic, or medical tourism assumptions. Results are simplified planning estimates.
Maintenance over use period
₩336,000,000
Net device cost
₩344,000,000
Monthly reserve target
₩477,778
60 year use
This English page explains Korea NHIS yoyangbi (medical-supply benefit) support for diabetes devices — the insulin pump (automatic injector), the continuous glucose monitoring (CGM) sensor and reader, and consumables (test strips, lancets, needles, infusion sets), based on the MOHW notice “Standards and Methods for Yoyangbi Benefits” (No. 2026-93, effective 2026-05-01), Annex 6. Each item has its own base amount and support rate, and reimbursement is the lower of actual price and base amount times the support rate, with the excess above the base and the un-supported remainder both self-paid. (1) Consumables (strips/lancets/syringes/pen needles/pump infusion sets) are supported at 90% for all insulin-treated diabetes; the per-day base is KRW 2,500/day for type 1 (KRW 4,500 for under-19 hybrid closed-loop users), KRW 900/1,800/2,500 for type 2 adults by 1/2/3+ injections a day, and KRW 2,500 (insulin) or 1,300 (not) for pregnancy; only under-19 hybrid closed-loop consumables drop to 70%. (2) The CGM sensor (electrode) is type-1-and-pregnancy only (NOT type 2), base KRW 10,000/day (KRW 11,000 for under-19 type 1 with a sensor-integrated/hybrid pump), supported 70% for adults/pregnancy and 90% for under-19 type 1. (3) Management devices are type-1-only: the CGM reader is KRW 210,000/3 months at 70% (no under-19 exception), and the insulin pump is per device over 60 months (5 years) with a base of KRW 1.7M/2.5M/4.5M (under-19 basic/sensor-integrated/hybrid) or KRW 1.7M (19+, any tier), supported 70% for adults and 90% for under-19 — so a KRW 4.5M hybrid pump costs a child about KRW 450,000 (down from ~KRW 3.8M since the 2024-02-26 expansion). Yoyangbi is a post-purchase reimbursement (buy from a registered supplier, then claim within 3 years; delegated claims let you pay only the self-pay share), and support starts only from prescriptions issued after patient registration. Private indemnity insurance generally does not cover these purchases, but self-pay for prescribed devices/consumables qualifies for the medical-expense tax credit (Income Tax Act Article 59-4). It is planning guidance based on 2026 Korean rules, not medical advice or an insurer decision.
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What is the insulin pump & CGM benefit (yoyangbi) calculator?
This calculator estimates how much of an insulin pump, continuous glucose monitoring (CGM) sensor, and diabetes consumables (test strips, lancets, needles) a diabetes patient is reimbursed by Korea’s National Health Insurance (NHIS) as a “yoyangbi” (medical-supply benefit), and how much they pay out of pocket.
Enter the diabetes type (type 1, insulin-treated type 2, gestational), age band (under/over 19), the devices used, and the actual purchase prices, and it shows per-item reimbursement and self-pay, and the monthly, annual, and 5-year burden.
The base amounts and support rates are taken directly from the MOHW notice “Standards and Methods for Yoyangbi Benefits” (No. 2026-93, effective 2026-05-01), Annex 6, so it reflects the current 2026 Korean rules.
The key mechanic is that each item has a different base amount and a different support rate.
The reimbursement is “the lower of actual price and base amount × support rate,” and both the excess above the base and the un-supported remainder are self-pay.
Korea-based estimate. This calculator is based on 2026 Korean NHIS rules (MOHW notice No. 2026-93). It is planning guidance, not medical advice, and does not replace a diagnosis, a physician’s device decision, a supplier quote, or an NHIS benefit decision.
Three benefit categories for diabetes
Support under Article 49 (Yoyangbi) of the National Health Insurance Act splits into three categories, each with its own base-amount unit (per day / per 3 months / per device) and support rate.
① Diabetes consumables (90% support)
Includes blood-glucose test strips, lancets, insulin syringes, pen needles, and insulin-pump infusion sets. The base is per day; eligible for all insulin-treated diabetes (type 1 and 2) plus those under 19 or pregnant.
- • Type 1 (all): KRW 2,500/day (KRW 4,500/day for under-19 hybrid closed-loop pump users)
- • Type 2, 19+: KRW 900 (1 injection), 1,800 (2), 2,500/day (3+ injections/day)
- • Pregnancy: KRW 2,500/day (insulin-treated), 1,300/day (not treated)
- • Rate: 90% (only the under-19 hybrid closed-loop consumables are 70%)
② CGM sensor (electrode) — 70/90% support
The CGM sensor (electrode) used with Dexcom, FreeStyle Libre, etc. Eligible for type 1 diabetes and gestational diabetes (insulin-treated); type 2 is NOT eligible.
- • Base: KRW 10,000/day (type 1 all, pregnancy); KRW 11,000/day (under-19 type 1 with sensor-integrated/hybrid pump)
- • Rate: 70% for adult type 1 and pregnancy; 90% for under-19 type 1
- • Calculation: product usable days × per-day base amount
③ Diabetes management devices — CGM reader + insulin pump (70/90%)
The CGM reader/transmitter and the insulin automatic injector (pump). Both are type-1-only, with fixed re-supply cycles.
- • CGM reader (device): KRW 210,000/3 months, 70% (no under-19 exception)
- • Insulin pump: per device / 60 months (5 years). 70% adult, 90% under-19
- • Pump base: under-19 KRW 1.7M (basic) / 2.5M (sensor-integrated) / 4.5M (hybrid closed-loop); 19+ KRW 1.7M regardless of type
Who is eligible for what
The most common confusion is “what does my diabetes type cover?” Here is the eligibility by type.
- • Type 1: consumables + CGM sensor + CGM device + insulin pump (all eligible)
- • Type 2 (insulin-treated): consumables only (CGM and pump NOT eligible)
- • Gestational: consumables + CGM sensor (CGM device and pump NOT eligible)
So the CGM reader and the insulin pump body are reimbursed only for type 1 patients.
If a type 2 patient uses a CGM or a pump, that cost is fully self-paid, so the calculator marks non-eligible items as full self-pay.
Under-19 type 1 special support (10% self-pay)
From 2024-02-26, support for children/adolescents (under 19) with type 1 diabetes expanded sharply.
Self-pay for the insulin pump and CGM sensor dropped from 30% to 10%, and pumps were split into three functional tiers with higher base amounts.
Under-19 highlights
- • Pump/sensor 90% support: self-pay cut to 10%
- • Hybrid closed-loop pump base KRW 4.5M: about KRW 450,000 self-pay at base price (down from ~KRW 3.8M)
- • Sensor base KRW 11,000/day: higher than the adult KRW 10,000
- • Infusion-set consumables KRW 4,500/day: for under-19 hybrid closed-loop pump users
Note that even under the child special case, the CGM reader (device body) is still supported at 70% like adults — the 90% exception applies only to the insulin pump and the CGM sensor.
How to use the calculator
Step 1: Patient and type
Choose the diabetes type (type 1 / type 2 / gestational), whether under 19, and second-lowest-income copay-relief status.
For type 2 adults, also pick the daily insulin injection count.
Step 2: Device and consumable prices
Enter the monthly consumables price, monthly CGM sensor price, 3-month CGM device price, and the pump tier and body price.
Toggle off items you do not use.
Step 3: Tax credit
Set whether to apply the medical-expense tax credit, total salary, and the 65+/disabled no-cap status.
Prescribed devices and consumables count toward the credit.
Step 4: Review results
See monthly/annual/5-year self-pay and reimbursement, per-item breakdown, an eligibility matrix by type, a pump-tier table, and the after-tax real burden.
The 5-year figure reflects the 60-month pump cycle.
Applying and registering for yoyangbi
Diabetes management-device support is not a voucher — it is a post-purchase reimbursement.
You buy from a registered supplier first, then claim from the NHIS.
- Diagnosis and registration: get a diabetes diagnosis and a patient-registration form, then register with the NHIS.
- Prescription: for type 1, an internal-medicine, family-medicine, or pediatrics specialist issues the prescription (each item has its own form).
- Buy from a registered supplier: purchase devices/consumables at an NHIS-registered supplier.
- Claim and refund: claim within 3 years of purchase. With a delegated claim, you pay only the self-pay share and the supplier bills the NHIS share.
Crucially, support starts only from prescriptions issued after registration.
Purchases made before registration are not reimbursed retroactively, so register and get the prescription first.
Frequently asked questions (FAQ)
Q. Does type 2 diabetes get pump/CGM support?
A. No.
The CGM reader and insulin pump are type-1-only. Type 2 diabetes is supported only for insulin-injection consumables (strips, lancets, syringes, needles) at 90%.
Q. How much of the CGM sensor is reimbursed per month?
A. The base is KRW 10,000/day for adult type 1 and pregnancy.
Over 30 days that is a KRW 300,000 base, so adults get up to ~KRW 210,000 (70%) and under-19 type 1 up to ~KRW 270,000 (90%). If the actual price is below the base, support is on the actual price.
Q. What does a child pay for a hybrid closed-loop pump?
A. The under-19 hybrid closed-loop base is KRW 4.5M at 90%.
At the base price, self-pay is about KRW 450,000. Anything above the base is fully self-paid, so check the actual price.
Q. How often is the pump re-supported?
A. The insulin pump is supported once per 60 months (5 years).
The CGM reader has up to a 12-month prescription cycle, and sensors and consumables are supported repeatedly per prescription days.
Q. Do private insurance or the tax credit apply?
A. Private indemnity (silson) insurance generally does not cover yoyangbi consumables/devices.
However, self-pay for prescribed devices (pump, CGM reader) and consumables qualifies for the year-end medical-expense tax credit; the amount reimbursed as yoyangbi is excluded.
Cautions
- Estimate only: based on the 2026 notice (No. 2026-93) Annex 6 base amounts and rates. Actual support varies with product usable days, prescription days, and actual price.
- Not medical advice: device choice and prescriptions are decided by the treating specialist. This tool is for cost planning only.
- Rules may change: base amounts, rates, and eligibility can change by notice. Check the NHIS (1577-1000) and the latest notice.
- Extra costs: consultation fees, insulin drug cost, and device accessories may be billed separately.