Korea Long-Term Care Welfare Equipment Annual Cap and Copay Calculator

Plan purchases and rentals under Korea’s 2026 KRW 1.6 million welfare-equipment cap using confirmed product prices, prior cap use, and 15%, 9%, 6%, or 0% copay status.

Current notice from Jan 20, 2026 · KRW 1.6M cap

Welfare-equipment plan

Enter prices confirmed in the benefit confirmation, NHIS product listing, or provider quote. No market averages are used.

Copay category

The annual period starts on the long-term-care recognition effective date, not January 1.

Input order is treated as expected service and claim order, and the remaining cap is allocated in that order.

Item 1

Benefit limit: 1 · Useful-life period: 5 years

Annual cap and copay result

Cap remaining after plan KRW 1,600,000

Annual cap usage 0.0% · KRW 0 / KRW 1,600,000

Estimated patient paymentKRW 0
NHIS paymentKRW 0
Benefit copayKRW 0
Full payment above capKRW 0
Already usedKRW 0
Cap before planKRW 1,600,000
Cap used by this planKRW 0
Non-benefit extrasKRW 0
Cap remaining after planKRW 1,600,000

Equipment consultation plan

Equipment consultation plan
Welfare-equipment itemPlanned modeMonthly rentalPlanned benefit costWithin capAbove-capNHIS paymentPatient paymentCap after line
Bath chair×1PurchaseKRW 0KRW 0KRW 0KRW 0KRW 0KRW 1,600,000

Checks before contracting

  • The planned benefit price for Bath chair is zero. Check the NHIS product listing or provider quote.
  • The welfare-equipment benefit confirmation, NHIS lookup, and provider record control final eligibility, product price, and copay rate.

Rule data dated 2026-01-20. Planning values are rounded to won. Actual proration and claim rounding follow the NHIS and provider record.

Related calculators

What this Korea-specific calculator does

Welfare equipment is a Korean Long-Term Care Insurance home-care benefit for equipment that supports daily living, physical activity, and cognitive function at home.
A beneficiary may purchase or rent approved items such as a care bed, manual wheelchair, bath chair, pressure-relief product, safety aid, or wandering detector when the welfare-equipment benefit confirmation permits it.
This calculator is for budgeting after recognition, not for predicting a long-term-care grade or deciding whether a product is medically suitable.

Enter the product-specific benefit price shown in the NHIS listing or confirmed by the welfare-equipment provider.
The model combines that price with benefit cost already used in the current recognition-year period, the selected confirmed copay category, rental months, quantities, and separately confirmed non-benefit extras.
It then separates the benefit amount within the cap, NHIS payment, benefit copay, full patient payment above the cap, and other full-payment amounts.

Korea 2026 jurisdiction note

The rules are based on Korean statutes and Ministry of Health and Welfare notices checked on August 18, 2026.
The equipment catalog uses the notice effective January 20, 2026, while product prices remain user inputs because prices differ by registered product and can change through later product-list notices.

How the KRW 1.6 million annual cap works

It is a recognition-year period

Article 3 of the current welfare-equipment benefit notice sets a KRW 1.6 million cap per beneficiary.
The period begins on the first long-term-care recognition effective date and renews every year from that date.
It is not automatically January through December, so confirm the exact period in the NHIS record before entering prior use.

Both payer shares use the cap

Benefit cost means NHIS payment plus the beneficiary copay.
If a purchase has a KRW 300,000 benefit price and the standard copay is 15%, the patient pays KRW 45,000 and NHIS pays KRW 255,000, but the cap falls by the full KRW 300,000.
Amounts above the remaining cap become full patient payment.

A copay exemption does not create an unlimited benefit.
When the cap is exhausted, the next approved-price amount is treated as full patient payment even if the beneficiary has a 0% copay within the cap.
Confirmed costs outside the benefit price are also paid separately and do not consume the cap.

The four copay categories

Article 15-8 of the Enforcement Decree sets the ordinary home-care benefit copay at 15%.
The separate copay-reduction notice reduces that copay by 40% or 60%, producing effective rates of 9% and 6%.
A beneficiary in the statutory Medical Aid exemption category pays 0% on benefit cost inside the cap.
The calculator asks for the category shown by NHIS rather than estimating eligibility from income or assets.

Korean long-term-care welfare-equipment copay categories for 2026
Confirmed statusEffective copayPatient on KRW 1MNHIS on KRW 1M
Standard15%KRW 150,000KRW 850,000
40% copay reduction9%KRW 90,000KRW 910,000
60% copay reduction6%KRW 60,000KRW 940,000
Exempt0%KRW 0KRW 1,000,000

Purchase, rental, and mixed-mode catalog rules

The January 20, 2026 notice contains 25 benefit item groups.
The calculator separates the anti-slip and ramp subtypes by mode and quantity rule, producing 27 selectable entries with a permitted acquisition mode, useful-life period, and quantity limit.
A general online retail label is not enough because an NHIS benefit item and registered product code control the claim.
Use the benefit confirmation and provider product sheet when selecting an entry.

Purchase only

  • Mobile commode, diaper sensor, bath chair, and mouthpiece oral irrigator
  • Walker, cane, grab bar, anti-slip items, and bedside urinal or bedpan
  • Pressure cushion, positioning aid, incontinence underwear, and tag detector
  • Hip protector and fall alert system

Rental only

  • Manual wheelchair
  • Electric or manual care bed
  • Portable bath and bath lift
  • Wandering detector
  • Outdoor ramp

Purchase or rental

  • Pressure-relief mattress
  • Transfer assist device
  • Interactive emotional-support device
  • Indoor ramp is separately purchase only

Limits that often change the plan

  • Electric and manual care beds count as the same item and cannot be used together.
  • Indoor ramps are purchase only and outdoor ramps are rental only, but the two types may be used at the same time.
  • Other mixed-mode items cannot be received through purchase and rental at the same time.
  • Annual-period limits include ten grab bars, six pairs of anti-slip socks, five anti-slip mats or liquid products, two bedside urinals or bedpans, five positioning aids, and four incontinence-underwear items.
  • Most useful-life items are limited to one, with stated exceptions such as two adult walkers, two tag detectors, and six indoor ramps.

Inputs and calculation order

  1. Confirm the recognition-year period. Record its start date and benefit cost already used, including both NHIS and patient portions.
  2. Select the documented copay category. Use the NHIS record or reduction certificate, not a self-estimated income tier.
  3. Add up to ten equipment lines. Choose the benefit item, planned purchase or rental mode, quantity, and months within this annual period.
  4. Enter registered product prices. Use the benefit purchase price or monthly benefit rental price, not an unverified retail average.
  5. Enter separately confirmed full-payment extras. These are shown as patient cost but are excluded from the annual-cap calculation.
  6. Arrange the expected claim order. The calculator allocates the remaining cap from the first line downward.

Formula used for each line

Starting cap = KRW 1,600,000 − benefit cost already used

Purchase benefit cost = purchase price × quantity

Rental benefit cost = monthly rental price × rental months × quantity

Within-cap base = smaller of planned benefit cost and cap remaining before the line

Patient payment = rounded within-cap base × copay rate + cap excess + non-benefit extra

NHIS payment = within-cap base − rounded benefit copay

Whole-won rounding is a planning display convention.
Actual provider billing can differ because the notice calculates rental by month and may use daily proration for a mid-month start or end, with a special rule for fewer than 15 consecutive rental days.
Ask the provider to confirm the service dates and final claim rounding.

Worked examples

Example 1: three items stay within the cap

Assume a standard 15% beneficiary has already used KRW 400,000.
The plan is a KRW 300,000 bath-chair purchase, six months of an electric care bed at KRW 70,000 per month, and six months of a pressure-relief mattress at KRW 50,000 per month.
Planned benefit cost is KRW 1,020,000, below the KRW 1,200,000 remaining cap.
The benefit copay is KRW 153,000, NHIS payment is KRW 867,000, and KRW 180,000 remains in the cap.
If a separately confirmed extra is KRW 60,000, total patient payment is KRW 213,000.

Example 2: only KRW 200,000 remains

A standard beneficiary has already used KRW 1,400,000 and selects a product with a KRW 300,000 benefit purchase price.
Only KRW 200,000 fits inside the cap, so the benefit copay is KRW 30,000 and NHIS pays KRW 170,000.
The remaining KRW 100,000 is full patient payment.
With a confirmed KRW 20,000 extra, total patient payment becomes KRW 150,000.

How to read the purchase-rental crossover

For an item available in either mode, enter both its benefit purchase price and monthly benefit rental price.
The simple crossover month is the purchase price divided by the monthly rental price, rounded up to the next whole month.
A KRW 600,000 purchase and KRW 60,000 monthly rental cross at month 10; six months of rental have a KRW 360,000 base price.

It is a price comparison, not an equipment recommendation

  • The benefit confirmation and the beneficiary’s functional needs come first.
  • The comparison does not model daily rental proration, product replacement, maintenance quality, or return terms.
  • For use beyond one recognition-year period, it does not automatically reset the annual cap or update later prices.
  • Do not select a product solely because its raw benefit price is lower over the entered months.

Eligibility and billing boundaries

Facility residence

Welfare-equipment benefit is restricted during a stay using facility benefit. Confirm the transition and return dates.

Hospital admission

Electric beds, manual beds, portable baths, and bath lifts are restricted during hospital admission, with special handling when admission begins during an existing rental.

Prior supply under another law

The same item supplied under another program can restrict another benefit during its useful-life period.

Changed functional condition

A damaged or unsuitable item within its useful-life period may require an additional-benefit application and NHIS approval.

The calculator does not determine grade, benefit eligibility, reduction status, product necessity, safety, duplicate-supply history, or approval of an additional item.
It also does not decide whether a provider may separately charge an entered extra.
The current notice states that delivery, installation and removal, repair and replacement parts, cleaning, and disinfection are included in the welfare-equipment price and cannot simply be added as separate charges.

Frequently asked questions

Does the KRW 1.6 million cap reset every January?

No. It renews every year from the beneficiary’s long-term-care recognition effective date. Check the individual NHIS period.

Does only the patient copay reduce the cap?

No. The full benefit price, including NHIS payment and patient copay, reduces the cap.

Does a 60% reduction mean the patient pays 60%?

No. It reduces the ordinary 15% copay by 60%, producing an effective 6% rate. A 40% reduction produces 9%.

Does a 0% beneficiary pay nothing after the cap is exhausted?

No. The exemption applies within the cap. Above-cap and non-benefit amounts remain full patient payment.

Can I enter an online retail price?

Use the registered benefit price or a provider-confirmed benefit price. A retail sale price may not match the NHIS claim price.

Can this calculator handle a ten-day rental exactly?

No. It uses whole months. Ask the provider to apply the notice’s daily-proration and under-15-day rules to the actual dates.

Does a calculated line prove that the item is covered?

No. The welfare-equipment benefit confirmation, product code, useful-life history, and NHIS or provider lookup control the final result.

Official sources and update checkpoint

Catalog rules are versioned to January 20, 2026, and the product-price notice checkpoint is February 1, 2026.
Recheck the cap, item modes, useful-life periods, quantity limits, copay rules, and product prices whenever the Korean notices or NHIS listing changes.

Take a verified plan to the equipment provider

Confirm the recognition-year period and prior use with NHIS, then enter each registered product’s benefit price and expected service order.
Print the result and ask the provider to verify benefit-confirmation eligibility, actual start and return dates, daily rental proration, existing supply history, and the final patient amount before signing the contract.