Plan a Korean moyamoya operation from the hospital quote
Moyamoya surgery creates an alternative route for blood flow rather than assigning one standard operation and one national price to every patient.
A Korean neurosurgical team may discuss direct anastomosis, indirect revascularisation, a combined operation, or another provider-defined plan after reviewing age, symptoms, vessel imaging and cerebral perfusion.
Admission length, intensive-care use, imaging, anaesthesia, materials, laterality and follow-up can therefore change the bill even when two plans use a similar procedure label.
No invented average
All hospital-cost fields start at zero so that the result reflects an itemised provider quote instead of an unsupported market average.
Separate cash stages
Enter stage one, an optional stage two, and recovery costs independently to see when cash may be needed.
Korean benefit logic
Apply a confirmed covered-care rate, then add non-covered and non-medical costs without multiplying them by that rate again.
This calculator is for financial planning in South Korea.
It does not diagnose moyamoya disease, recommend an operation, estimate clinical risk or predict recovery.
The treating hospital, National Health Insurance Service, insurer and tax authority determine the actual billed or reimbursed amount.
Understand V128 at 10% and hospital-confirmed V191 at 5%
The Korea Disease Control and Prevention Agency lists moyamoya disease under diagnosis code I67.5 and rare-disease special-case symbol V128.
Qualifying covered care for a registered rare-disease patient generally uses a 10% patient share, and the registration period is five years.
Registration does not make every unrelated service or non-covered item 10%, so the itemised scope still matters.
A separate cerebrovascular surgery route, V191, can use a 5% covered-care patient share for an inpatient period of up to 30 days when both the listed condition and listed operation requirements are met.
The official annex includes the I60–I67 condition range and procedures such as intracranial vascular anastomosis codes S4661–S4664 and shunt or bypass creation codes S4711–S4715.
Because the diagnosis alone does not prove that the actual claim satisfies every requirement, the calculator never switches to 5% automatically.
Comparison of covered-care patient-share modes for Korean moyamoya surgery planning| Calculator mode | Covered share | What to confirm | Period reference |
|---|
| V191 cerebrovascular surgery | 5% | Hospital confirms the condition, operation code and claim scope | Qualifying inpatient care for up to 30 days |
| V128 registered rare disease | 10% | I67.5 registration and whether the care falls within its scope | Five-year registration period |
| Ordinary inpatient comparison | 20% | No special-case rate confirmed for the entered covered care | The quoted treatment scope |
Non-covered charges, full patient-pay items, caregiver expenses, travel and accommodation do not receive the selected covered-care percentage in this model.
If a V128 application is filed within 30 days after the confirmed diagnosis, the special-case rule may permit application from the diagnosis date, while a later filing generally starts from the filing date.
Ask the hospital registration desk to confirm the actual start date and every inpatient day covered by the planned claim.
How to use the calculator
- Record the clinical-plan context.
Select the patient group, provider-proposed method and one-stage or two-stage structure.
These labels do not set a price or recommend a procedure.
- Choose only a confirmed covered-care rate.
Use V191 only after the hospital confirms the relevant claim conditions, or use V128, ordinary inpatient care, or a provider-confirmed custom rate.
- Separate covered gross charges from patient-paid charges.
For surgery, tests and admission, enter the covered amount before the patient-share rate and then enter each non-covered amount separately.
- Add recovery and household cash costs.
Include rehabilitation, outpatient imaging, caregiver time, transport and accommodation in the appropriate fields.
- Apply offsets and the tax estimate.
Enter an insurer estimate and confirmed public support, then use annual salary and other eligible medical expenses to estimate only the incremental Korean medical-expense tax credit.
Covered gross charge versus the amount due
Covered gross charge
This is the covered treatment amount before multiplying by 5%, 10%, 20% or the custom rate.
If the estimate shows only the expected amount due, ask the billing desk for the itemised covered gross amount.
Non-covered or other patient-pay amount
Enter what the patient is expected to pay for that line without applying the selected percentage again.
Check the current hospital disclosure because Korean providers must disclose their non-covered prices and may update them.
Direct, indirect and combined plans
Direct revascularisation connects an extracranial donor vessel to an intracranial vessel to provide a more immediate blood-flow route.
Indirect revascularisation places vascularised tissue near the brain surface so that collateral circulation can develop over time.
A combined operation uses both approaches within one plan, while a hospital may describe another tailored combination in the consent form.
Children commonly receive indirect approaches, but age alone does not determine the appropriate operation and this tool never assumes that one method is suitable.
Bilateral disease also does not mean that one quote should simply be doubled.
A second stage may have different imaging, admission days, method, timing and prices, so obtain a separate provider estimate whenever possible.
Make provider quotes comparable
- Confirm whether angiography, MRI and perfusion studies are included before and after surgery.
- Confirm the expected intensive-care and ward days and the quoted room category.
- Ask whether the quote is unilateral, bilateral in one admission, or one stage of a staged bilateral plan.
- Ask for the formal operation name, planned billing codes and the special-case symbol expected on the claim.
- List wound review, outpatient imaging and rehabilitation that will be billed after discharge.
Worked two-stage cash-planning example
The following figures demonstrate the formula and are not Korean hospital price claims.
Assume total covered gross charges of KRW 25,500,000 and a hospital-confirmed V191 rate of 5%.
The covered patient share is KRW 1,275,000, compared with KRW 5,100,000 under a simple ordinary 20% comparison, for a difference of KRW 3,825,000.
Illustrative cash schedule for a staged bilateral moyamoya surgery plan| Timing | Illustrative cash need | Possible components |
|---|
| Stage one | KRW 2,550,000 | Covered share, non-covered care, caregiver and travel |
| Stage two | KRW 1,950,000 | Second admission and caregiver stay |
| Recovery and follow-up | KRW 675,000 | Outpatient care, rehabilitation and transport |
Gross cash need in the example is KRW 5,175,000, of which KRW 3,975,000 is medical patient-pay and KRW 1,200,000 is non-medical cash cost.
If insurance and confirmed support total KRW 1,500,000, the remaining eligible medical amount is KRW 2,475,000.
For annual salary of KRW 50,000,000, KRW 1,000,000 of earlier eligible expense, and the no-ordinary-cap group, the eligible-base increase above the 3% salary threshold is KRW 1,975,000 and the incremental 15% credit estimate is KRW 296,250.
Net planning cash is therefore KRW 3,378,750, with a 10% variation range of KRW 3,040,875–3,716,625.
Insurance, support and Korean medical-expense tax credit
Enter an insurer estimate, not the policy limit
Korean indemnity medical insurance varies by product generation, deductible, covered and non-covered treatment rules, exclusions and the insurer review.
Enter an amount the insurer has estimated for this claim rather than assuming that every patient-paid item will be reimbursed.
The calculator caps insurance and public-support offsets at the medical patient-pay amount so they do not create a negative medical expense.
The tax result is incremental, not guaranteed
The model uses the Korean Income Tax Act structure of a 3% annual-salary threshold and a 15% medical-expense credit rate.
It subtracts indemnity-insurance compensation before determining the eligible amount.
The ordinary-family option applies the KRW 7,000,000 eligible-base cap, while the selected no-ordinary-cap group represents the taxpayer, a child age six or under, a person age 65 or older, a disabled person, or a qualifying serious-disease case.
Actual relief can be lower when eligibility fails or assessed tax is insufficient.
Keep household costs separate
Ordinary caregiver charges, transport, meals and accommodation affect the household cash plan but are not added to this medical tax-credit base.
Disaster medical-expense support, rare-disease assistance, the annual covered-care out-of-pocket ceiling and local programmes are not guessed automatically because eligibility and timing differ.
Enter only support that has been confirmed for the case.
Frequently asked questions
Does every moyamoya operation receive the 5% V191 rate?
No.
V128 at 10% is the registered rare-disease route, while V191 at 5% requires the listed cerebrovascular condition, operation and inpatient-period criteria to be met on the actual hospital claim.
Should I double a one-side quote for bilateral surgery?
No automatic doubling is recommended.
Obtain separate stage estimates because the method, tests, admission days and later prices can differ.
Where can I verify a non-covered price?
Start with the hospital non-covered price disclosure and its itemised estimate.
The Health Insurance Review and Assessment Service also publishes comparison information, but the hospital must confirm the scope of the actual planned quote.
Does the variation range predict complications?
No.
It only moves the calculated net cash amount by the percentage you entered and is not a medical probability, prognosis or complication estimate.
Questions to take to the Korean hospital
- What formal operation name and billing codes will appear on the consent form and claim?
- Will the admission use V191 at 5%, V128 at 10%, another rate, or different rates for different lines?
- What are the confirmed start and end dates of the special-case scope?
- Does the quote show covered gross charges separately from non-covered and full patient-pay amounts?
- For bilateral care, is this one combined admission or the first of two separate stages?
- Which imaging, rehabilitation and follow-up services will be billed after discharge?
Start with confirmed line items
Enter only the amounts that the provider, insurer or support programme has actually explained.
Use the stage table and result breakdown as a checklist for the next billing consultation.
Official references and effective basis
- The KDCA Rare Disease Helpline moyamoya page identifies I67.5 and V128.
- The NHIS special-case benefit guide explains the rare-disease patient share and registration scope.
- The calculation basis uses Ministry of Health and Welfare Notice 2026-101 effective May 1, 2026, and was verified on July 29, 2026.
- Rules, provider billing and benefits can change after the verification date, so recheck the live official sources before relying on the estimate.