Proton and Heavy-Ion (Carbon-Ion) Radiation Therapy Cost Calculator
This calculator estimates the out-of-pocket cost of particle (charged-particle) radiation therapy in Korea and keeps the same pure calculation model as the Korean page. Proton beam therapy and heavy-ion (carbon-ion) therapy both use the Bragg peak to concentrate dose on the tumor, but health insurance treats them oppositely, so the real patient burden ranges from a few million to tens of millions of won for the same idea. Proton therapy has been NHIS-covered (by indication) since September 2015, so a registered cancer patient pays a 5% benefit self-pay. Heavy-ion therapy is still fully non-covered (out of pocket): roughly KRW 50-65 million depending on the site. The calculator compares proton, heavy-ion, intensity-modulated radiation therapy (IMRT/VMAT), and stereotactic body radiation therapy (SBRT) for a chosen cancer site, and layers the special case, the out-of-pocket ceiling, private indemnity, the cancer-insurance radiation rider, and the medical expense tax credit on top. All figures use 2026 Korean rules.
Proton vs heavy-ion vs IMRT vs SBRT
Proton beam therapy accelerates hydrogen (proton) particles and is delivered at centers such as the National Cancer Center (2007) and Samsung Medical Center (2015). Since September 2015 it has been NHIS-covered for most cancers, so a registered cancer patient pays a 5% special-case self-pay and the per-course out-of-pocket is reported around KRW 1.5 million. Coverage is indication-specific, however — breast, prostate, and rectal cancer were historically excluded — so proton coverage must be confirmed with the hospital and the National Health Insurance Service (NHIS).
Heavy-ion (carbon-ion) therapy uses carbon ions that are about 12 times heavier than protons, with a biological effect roughly 2-3 times that of X-rays or protons. Korea’s first center opened at the Yonsei Cancer Center in April 2023, treating about 10 cancer types (head and neck, skull base, esophagus, lung, liver, pancreas, kidney, rectum, prostate, and bone/soft-tissue sarcoma) as of 2025, but it is still fully non-covered: about KRW 55 million for prostate (12 fractions), KRW 50 million for liver (4 fractions/week), and KRW 65 million for pancreas (12 fractions over 3 weeks). IMRT/VMAT (covered standard X-ray radiation over ~20-35 fractions) and SBRT/SABR (covered high-dose radiation in 3-10 fractions) are the covered alternatives, both with the 5% special case.
- Proton (covered): 5% special-case self-pay; per-course out-of-pocket around KRW 1.5 million; coverage is indication-specific.
- Heavy-ion (non-covered): full out of pocket, about KRW 50-65 million by site; no special case, no ceiling.
- IMRT/VMAT (covered): standard X-ray radiation, the lowest-cost baseline at 5%.
- SBRT/SABR (covered): 3-10 high-dose fractions, effective for early lung/liver tumors, 5%.
The cancer special case: 5% on covered radiation, and a tax-credit exception for heavy-ion
The biggest cost driver is the cancer (severe-disease) special case, registration code V193, whose eligible diagnosis codes are the malignant neoplasm range C00-C97. Registration drops the covered self-pay from 20% to 5% for proton, IMRT, and SBRT, and the 5% also covers outpatient radiation and follow-up imaging within the five-year window. If you register within 30 days of diagnosis, it applies retroactively to the confirmation date.
The 5% special case applies only to covered services, so it does NOT reduce the non-covered heavy-ion cost. But the special case still matters for heavy-ion in a different way: a patient registered as a severe-disease (cancer) patient has no KRW 7,000,000 cap on the medical expense tax credit under Income Tax Act Article 59-4, so even a KRW 55 million out-of-pocket heavy-ion bill is fully creditable against income above 3% of salary at 15%.
- Proton / IMRT / SBRT (covered): special-case 5% self-pay for 5 years.
- Heavy-ion (non-covered): the 5% does not apply; the full self-pay stands.
- Tax credit: a registered severe-disease patient has no KRW 7,000,000 cap, so the heavy-ion out-of-pocket is fully creditable.
- Duration: 5 years from confirmation, re-registerable on recurrence.
Out-of-pocket ceiling, private indemnity, and the cancer-insurance radiation rider
The annual out-of-pocket ceiling refunds covered self-pay (including the 5% special-case amount) above the income-tier cap, which for 2026 is provisionally about KRW 900,000 to KRW 8,430,000 by income decile (finalized each August). It applies to covered radiation (proton, IMRT, SBRT) but NOT to the non-covered heavy-ion cost or upper-grade room surcharges.
For private indemnity (silson), covered radiation reimburses the covered self-pay after the generation-specific deductible. Heavy-ion therapy, however, is a new-technology non-covered service that most indemnity policies do NOT reimburse or heavily restrict, so the model treats heavy-ion silson reimbursement as zero. The practical safety net for the KRW 50-65 million heavy-ion bill is a fixed-benefit cancer-insurance radiation (or carbon-ion) rider, so confirm whether you hold such a rider and its limit.
- Ceiling: covered radiation only; heavy-ion and room surcharges are excluded.
- Private indemnity: reimburses covered radiation self-pay; heavy-ion is generally not reimbursed.
- Cancer-insurance radiation rider (fixed benefit): the main way to offset the heavy-ion out-of-pocket.
- Enter the rider amount to see the offset in the estimate.
Cost by cancer site
The site mainly drives the heavy-ion out-of-pocket. Prostate cancer was Korea’s first heavy-ion indication at about KRW 55 million (12 fractions) and can also be treated with covered proton or IMRT, so a cost-versus-benefit comparison matters. Early liver and lung tumors are often well treated with covered SBRT at a much lower burden, while heavy-ion (about KRW 50 million for liver) is considered when the tumor location or nearby-organ risk is high. Pancreatic cancer is the highest-cost and most technically demanding site at about KRW 65 million for heavy-ion, and is usually combined with surgery and chemotherapy.
Use the calculator to switch the modality and site and read the four-way modality comparison card: it shows, for the same site, how proton at 5% (around KRW 1.5 million) sits next to heavy-ion at 100% (around KRW 55 million), with IMRT and SBRT as the low-cost covered baselines.
How to read the result
Enter the modality (proton, heavy-ion, IMRT, or SBRT), the cancer site, special-case registration, an optional direct-input total (a hospital quote), and any other non-covered items (upper-grade room, special materials). Then set the health-insurance type, the indemnity generation, the cancer-insurance radiation rider amount, the income decile, and annual salary. The result shows the proton-covered-5% versus heavy-ion-non-covered-100% comparison, a four-way modality comparison, the ceiling refund (covered only), the private indemnity and rider estimate, the tax credit, and the final net cost.
This is a cost-planning estimate based on 2026 Korean rules, not medical advice. Public single-price tables for radiation therapy do not exist, so figures vary with the site, fraction count, materials, and hospital. Confirm coverage and cost with the radiation oncology team, the NHIS, and the insurer — especially whether proton is covered for your indication and whether your cancer-insurance rider covers heavy-ion.
This calculator is based on Korean rules (2026 National Health Insurance cancer special case at 5% for five years covering covered radiation, the out-of-pocket ceiling, and Income Tax Act Article 59-4 medical expense tax credit with no KRW 7,000,000 cap for registered severe-disease patients), plus market cost estimates for proton, heavy-ion (carbon-ion), IMRT/VMAT, and SBRT. Proton coverage is indication-specific and heavy-ion is currently fully non-covered, and most private indemnity plans do not reimburse heavy-ion therapy. Figures are planning estimates, not medical advice, an insurer decision, or a hospital quote.