Plan catheter quantities and quarterly costs under Korean health insurance
Intermittent self-catheterization supplies are a recurring household expense.
A small difference in the price of one catheter can become a meaningful amount when multiplied by daily use and the number of days in a quarter.
This calculator uses a clinician-confirmed daily quantity, actual prescriptions, NHIS registration information and a supplier quote to estimate planned purchases and the Korean medical-supply cash benefit, or yoyangbi.
The results distinguish the quantity counted for support, the unsupported quantity, estimated reimbursement and final household cost.
A catheter counted for support is still subject to the daily monetary ceiling; its entire price is not necessarily reimbursed.
This page covers recurring catheter purchases under South Korea’s verified 2026 rules.
Kidney or bladder cancer surgery, inpatient treatment and other medical bills require separate calculations.
Daily use is an input from your clinician
This is a Korea-specific budget tool, not medical advice or a recommendation about frequency, reuse or a particular catheter.
Follow the treating clinician’s prescription and instructions even when the cost estimate shows an unsupported quantity.
The calculator does not diagnose neurogenic bladder, determine registration eligibility or approve an NHIS claim.
Verified 2026 limits: KRW 9,000 and up to 6 catheters per day
Quantity ceiling
On an eligible day, the supported quantity is the smallest of daily use, the daily count on that prescription and 6.
For example, entering six daily purchases with a prescription for four counts only four for the benefit calculation.
The extra quantity remains in the household budget at full cost.
If actual use differs from the prescription, confirm the instructions with your clinician.
Monetary ceiling
Multiply the supported daily quantity by the actual unit price, then compare that amount with KRW 9,000.
The smaller amount becomes the daily benefit base.
KRW 9,000 is a daily total, so it must not be multiplied by the number of catheters again.
Dividing it by six also does not create a universal KRW 1,500 per-unit cap.
Standard Korean health insurance pays 90% of the eligible benefit base.
The confirmed reduced-copay NHIS category, identified as C/E/F, uses 100% within that base.
Even with this category, excess quantities and spending above the monetary ceiling may remain payable by the patient.
Do not select it merely because of cancer special-case status or an assumed welfare entitlement.
Korea’s separate Medical Aid system is outside this calculator’s scope.
A calendar quarter is different from a 90-day prescription
In 2026, Q1 contains 90 days, Q2 contains 91 days and Q3 and Q4 each contain 92 days.
The quarter is a household budgeting interval here, not a separate statutory quarterly allowance.
One self-catheterization prescription may cover no more than 90 days.
Check whether actual valid prescriptions cover the whole quarter before treating support as secured.
One 90-day prescription in Q4
Counting October 1 as day one, a 90-day prescription ends on December 29.
December 30 and 31 appear as a prescription gap until a further valid prescription is entered.
Add the next prescription when it has actually been issued and its conditions are confirmed.
An expected renewal should not be presented as an already secured benefit.
A prescription issued before the quarter contributes only its dates inside the selected quarter.
Overlapping prescriptions produce an error so that a day is not counted twice.
The model checks prescriptions, confirmed registration validity and excluded periods day by day.
Consequently, the number of eligible days can be smaller than the prescription duration.
Prepare the inputs and calculate the budget
- Select a 2026 quarter, enter clinician-confirmed daily use and copy an actual per-catheter quote from the registered supplier.
Keep delivery charges and other hygiene supplies outside the catheter unit price and budget for them separately.
- Enter NHIS registration status and the confirmed benefit start and end dates.
Do not infer retroactive registration or re-registration.
If there is no end limit, use the end of the budget year.
- Confirm the registered supplier, registered catheter product, valid prescriptions and purchase/submission conditions within prescription validity after registration.
Leave an unconfirmed condition unchecked to see the budget without assuming reimbursement.
- Copy each prescription’s issue date, duration of 1–90 days and prescribed daily count.
Up to four prescriptions can be entered for dates overlapping the quarter.
- Add periods NHIS confirms should be excluded from this calculation, such as days already claimed or overlapping inpatient benefits.
Review the quantity and cost breakdown and save the monthly plan and checklist as CSV.
If registration, supplier, product or purchase conditions remain unconfirmed, the calculator budgets support at zero.
This is a pending-confirmation budget, not an NHIS denial.
Empty or invalid dates, reversed ranges and overlapping prescriptions hide the financial results until the inputs are corrected.
The price defaults to zero; use your own quote or the explicitly fictional example button.
Benefit and out-of-pocket formulas
- Total planned quantity = quarter days × daily use
- Supported quantity on an eligible day = min(daily use, prescribed daily count, 6)
- Daily benefit base = min(supported quantity × actual unit price, KRW 9,000)
- Estimated reimbursement = sum of daily benefit bases × 90% or 100%
- Final out of pocket = total purchase cost − estimated reimbursement
An ineligible day has zero supported quantity.
The final household cost is split into the full cost of unsupported quantities, spending above the daily monetary cap for supported quantities, and the remaining copay within the benefit base.
This makes it easier to see whether the cost comes from price, timing, confirmation conditions or the daily count limit.
Estimated reimbursement is rounded to the nearest Korean won after applying the support percentage to the benefit base.
Monthly amounts use differences between rounded cumulative totals so the monthly figures reconcile to the quarter.
Actual NHIS claim units and rounding may differ; the final NHIS payment statement takes precedence.
No future reimbursement date or private-insurance recovery is predicted.
Fictional quotes for a 90-day quarter
These examples assume all registration, prescription and purchase conditions are satisfied for 90 days in Q1 2026, with the prescribed daily count at least as high as daily use.
The KRW 1,500 and KRW 2,000 prices are arithmetic examples, not market averages or product recommendations.
90-day catheter quantity and benefit comparisons, with amounts in KRW| Daily use / unit price / category | Supported units | Benefit (KRW) | Out of pocket (KRW) |
|---|
| 6 / 1,500 / standard | 540 | 729,000 | 81,000 |
| 6 / 2,000 / standard | 540 | 729,000 | 351,000 |
| 6 / 2,000 / reduced | 540 | 810,000 | 270,000 |
| 4 / 2,000 / standard | 360 | 648,000 | 72,000 |
| 8 / 1,500 / standard | 540 | 729,000 | 351,000 |
Six catheters a day at KRW 2,000 for 90 days cost KRW 1,080,000.
The daily ceiling produces a total benefit base of KRW 810,000; applying 90% gives KRW 729,000 in estimated support.
The KRW 351,000 household cost consists of KRW 270,000 above the monetary ceiling and KRW 81,000 copay within the base.
There are no unsupported quantities in this example.
Household planning scenarios
Registration begins during the quarter
Even when prescriptions cover the whole quarter, dates outside confirmed registration validity receive no support in the model.
Do not move the registration date earlier merely because retroactive registration might be possible.
Use the effective date confirmed by NHIS, then recalculate.
A renewal is needed at quarter end
Q4 has 92 days, so six daily catheters at KRW 1,500 produce 552 planned units.
With only the October 1 prescription for 90 days, the supported quantity is 540, the standard benefit is KRW 729,000 and household cost is KRW 99,000.
A further valid two-day prescription starting December 30 changes these to 552 supported units, KRW 745,200 support and KRW 82,800 out of pocket.
Use exceeds the count ceiling
If both prescribed and actual daily use are eight, the benefit calculation still counts at most six per day.
Clinical need and financial support are separate questions.
Do not reduce prescribed use or reuse a catheter because the calculator shows excess cost.
The reduced category uses a higher-price product
The 100% percentage applies to the eligible benefit base.
If the daily purchase cost for supported units exceeds KRW 9,000, the excess remains payable even under the reduced-copay category.
Enter the actual quote to estimate the cash needed.
Documents for registration, purchase and claiming
Confirm the combination of registered neurogenic-bladder patient status, a valid specialist prescription and a registered product purchased from a registered supplier.
A similar diagnosis or a purchase made before checking conditions does not automatically establish a benefit.
Ask the medical institution and NHIS about the patient-registration form, required examination evidence and any re-registration requirement.
- Confirmed patient registration and benefit-validity information, including necessary registration or re-registration documents
- A specialist-issued prescription for self-catheterization supplies
- The benefit claim and a tax invoice identifying the product, quantity and unit price
- Payment-account information and any required authorization for claiming on someone’s behalf
NHIS guidance mentions a claim period of three years from product purchase.
That does not permit purchasing outside the prescription’s validity period.
The prescribed form states that purchase and submission must be within its use period, from issue date through the prescription duration.
Check the procedure before buying, and confirm current rules for retaining originals, submitting copies, electronic claims and authorized supplier claims.
Excluded periods and limits of the estimate
Supplies duplicating benefits already provided during an inpatient stay require separate review.
The calculator does not automatically exclude every hospital day; enter the dates NHIS confirms must be excluded for your claim.
Overlapping exclusion ranges count each day only once.
The model does not transfer an unused daily ceiling to another day or duplicate the same quantity across claims.
Buying supplies while abroad can affect eligibility for that purchase itself.
Do not merely subtract travel dates and assume the remaining purchased quantity qualifies.
Clear the purchase-condition confirmation and ask NHIS about the transaction.
Previously claimed dates should likewise be checked before preparing another claim.
Daily use and unit price are assumed constant within the quarter.
If the product, price or use changes, separate the purchase records and review them individually.
Shipping, additional hygiene supplies, consultations, private-insurance recoveries and tax credits are not automatically added.
Also review the gross purchase cost: the eventual net burden does not establish how much cash is needed before reimbursement arrives.
Frequently asked questions
Should I multiply KRW 9,000 by daily quantity?
No.
KRW 9,000 is the daily monetary ceiling, compared with the purchase cost of the supported daily quantity.
It is not a per-catheter allowance.
Does using four per day impose a KRW 1,500 unit cap?
The daily amount and count ceilings are applied separately.
Four eligible catheters at KRW 2,000 each create an KRW 8,000 daily benefit base, below KRW 9,000, and KRW 7,200 standard support.
Does the reduced category always mean zero cost?
No.
It pays 100% of the eligible benefit base.
Unsupported quantities and cost above the monetary ceiling remain in the household budget.
Is one 90-day prescription enough for any quarter?
The 2026 quarters contain 90, 91 or 92 days.
Check actual prescription end dates and further valid prescriptions, counting only their overlap with the quarter.
Why is support zero while registration is pending?
Unconfirmed support is not included in the budget.
This is not a denial; update confirmed registration dates and purchase conditions after checking with NHIS.
Can I combine remaining quantities from overlapping prescriptions?
The same date is not counted twice.
Confirm canceled or changed prescriptions and the actual recognized periods with the medical institution or NHIS before entering them.
How should hospital stays or overseas travel be entered?
Use NHIS-confirmed exclusion dates for overlapping inpatient benefits.
An overseas purchase can be excluded as a transaction, so do not simply deduct travel days without confirming purchase eligibility.
Can I claim directly or reduce use based on these results?
The table helps plan purchases and prepare documents.
NHIS makes the final payment decision, and the cost result should not change the clinician’s prescription or use instructions.
Official sources and rule dates
The current Korean National Health Insurance Act Article 49, Enforcement Rule Article 23 and medical-expense benefit notice were checked directly through the National Law Information OPEN API on September 10, 2026.
The Act, MST 276651, is effective January 2, 2026, and the Enforcement Rule, MST 288087, is effective August 11, 2026.
MOHW Notice No. 2026-93 was issued April 23, 2026 and took effect May 1, 2026; its administrative-rule serial is 2100000278136.
Notice Articles 5, 7 and 8, Annexes 5 and 6 and prescription Form 1 were cross-checked against NHIS catheter-supply guidance.
This calculator applies that current rule version to 2026 budget scenarios, rather than recreating a historical adjudication or promising the same rules for a future year.
After an amendment, recheck the daily amount, count ceiling, support percentages, prescription duration and registration/submission conditions together.
Save the quarter plan alongside your prescription and quote
Review supported and unsupported quantities together with monthly purchases, estimated reimbursement and final household cost.
The CSV includes registration, prescriptions, exclusions, confirmation conditions, assumptions and the document checklist, so the basis of the estimate remains visible when you discuss it with family.
Before buying, confirm products and purchase conditions with the registered supplier and registration validity and claim documents with NHIS.