Compare Korean cast, pin and plate quotes, upfront medical funds and net costs after confirmed indemnity and fixed injury benefits under 2026 rules.
Use one insurer-confirmed deductible unit, such as one admission or one outpatient visit. Do not pool multiple visits or multiply benefits by the number of indemnity policies. A zero remaining limit produces zero reimbursement.
20% is the ordinary inpatient covered planning default. Use actual payment for meals, differently rated rooms, selective benefits and reduced copays.
Cast-only care has zero surgery benefit in this tool. Verify any separate cast-treatment rider with your insurer.
20% is the ordinary inpatient covered planning default. Use actual payment for meals, differently rated rooms, selective benefits and reduced copays.
Pins or plates do not automatically determine surgery classification or rider entitlement. Verify the operative certificate against the policy.
20% is the ordinary inpatient covered planning default. Use actual payment for meals, differently rated rooms, selective benefits and reduced copays.
Pins or plates do not automatically determine surgery classification or rider entitlement. Verify the operative certificate against the policy.
A clinician determines whether and when removal is appropriate. This budget is added separately and never included in the current claim base.
Hardware removal cost calculator →These are alternative quotes. Costs and benefits do not determine the appropriate treatment. Unknown coverage differs from a confirmed zero benefit; the final balance remains pending.
★ Upfront patient medical cost
Pending confirmation
Signed net cost after benefits
Pending confirmation
Pending: Provider quote, Indemnity coverage, Fracture diagnosis benefit
★ Upfront patient medical cost
Pending confirmation
Signed net cost after benefits
Pending confirmation
Pending: Provider quote, Indemnity coverage, Fracture diagnosis benefit, Procedure-specific surgery rider
★ Upfront patient medical cost
Pending confirmation
Signed net cost after benefits
Pending confirmation
Pending: Provider quote, Indemnity coverage, Fracture diagnosis benefit, Procedure-specific surgery rider
Checks stay only on this screen. Checking a box or saving the report does not submit a claim. Commercial Act Article 662 provides a three-year limitation for insurance benefit claims; confirm the individual starting point and limitation issues.
Official sources checked: 2026-10-04. Recheck prices, procedure classification, policy generation, riders and payment timing with your provider and insurer.
After a fall, a distal-radius wrist fracture or an ankle malleolar fracture can create both a hospital payment and an insurance paperwork task.
This calculator organizes treatment quotes already discussed with your clinician, separating upfront medical funds from later insurance recovery.
It uses South Korean health insurance and injury-policy context verified for 2026, with every amount in KRW.
It does not diagnose a fracture, choose a treatment, predict recovery or decide insurance entitlement.
Patients scheduled for fixation and family members organizing a quote can compare confirmed patient charges and prepare claim documents.
Distinguish primary wrist or ankle fixation from carpal-tunnel or finger procedures and from a later operation to remove existing hardware.
The latter has a separate calculator linked from the input screen.
Enter the complete cast-care quote explained by the provider.
The surgery benefit is zero for cast-only care in this tool.
Ask the insurer separately about any cast-treatment rider.
Enter the quoted reduction and pin-fixation costs.
A treatment name does not establish a policy surgery category.
Confirm the actual procedure and rider requirements with the insurer.
Enter the open-reduction and internal plate-fixation quote.
The calculator does not multiply prices or benefits by the number of plates or screws.
Enter only the rider total confirmed for that procedure.
Leave unquoted alternatives unconfirmed.
These three rows are alternatives for comparison, so their costs are not added into one treatment bill.
A cheaper or better-insured option is not a clinical recommendation.
Covered gross includes both the patient share and the National Health Insurance Service share.
Do not enter an already-calculated copay as gross and apply the percentage again.
If the provider has calculated your covered patient payment, use actual-copay mode.
Enter the full patient cost of provider-disclosed non-covered materials and room charges.
Additional medical costs are already-calculated patient amounts, such as meal, testing or follow-up charges that are absent from the other inputs.
Remove duplicates and note that additional medical costs are not automatically included in either indemnity reimbursement base.
20% is an ordinary inpatient covered planning default.
Outpatient care, meals, differently rated rooms, selective benefits and reduced copays require different treatment.
For a mixed-rate quote, the provider-confirmed actual covered copay is clearer than applying one percentage to every line.
The KRW 100,000,000 amount bounds and 365-day bounds are input-validation limits, not statutory insurance limits.
Indemnity insurance does not automatically refund every patient charge.
Confirm enrollment, renewal or conversion terms, covered treatments, non-covered riders, room provisions, minimum deductibles and remaining limits with your policy and insurer.
The tool does not infer a policy generation or apply one set of percentages to every product available in 2026.
The covered reimbursement base is the eligible part of the patient copay, not the gross covered charge.
It cannot exceed that copay.
The non-covered reimbursement base cannot exceed the entered non-covered charge; remove excluded materials or room costs.
If you hold multiple indemnity contracts, check proportional settlement instead of multiplying reimbursement by policy count.
Maximum mode subtracts the larger of the percentage deductible and the minimum deductible.
Select sum mode only if the insurer confirms that the policy adds the two deductions.
A zero remaining limit means zero reimbursement, not unlimited coverage.
Enter a single insurer-confirmed deductible unit, such as one admission or one outpatient visit; pooling several outpatient visits may change the deduction.
Confirm that the accident and diagnosis qualify under your fracture rider, then enter the payable total.
Neither the diagnosis label nor the anatomical site automatically sets a benefit.
Check multiple sites, repeat claims for the same event and differences between insured amounts and payable amounts.
Verify each pin or plate scenario against the actual procedure, policy surgery definition and event coverage.
Add only riders that may actually pay together, taking account of restrictions on simultaneous benefits.
The cast row excludes surgery benefits but can still include a confirmed diagnosis benefit and qualifying admission daily benefits.
Subtract policy-excluded days from the confirmed admission length, cap by the remaining maximum payable days, then multiply by the confirmed daily amount.
Five admission days, two excluded days and two remaining payable days produce two paid days.
Outpatient scenarios have zero admission daily benefit; the insurer determines admission recognition and day counting.
Upfront medical cost = covered patient copay + non-covered charge + additional medical charges.
In percentage mode, covered copay = covered gross × copay percentage, rounded to the nearest KRW.
Reimbursement per category = min(remaining limit, max(0, eligible patient base − deductible)).
Add covered and non-covered reimbursement to get the indemnity total.
Provider billing rounding may differ; use actual-copay mode when the precise amount is known.
Fixed benefits = diagnosis benefit + procedure-specific surgery benefit + daily amount × min(remaining payable days, max(0, admission days − excluded days)).
Signed net cost = upfront medical cost − indemnity − fixed benefits.
Confirmed fixed benefits may pay separately from indemnity, so the balance is allowed to be negative.
A negative balance is labeled as benefits exceeding medical costs; it is a planning result, not a payment approval.
The example button fills only the plate quote and leaves alternative prices unknown.
Covered gross KRW 3,000,000 × 20% gives KRW 600,000 copay; adding KRW 400,000 non-covered charges gives KRW 1,000,000 medical cost.
Both patient amounts are assumed fully eligible, with zero minimum deductibles and KRW 10,000,000 remaining limits in each category.
20% / 30% are fourth-generation indemnity example assumptions from the FSC guidance, not universal 2026 policy rates.
A 20% deductible on KRW 600,000 leaves KRW 480,000 covered reimbursement.
A 30% deductible on KRW 400,000 leaves KRW 280,000 non-covered reimbursement.
The total is KRW 760,000.
Diagnosis KRW 300,000 plus surgery KRW 500,000 plus daily KRW 30,000 × 5 days = KRW 150,000 gives KRW 950,000.
Zero excluded days and 180 remaining payable days are fictional policy assumptions.
These amounts are not standard rider benefits or enrollment recommendations.
Total benefits KRW 1,710,000 subtracted from medical cost KRW 1,000,000 give a signed balance of KRW −710,000.
Benefits exceed medical costs by KRW 710,000, while the upfront provider payment still needs funding.
Excluding indemnity from the same example leaves KRW 50,000 net cost.
Commercial Act Article 662 provides a three-year limitation period for insurance benefit claims.
The calculator does not determine the starting point, interruption or expiry in an individual case.
For an older accident or disputed claim, confirm the applicable timing and evidence separately.
If the provider must be paid before reimbursement arrives, secure the upfront medical funds first.
If your clinician discusses later removal, enter a separately verified net removal budget from the hardware-removal calculator.
It is added to the final budget and never included in current claim bases.
An unconfirmed quote or relevant coverage status keeps the final number pending.
A provider-confirmed zero quote can be entered as zero with its confirmation checked.
Excluded coverage, exhausted limits and 100% deductibles are genuine zero-recovery conditions.
Medical tax credits, NHIS annual copay-cap refunds, workers’ compensation, automobile insurance, disability benefits, lost income, caregiving and travel are not automatically reflected.
Check exclusions and category-specific limits of newer indemnity products and riders against your actual policy.
For claims that cannot be represented as one deductible unit, organize a separate settlement using the insurer’s calculation.
No.
The site organizes your quote and does not multiply prices or benefits.
Enter the actual provider estimate for that site.
The cast row has zero surgery benefit in this tool.
Verify separate cast-treatment riders with the insurer; diagnosis and qualifying admission daily benefits remain separate.
A treatment name does not automatically assign a policy surgery category.
Compare the actual certificate and operative record with the policy definition.
Use separate amounts if both are confirmed payable under the policy.
Account for restrictions on simultaneous benefits and do not multiply indemnity by contract count.
It means planned benefits exceed medical costs.
Insurer review and payment timing are separate, and upfront provider funds still need to be prepared.
If the deductible applies to each visit, pooling visits changes the result.
Use one insurer-confirmed deductible unit and settle the overall claim separately.
No.
The separate net removal budget is added only to the final budget.
A clinician determines whether and when removal is appropriate.
No.
Checks stay on this screen and are not sent to the insurer.
Verify the actual reference and payment, and keep a TXT or printed report if needed.
Official evidence was checked on 2026-10-04.
The current texts verified were National Health Insurance Act Article 44, effective 2026-01-02; Enforcement Decree Article 19, effective 2026-10-01; and Commercial Act Article 662, effective 2026-09-10.
The ordinary inpatient 20% in Annex 2 was cross-checked against current HIRA guidance; future Annex 2 provisions dated 2027-01-01 in the API document are not automatically applied to 2026.
Recheck provider prices and actual policy terms whenever a quote, policy or benefit statement changes.
Confirm medical charges, then ask the insurer about eligible bases, deductions, limits and surgery classification.
Save the report with its assumptions and prepare diagnosis, surgery and billing documents as requested.
Confirm actual claim submission and payment directly with the insurer.