Private Insurance to Cover Dental, Piles Treatments

Private health insurance from next month will cover costs for dental and piles treatment and traditional Asian medicine. Also to be covered are geriatric injuries and diseases excluding dementia.

The Financial Supervisory Service said yesterday that a measure to standardize real cost coverage of health insurance involving these and other benefits will take effect Oct. 1.

An official said, “The measure is aimed at preventing people from buying multiple insurance policies from different companies by standardizing the scope of coverage that is different from company to company.”

Things covered by the public health insurance program, including traditional Asian medicine, piles (hemorrhoid) surgery and dental treatment, will be covered by private health insurance. Dental and piles treatment had been excluded from private coverage, while companies have had different coverage policies for traditional Asian medicine.

Private health insurance, however, will not pay for treatment not covered by public health insurance, such as dental implants. Urinary incontinence will not be covered by private insurance either because patients could buy an insurance policy while keeping their disease history under wraps and due to the difficulty in confirming such a condition.

The financial watchdog set the treatment cost an insurance policy holder must pay in case of hospitalization at two million won (1,600 dollars) per year. The coverage ceiling of private health insurance will decline to 90 percent of the treatment cost of a disease next month, and insurers will be able to pay the policyholder any amount over the two million won.

The maximum amount of hospitalization coverage of 100 million won (80,000 U.S. dollars) will be cut to 50 million won (40,000 dollars). The maximum amount of coverage for outpatient treatment will be 300,000 won (240 dollars), including medical checkup and drug costs.

Insurers can cover half of the hospital bed cost, which is paid according to the level of quality, up to 100,000 won (80 dollars) a day. They can cover the overseas treatment costs of a policyholder through special policy terms.

weappon@donga.com