Monthly Non-Covered Hospital-Level Medical Expenses Reach 750 Billion Won... Concentrated in Manual Therapy and Single-Person Room Charges

Ministry of Health and Welfare and National Health Insurance analyze 1,251 items from September 2025

Annualized total approaches 9 trillion won... Orthopedic non-covered charges reach 202.4 billion won

The total amount of non-covered medical expenses at hospital-level medical institutions nationwide has reached 750 billion won per month. The largest categories of non-covered expenses were premium single-person room charges, manual therapy, and dental implants, in that order.

The Ministry of Health and Welfare and the National Health Insurance Service released the results of their analysis on September 9, based on data from the "Second Half 2025 Non-Covered Expenses Reporting System," which examined treatment details from September of last year for 4,098 hospital-level medical institutions.

Non-covered expenses refer to items not reimbursed by health insurance, for which patients must bear 100% of the cost. To monitor the status of non-covered expenses, the government has implemented a reporting system since September 2023. In the first half of the year, all medical institutions, including local clinics, were surveyed for March treatment data, while in the second half, only hospital-level institutions (excluding clinics) were surveyed with September treatment data.

During September last year, the total medical expenses for 1,251 non-covered items at hospital-level medical institutions were 749.9 billion won, an increase of 63.5 billion won compared to 686.4 billion won in the first half (March). When simply annualized (multiplied by 12 months), this equates to about 9 trillion won (8.9986 trillion won) per year.

By type of medical institution, hospitals accounted for the highest amount at 312.2 billion won (41.6%), followed by general hospitals at 158.7 billion won (21.2%), tertiary hospitals at 108.4 billion won (14.5%), dental hospitals at 65.9 billion won (8.8%), and Korean medicine hospitals at 58 billion won (7.7%).

Among all non-covered items, the single-person room charge in premium wards was the largest at 56.1 billion won (7.5%). This was followed by manual therapy at 55.2 billion won (7.4%), dental implants (per tooth, zirconia) at 31.4 billion won (4.2%), soft tissue reconstructive materials at 28.1 billion won (3.8%), and other tumor therapies such as thymosin alpha-1 at 27.4 billion won (3.7%).

By field, non-covered expenses in western medicine (medical field) amounted to 657.7 billion won, representing 87.7% of the total. Dental expenses were 72.8 billion won (9.7%), while Korean medicine accounted for 19.4 billion won (2.6%).

In the medical field, the single-person room charge in premium wards was also highest at 56.1 billion won, followed by manual therapy at 55.2 billion won, soft tissue reconstructive materials at 28.1 billion won, thymosin alpha-1 at 27.4 billion won, and lumbar and sacral MRI scans at 25.4 billion won.

In dental services, dental implants (zirconia) accounted for 31.4 billion won or 43.2% of all non-covered dental expenses. Crowns (zirconia) followed at 16 billion won (22.0%), and orthodontics at 7.3 billion won (10.0%). The top three items accounted for 75.2% of all non-covered dental expenses.

In Korean medicine, herbal preparations and herbal pharmaceutical agents constituted the majority at 14.4 billion won (73.9%), followed by pharmacoacupuncture at 4.5 billion won (23.1%).

Non-covered orthopedic expenses reach 202.4 billion won, accounting for 27% of the total

By medical specialty, orthopedic surgery accounted for the largest amount of non-covered expenses at 202.4 billion won (27.0%). This was followed by neurosurgery at 100.5 billion won (13.4%), internal medicine at 81.6 billion won (10.9%), general surgery at 55.6 billion won (7.4%), and obstetrics and gynecology at 37.2 billion won (5.0%). The top 10 specialties comprised 81.1% of all non-covered medical expenses.

By principal disease, disorders of the musculoskeletal system and connective tissue accounted for 217.1 billion won (29.0%), followed by neoplasms at 123.2 billion won (16.4%), consequences of injury, poisoning, and certain other external causes at 93.8 billion won (12.5%), and digestive system diseases at 74.1 billion won (9.9%).

The average monthly non-covered medical expense per institution was 182.99 million won. This figure was highest at tertiary hospitals (2.30563 billion won), followed by general hospitals at 479.31 million won, dental hospitals at 268.84 million won, and hospitals at 225.28 million won.

Since July of this year, the Ministry of Health and Welfare has established fee schedules and treatment standards for manual therapy, one of the highest-cost non-covered items in the medical field, and now applies them as "managed covered" items. For extracorporeal shock wave therapy, the ministry has laid the groundwork for medical associations to voluntarily regulate non-covered treatment frequency, intervals, and indications. The government plans to continue monitoring managed covered and non-covered items and to expand the applicable items under managed coverage.

Jooheon Yoo, Director General of Health Insurance Policy at the Ministry of Health and Welfare, said, "We will continue to strengthen oversight and management of excessive non-covered items that burden people's healthcare costs beyond medical necessity. We will also expand the provision of non-covered information using reporting data to uphold the public's right to know."

This content was produced with the assistance of AI translation services.