[2026 National Assembly Audit] Catastrophic Health Expense Budget 94% Spent... Support Takes 84 Days to Arrive

Just 7.5 billion won remains in this year's budget
Some applicants waited as long as 455 days after applying

Concerns have been raised that the Catastrophic Health Expense Support Program, which assists low-income households facing financial hardship due to excessive medical expenses, is failing to fulfill its purpose because its budget is being depleted early and payments are delayed. The average time to receive support has risen to 84 days this year, nearly four times the 2023 figure, and some applicants have waited more than a year.

According to data submitted by the National Health Insurance Service (NHIS) to Rep. Nam In-soon of the Democratic Party of Korea, a member of the National Assembly’s Health and Welfare Committee, 141 billion won, or 94%, of this year’s 148.5 billion won budget for the Catastrophic Health Expense Support Program had already been spent by September. Just 7.5 billion won remains. The NHIS plans to allocate an additional 83.1 billion won in the fourth quarter through sources including the Lottery Fund and health insurance contributions.

The program’s main budget has been depleted early, forcing additional allocations at the end of each year. The budget was increased by 7.7 billion won in 2023, 27.1 billion won in 2024, and 60 billion won in 2025. Rep. Nam said the government underestimated the main budget because it failed to adequately forecast the rise in applications following the easing of eligibility criteria and expansion of covered diseases.

In addition to budget shortfalls, delays in support payments are worsening. The average time from applying for medical expense support to receiving payment rose from 21.3 days in 2023 to 35.4 days in 2025, reaching 83.7 days as of the end of August this year. Applications surged 38.9% year over year during the same period, and the budget shortfall has compounded the problem, with applicants now waiting more than 80 days on average to receive support. In one case, it took as long as 455 days from application to payment.

“Catastrophic medical expense support is an emergency social safety net that should be provided promptly to low-income households facing financial crises due to excessive medical expenses,” Rep. Nam said. “If it takes nearly three months to receive payment, patients and their families have no choice but to take on debt to cover their high medical bills, seriously undermining the purpose of the program.”

She added, “The government and the NHIS should stop relying on temporary budget increases that recur every year and set a realistic main budget based on precise demand forecasts. They should also overhaul the payment system so that support is provided immediately after approval, and reasonably restructure how funding for non-covered medical services is shared between health insurance funds and the national treasury.”

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