Last Change:
08/18/2025
Enforcement Decree of the National Health Insurance Act
Original names of the law: 국민건강보험법 시행령
Year: 2000
Type: Domestic law
Rights Category: Health
Selected provisions
(1) Additional benefits prescribed in Article 50 of the Act mean medical expenses for pregnancy and delivery (including miscarriage and stillbirth; hereinafter the same shall apply). <Amended on Sep. 19, 2017>
(2) A person eligible for the medical expenses for pregnancy and delivery prescribed in paragraph (1) shall be as follows: <Amended on Dec. 24, 2018; Jun. 29, 2021>
1. An insured person who is pregnant or gave birth to a baby, or her dependents;
2. Legal representative (limited to where the insured person gave birth to a baby or her dependents died) of the insured or his or her dependents under two years of age (hereinafter referred to as "infants and young children under two years of age").
(3) The NHIS may issue a person falling under any subparagraph of paragraph (2) with treatment coupons for medical expenses for pregnancy and delivery which can be used to pay any of the following expenses: <Amended on Dec. 24, 2018; Jun. 2, 2021; Jun. 29, 2021>
1. Expenses incurred in relation to medical treatment related to an insured person who is pregnant or gave birth to a baby;
2. Expenses incurred in purchasing medicines or materials for medical treatment for an insured person who is pregnant or gave birth to a baby or her dependents;
3. Expenses incurred in relation to medical treatment for infants and young children under two years of age;
4. Expenses incurred in purchasing medicines or materials for medical treatment prescribed for infants and young children under two years of age.
(4) A person who intends to be issued with treatment coupons (hereafter in this Article referred to as "applicant") shall submit an application for issuance prescribed by Ordinance of the Ministry of Health and Welfare, along with a certificate verifying that the applicant falls under any subparagraph of paragraph (2). <Amended on Dec. 24, 2018>
(5) Upon receipt of an application for issuance of treatment coupons prescribed in paragraph (4), the NHIS shall issue the applicant with the coupons after verifying that he or she falls under any subparagraph of paragraph (2). <Amended on Dec. 24, 2018>
(6) The period of using treatment coupons shall be from the date of being issued with the treatment coupons pursuant to paragraph (5) until any of the following days: <Amended on Dec. 24, 2018; Jun. 29, 2021>
1. The insured who is pregnant or gave birth to a baby, or her dependents: A date when two years have elapsed from the date of childbirth (in cases of miscarriage and stillbirth, the relevant date);
2. Legal representative of infants and young children under two years of age: A date when two years have elapsed from the date of birth of infants and young children under two years of age.
(7) The upper limit of payable amount of a treatment coupon shall be as follows: Provided, That if deemed necessary and publicly notified by the Minister of Health and Welfare, the payable amount may exceed the following upper limits: <Amended on Dec. 24, 2018; Jun. 29, 2021>
1. In cases of being pregnant with or giving birth to a fetus: 1 million won;
2. In cases of being pregnant with or giving birth to at least two fetuses: 1.4 million won.
(8) Except as provided in paragraphs (2) through (7), matters necessary for the procedures for and methods of the payment of the medical expenses for pregnancy and delivery, the issuance and use of treatment coupons, and other relevant matters shall be prescribed by Ordinance of the Ministry of Health and Welfare. <Amended on Jun. 30, 2016>