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No symptoms medical insurance will not reimburse? Controversy over pricing of nucleic acid testing in Korean community hospitals

As the new crown epidemic continues to spread, the South Korean government has changed its epidemic prevention system, and community hospitals can also conduct new crown rapid antigen testing and treatment earlier this month. But recently, some people said that the test cost was only 5,000 won (about 27 yuan), while some people were tested at 10 times the price of the former, costing 50,000 won. This situation has sparked controversy among South Koreans, who believe that the pricing of tests is chaotic. So how much does a rapid controversy antigen test cost at a Korean community hospital?

The Ministry of Health and Welfare of South Korea held a meeting of the Health Insurance Policy Review Committee on the 28th of last month and decided that part of the testing costs of suspected new crown cases can be temporarily reimbursed by medical insurance. According to regulations, suspected cases of the new crown only need to pay part of the inspection fee to receive a rapid antigen test at a nearby hospital.

The approved rapid antigen test fee standard is 55,920 won (about 300 yuan), including a single diagnosis and treatment fee (16,970 won), testing fee (17,260 won), and prevention management fee (21,690 won). Among them, the patient himself needs to bear 30% of the cost of a single diagnosis and treatment, that is, about 5,000 won and the rest of the cost is covered by medical insurance reimbursement and the state’s burden. If you go to a general hospital where the cost of medical treatment is relatively expensive, the cost you need to bear is about 10,000 won. However, medical insurance reimbursement is limited to cases with suspected symptoms such as fever and cough, or asymptomatic cases deemed necessary by doctors after diagnosis and treatment. In addition, if it is used to issue an epidemic prevention pass (vaccination certificate, nucleic acid negative certificate), medical insurance is also available.

This means that in the absence of symptoms if you want to go to the hospital for a rapid antigen test, you will not be able to enjoy medical insurance reimbursement, and the cost will be borne by yourself. Because the medical expenses that cannot be reimbursed by medical insurance can be priced by the hospital itself, and the testing prices of major hospitals are also different, but if it applies to medical insurance, the total cost is basically about 55,920 won. It is understood that most hospitals set the total cost of testing for asymptomatic patients at 50,000 to 70,000 won.

For this situation, many asymptomatic people who paid high prices for testing expressed dissatisfaction. Li Chung-kyu, chief of the insurance fund section of the Ministry of Health and Welfare, said that the criteria for judging whether or not to be eligible for medical insurance reimbursement for other types of disease testing are similar. From 2018, the cranial magnetic resonance (MRI) test in South Korea can be covered by medical insurance, but it is only applicable to the case of headache or other symptoms, and the doctor thinks that he should receive the cranial MRI test, otherwise the MRI fee must be fully paid by himself.

South Korea’s epidemic prevention department said that for those who have no symptoms but want to confirm whether they are infected with the new crown virus, it is recommended that people use a new crown test kit for testing, or go to a virus screening station for free testing. However, for those who have not received the new crown vaccine or have not completed the whole process of the new crown vaccine, if they receive the new crown rapid antigen test to obtain the epidemic prevention pass, they can enjoy medical insurance reimbursement treatment.

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