Ministry of Health and Welfare: "High-Cost MRI Exams Covered by Insurance Only When Abnormal Findings Are Present"

Vice Minister of Health and Welfare Appears on KBS Radio's 'Choi Kyung-young's Strongest Current Affairs'
Health Insurance Coverage for MRI and Ultrasound Based on 'Medical Necessity'

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[Asia Economy Reporter Yoon Seul-gi] The government’s decision to implement musculoskeletal ultrasound and magnetic resonance imaging (MRI) with medical validity reviewed and limited as part of health insurance financial efficiency measures has raised concerns that medical benefits may be reduced. In response, Park Min-su, the 2nd Vice Minister of the Ministry of Health and Welfare, emphasized that health insurance coverage will be applied according to medical necessity, stating, "It does not practically reduce benefits."

On the 9th, Park Min-su appeared on KBS Radio's 'Choi Kyung-young's Strong Current Affairs' and explained the 'Measures to Enhance the Sustainability of Health Insurance' announced by the government the previous day, saying, "It is about fixing the leaks and making it stronger."

He continued, "To briefly explain the announcement made yesterday, the first is benefit management. For example, in cases like brain or cerebrovascular MRI, there were instances where tests were conducted despite low medical necessity," adding, "We plan to strengthen the criteria for such cases and use them only when absolutely necessary."

He also said, "Cases of improper use regarding health insurance eligibility criteria for foreigners or overseas Koreans have been found, and we will improve these areas," and "Third, we will improve the system to enable rational medical use, and finally, we will operate a reporting center to improve management and operation."

The government stated that it will clarify the criteria for judging medical necessity to reduce confusion in the field regarding musculoskeletal ultrasound and MRI benefit issues.

Vice Minister Park explained with an example, "There have been cases where an MRI was taken even though neurological examinations showed no abnormal findings despite headaches or dizziness," adding, "This was a case of taking an MRI just because of pain, but since MRI is a very expensive test, we plan to improve the system so that health insurance coverage applies only when neurological examinations show suspicious findings."

Regarding concerns that personal expenses might increase, he said that it will be managed through partial adjustment of the personal burden rate. Vice Minister Park stated, "If fees are raised, personal expenses may also increase partially," and added, "As compensation in essential medical fields is strengthened, patients’ burdens may increase, but we will carefully manage this by partially adjusting the personal burden rate so that there is no significant change in the personal burden itself."

Furthermore, Vice Minister Park added, "Although the government announced the measures this time, this is not the end," and "We will continue to create and announce structural and fundamental system improvement measures in the future."