Deliberation and Resolution on Improvement Measures for Benefit Standards at the Health Insurance Policy Deliberation Committee
Strengthening Health Insurance Support for Healthy Pregnancy and Childbirth
The government will support continuous glucose monitors that provide real-time blood sugar levels to diabetic patients who need blood sugar management during pregnancy. The support for infertility treatments, which was previously limited to 25 times per infertile couple, will be expanded to 25 times per childbirth.
On the 26th, the Ministry of Health and Welfare held the '19th Health Insurance Policy Deliberation Committee Meeting of 2024' and announced that it reviewed and approved these improvement measures to support healthy pregnancy and childbirth processes for couples wishing to have children through health insurance.
First, to help diabetic patients during pregnancy give birth to healthy babies through proper blood sugar management, continuous glucose monitors (continuous glucose monitoring electrodes) that provide real-time blood sugar levels will be newly supported. Until now, continuous glucose monitors were supported only for type 1 diabetic patients who require insulin administration due to the pancreas not secreting insulin, but from now on, they will also be supported for pregnant women who must administer insulin due to difficulty controlling blood sugar.
The standard amount for continuous glucose monitors will be 10,000 KRW per day, the same level as for adult type 1 diabetic patients, with a 70% burden rate by the National Health Insurance Service (100% support for low-income groups). The support period will be up to 15 days from the expected delivery date. Insurance coverage for continuous glucose monitors is expected to be implemented after revising related notifications, starting from November.
The Ministry of Health and Welfare said, "We expect this to help prevent diabetic complications and enable pregnant women to give birth to healthy fetuses."
As a follow-up measure to the 'Measures to Reverse the Low Birthrate Trend' announced in June, support for infertility treatments will also be expanded.
Currently, the insurance coverage standard for infertility treatments is limited to a total of 25 times per infertile couple (5 times for artificial insemination, 20 times for in vitro fertilization), and even if pregnancy and childbirth are successful through infertility treatments, no additional opportunities are provided for subsequent pregnancies. Starting in November, couples who want to have more children after pregnancy and childbirth through infertility treatments will have all previously received support counts deducted, and will be newly granted 25 opportunities.
Regardless of individual health status, the out-of-pocket rate for infertility treatments, which currently imposes 50% on those aged 45 and older, will be improved to 30% for all ages.
Earlier, to actively support couples who want to have children in the era of low birthrate, the government exempted out-of-pocket expenses for inpatient treatment of newborns and children under 2 years old starting from January this year. In addition, the pregnancy and childbirth medical expense voucher for multiple births (twins or more) was expanded from 1.4 million KRW to 1 million KRW per fetus.
In June, the government included anti-nausea and vomiting medications for pregnancy, which had been distributed as non-covered items, under insurance coverage, and plans to promote health insurance coverage for non-covered drugs needed for infertility treatments in the future.
Currently, the out-of-pocket rate for natural delivery is 0%, and for cesarean section surgery is 5%, but starting next year, all out-of-pocket expenses will be waived.
A Ministry of Health and Welfare official said, "We will actively support people in various ways so that they can have as many children as they want without burden regarding pregnancy and childbirth."
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