From Next Year, Zero Out-of-Pocket Cost for Cesarean Deliveries

Resolution on Partial Amendment to the Enforcement Decree of the National Health Insurance Act
Free Coverage Extended to Both Natural Birth and Cesarean Section

Starting next year, the out-of-pocket expenses for cesarean section deliveries will be waived. Until now, only natural births were exempt from out-of-pocket costs, while cesarean sections required a 5% payment. However, going forward, out-of-pocket expenses will be free regardless of the delivery method.

On the 3rd, the Ministry of Health and Welfare approved a partial amendment to the Enforcement Decree of the National Health Insurance Act at the Cabinet meeting, which includes this provision.

The proportion of cesarean section deliveries has exceeded half of all deliveries since 2019 and has been increasing annually. Last year, out of approximately 227,000 deliveries, about 81,000 (35.7%) were natural births, and 146,000 (64.3%) were cesarean sections.

Until now, natural births did not require patients to pay out-of-pocket medical fees, whereas cesarean section deliveries required patients to pay 5% of the total medical benefit costs.

However, reflecting the need for practical support for couples who wish to conceive and give birth, the Low Fertility and Aging Society Committee established and announced the "Measures to Reverse the Low Birthrate Trend" in June. Accordingly, as one of the follow-up measures, the government amended the enforcement decree to waive the 5% out-of-pocket fee for cesarean section deliveries starting January 1, 2025, making it free just like natural births.

As a result, regardless of the delivery method, mothers will be exempt from hospitalization fees, delivery fees, medication costs, and anesthesia fees for painless delivery. However, mothers will still be responsible for fees related to the use of premium hospital rooms and non-covered items.

Lee Jung-kyu, Director of the Health Insurance Policy Bureau at the Ministry of Health and Welfare, stated, "This amendment reflects the reality of the high number of cesarean deliveries and the urgent need for groundbreaking support for parents who want children," adding, "We hope this will help reverse the low birthrate by creating a healthy childbirth and parenting environment."

At the same Cabinet meeting, the authority of the branch offices of the Health Insurance Review and Assessment Service (HIRA) was also expanded. Previously, to report or confirm the status and changes of medical institution facilities, equipment, and personnel under the National Health Insurance Act, or to verify whether costs borne by subscribers and dependents beyond their out-of-pocket payments were excluded from medical benefits, one had to report or request confirmation at HIRA headquarters. Going forward, these civil service tasks can be handled at nearby HIRA branch offices, improving accessibility and convenience for citizens.