If you are eligible for the national health checkup, you can receive the general checkup without any out-of-pocket costs. Depending on the type of cancer screening, there are those that are fully supported and those that pay a portion of the screening fee (usually 10%), and those who are eligible to receive medical benefits or are in the lower brackets of health insurance premiums are exempt from this.
The problem is an area that national screening does not cover. Below, we first summarize the range of services available for free, then explain what criteria to use when adding other checkups, and where to check the costs.
Summary
- General screening: Eligible recipients have no copayment. The standard cycle is once every two years for office workers and once a year for non-office workers.
- 6 Types of cancer screening: stomach, colon, liver, breast, cervix, lung. Cervical cancer and colon cancer are fully covered, and the rest is usually covered at 10%.
- Items not included in the national checkup (brain MRI, thyroid ultrasound, additional cost for stomach/colon sleep endoscopy, etc.) are not covered.
- Prices vary greatly from institution to institution, so prior inquiry is virtually essential.
1. National Health Screening — services provided without a copayment
1-1. General health checkup
Local subscribers, heads of household, employed subscribers, dependents over the age of 20, and Medical Aid beneficiaries between the ages of 19 and 64 are eligible. Since the National Health Insurance Corporation covers the cost, the recipient does not pay out-of-pocket costs at the examination facility.
The basic components include medical examination and measurements (height, weight, waist circumference, blood pressure), vision and hearing tests, chest X-ray, blood tests (hemoglobin, fasting blood sugar, lipids such as total cholesterol, liver function, kidney function), and urinalysis. Depending on age, additional tests such as dyslipidemia, bone density, hepatitis B antigen/antibody, depression screening, cognitive dysfunction test, and lifestyle evaluation are assigned.
The cycle is once every two years for office workers and once a year for non-office workers. Local subscribers and dependents are divided into odd-numbered years and even-numbered years based on the last digit of their year of birth.
1-2. Six types of national cancer screening
| Cancer type | Target age | Cycle | Copayment |
|---|---|---|---|
| Stomach cancer | Over 40 years old | 2 Years | Normally 10% |
| Colon cancer | Over 50 years old | 1 Year (fecal occult blood test) | None |
| Liver cancer | High-risk group over 40 years old | 6 Months | Normally 10% |
| Breast cancer | Women over 40 | 2 Years | Normally 10% |
| Cervical cancer | Women over 20 years old | 2 Years | None |
| Lung cancer | High-risk smokers aged 54 to 74 years | 2 Years | Normally 10% |
Medical Aid beneficiaries and those in the bottom 50% of health insurance premiums are exempt from out-of-pocket expenses. You can check which section you are in and what type of checkup you are eligible for this year by checking the health checkup target on the National Health Insurance Corporation website or The Health Insurance app, or by calling 1577-1000.
The first test for colon cancer is a fecal occult blood test. If a positive result is obtained, a colonoscopy is followed, and even if this follow-up test is performed within the national screening framework, additional costs are incurred if a biopsy or polyp resection is added.
2. Additional screening — where costs vary
Most items outside the national program are non-covered. Because each medical institution sets its own non-covered prices, there is a large difference between institutions for the same test.
| Item | Coverage status | How to check costs |
|---|---|---|
| Sedation for upper endoscopy | Non-covered (sedation costs) | Ask the screening center about the additional sedation fee. |
| Colonoscopy (for screening purposes) | Non-covered care | Check whether the bowel-preparation solution cost is included |
| Abdominal ultrasound | Not covered if there are no symptoms | Depends on liver, gallbladder, and kidney extent |
| Thyroid ultrasound | Non-covered care | Check whether it is included in your screening package |
| Cardiac ultrasound/Carotid artery ultrasound | Non-covered care | Considered when there are circulatory risk factors |
| Brain MRI/MRA | Non-covered care (coverage possible if symptoms exist) | Items with particularly large differences by institution |
| Low-dose chest CT | Lung cancer screening is not eligible or not covered | Check smoking history criteria |
You can compare prices by institution through the non-covered medical cost information disclosure service on the Health Insurance Review and Assessment Service website. Only registered items are displayed and may differ from the actual billed amount, but it is useful to get a rough estimate of the range.
3. Criteria for selecting items
Many people choose the most expensive package based only on its price, but the number of tests and their usefulness are not proportional. What really affects your judgment is your age, family history, smoking/drinking history, and any symptoms you have.
Especially if you have symptoms, it is better to seek a clinical evaluation rather than rely on screening. This is because tests performed based on symptoms can be treated as benefits, and are also recognized for treatment purposes from a Korean private indemnity insurance perspective. In the clinic, there are cases where an ultrasound is included in the checkup package after enduring a foreign body sensation in the throat or recurring nasal congestion for several months. If you have symptoms, it is better in terms of both cost and diagnostic accuracy to receive treatment appropriate for the symptoms first.
In the field of otolaryngology, only hearing tests are covered in national examinations. Symptoms such as a change in voice that lasts for more than two weeks, a muffled or blocked sensation in one ear, or difficulty swallowing are not filtered out as part of the examination, so if you have these symptoms, you should seek a separate clinical evaluation.
4. How to confirm screening costs
- Check which screening services you are eligible for this year on the National Health Insurance Corporation app and website.
- After deciding on a screening institution, list the items you wish to add in addition to the national screening.
- Call the screening center to confirm itemized non-covered care pricing and package inclusions
- If you are an employer-based subscriber, check with the general affairs department to see if the company-sponsored checkup and national checkup overlap.
- If you have Korean private indemnity health insurance, set your budget considering that tests for medical examination purposes are generally not covered by compensation.
Frequently Asked Questions
Q. What happens if I miss the target year for the national health checkup? A. In principle, if you do not receive it within the relevant year, it will not be carried over. However, if you are an employed subscriber and meet certain requirements, your coverage may be extended until the beginning of the following year, so please inquire with the National Health Insurance Corporation about your situation.
Q. Are company checkups and national checkups different? A. Many companies operate based on national health checkups and add non-covered care items. In this case, the general structure is that the corporation pays for the national checkup and the company pays for the additional cost. The actual configuration varies depending on the company contract, so it is best to check the scope of support first.
Q. Can private indemnity insurance reimburse health-screening costs? A. Checkups received for preventive or confirmatory purposes without symptoms are often excluded from compensation. However, if an abnormality is discovered during a checkup, the nature of the subsequent tests performed for diagnosis and treatment is different. Since individual decisions depend on the subscription product and terms and conditions, it is more accurate to inquire with the insurance company by citing the item name.
This article is general health information and is not a substitute for individual medical care. If symptoms persist or worsen, please seek treatment at a medical institution.