This report aims to provide in-depth understanding of the current state of the Private Health Insurance (hereinafter referred to as PHI) businesses in Korea. The market size, health plan types, and coverage developments are discussed as well as business strategy recommendations for medical device and pharmaceutical product manufacturers/importers to consider.
Table of Contents
Glossary of Key Terms and ConceptsDisclaimer
Preface
Executive Summary
1 Understanding Private Indemnity Health Insurance
1.1 PHI Types
1.2 Payment Methods
1.2.1 Supporting Documents for PHI Claims
1.3 Structural Issues
2 Market Overview
2.1 NHIS Reimbursement Volume
2.1.1 NHIS Medical Expenses and Coverage Rates
2.2 Market Size of PHI
2.2.1 Number of Current PHI Contracts and Premium Revenues
2.2.2 Number of New PHI Contracts
3 Changes in PHI Coverage
3.1 Changes in NHIS Reimbursement Coverage
3.2 Changes in PHI Benefits not Covered
3.2.1 Special Cases Designated as Critical Illness
3.2.2 Out-of-Pocket Maximums
3.2.3 Long-term Care Insurance for Seniors
4 Overtreatments & Claims of Non-Reimbursement Procedures
4.1 Manual Therapy
4.2 Extracorporeal Shock Wave Therapy
4.3 Prolotherapy
4.4 Magnetic Resonance Imaging (MRI) Diagnostics
4.5 Cataract Surgery
4.6 HIFU (High Intensity Focused Ultrasound) Therapy
4.7 Nasal Valve Repair
4.8 Vacuum Assisted Breast Biopsy
4.9 Varicose Vein Surgery
4.10 Thyroid Radiofrequency Ablation
4.11 MD Creams
4.12 Likely Scenario for Strengthening Review Criteria
5 Business Strategy Suggestions for Leveraging PHI
5.1 Therapeutic Material Pricing and Eligibility for PHI
5.2 Pharmaceutical Product Pricing and Eligibility for PHI
5.3 Conclusion
Methodology
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