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Emergency Referral
Overview of Emergency Referral
In the event of an unforeseen accident or other urgent condition where immediate treatment is necessary to preserve life or prevent serious complications, patients may receive care through the emergency room of a medical institution in accordance with Article 3 of the Medical Service Act and subsequently apply for reimbursement of the medical expenses.
Eligible Persons : Government-funded beneficiaries
How to Request Emergency Treatment
Unless there are unavoidable reasons, the patient or their guardian must notify the relevant Regional Office of Patriots and Veterans Affairs within 14 days from the date of the emergency room visit. If the emergency hospitalization is expected to exceed 14 days, an extension request may be submitted to the relevant Regional Office of Patriots and Veterans Affairs within the same period.
Not Covered Medical Expenses
- 01Medical expenses not classified as emergency treatment
- 02Arbitrary non-covered medical expenses not specified under the Standards for National Health Insurance Benefits
- 03All costs related to the donor incurred during long-term organ transplant surgery
- 04Room rate difference for using a higher-level hospital room (coverage limited to 7 days when the standard room is unavailable; excludes special/private rooms)
- 05Items classified as non-covered under Article 9, Paragraph 1 of the Regulation on National Health Insurance Care Benefits
- 06Costs for dental prosthetic materials, assistive devices, issuance fees for medical certificates, nursing care fees, telephone charges, medical supplies purchased from specialized medical supply companies or shops, and materials purchased outside domestic medical institutions or pharmacies
Higher-Level Hospital Room Charges Exceptionally Covered by the Government (Excluding Special/Private Rooms)
- When a higher-level hospital room is used for the purpose of sterile treatment or isolation treatment
- When a standard room is unavailable, the cost of a higher-level hospital room is covered for up to 7 days from the initial date of hospitalization
Medical Expense Claim Procedure
The patient must first pay the medical institution or pharmacy, then prepare the required documents—including the detailed statement of medical expenses, payment receipt for medical expenses (including pharmacy/prescription costs), first emergency treatment records, and certificate of higher-level hospital room usage (if applicable)—and apply for reimbursement to the relevant Regional Office of Patriots and Veterans Affairs.
Responsible Officials by Jurisdiction
| Jurisdiction | Contact Information | |||
|---|---|---|---|---|
| Designated Contracted Services |
Contracted Fee-Reduction Services |
Specialized Referral | Emergency Referral | |
| VHS Medical Center | +82-2-2225-1511 | +82-2-2225-1961 | +82-2-2225-1196 | +82-2-2225-1903 |
| Busan | +82-51-601-6720 | +82-51-601-6150 | +82-51-601-6132 | +82-51-601-6155 |
| Gwangju | +82-62-602-6062 | +82-62-602-6071 | +82-62-602-6065 | +82-62-602-6934 |
| Daegu | +82-53-630-7034 | +82-53-630-7045 | +82-53-630-7028 | +82-53-630-7026 |
| Daejeon | +82-42-939-0187 | +82-42-939-0204 | +82-42-939-0186 | +82-42-939-0287 |
| Incheon | +82-32-363-9722 | +82-32-363-9728 | +82-32-363-9722 | +82-32-363-9727 |
