In September of last year, non-covered medical expenses at hospital-level medical institutions approached 750 billion won. In the medical field, expenses for single rooms and physical therapy, along with dental implants, dominated the non-covered medical expenses. The government plans to significantly strengthen management of non-covered items suspected of excessive treatment.
The Ministry of Health and Welfare and the National Health Insurance Service (NHIS) released the results of their analysis on the '2025 Non-Covered Reporting System' on September 9. According to the analysis, the total medical expenses for 1,251 non-covered items in September 2025 amounted to 749.9 billion won, an increase of 63.5 billion won compared to the first half of the year (March), which recorded 686.4 billion won. This increase is attributed to the addition of 98 more medical institutions participating in the report and an average increase of 11.38 million won in non-covered medical expenses per institution.
87.7% of Total Non-Covered Expenses Concentrated in Medical Sector
When examining the non-covered medical expenses by type of medical institution, hospitals accounted for the largest share at 3.122 trillion won (41.6%), followed by general hospitals at 1.587 trillion won (21.2%) and advanced general hospitals at 1.084 trillion won (14.5%).
By medical field, the medical sector dominated with 6.577 trillion won (87.7%), followed by dentistry at 728 billion won (9.7%) and traditional medicine at 194 billion won (2.6%).
Analyzing the expenses by item, the largest expense in the medical field was for 'single room charges' at 561 billion won (8.5%). Physical therapy also accounted for 552 billion won (8.4%), while 'soft tissue reconstruction materials' used in spinal and joint surgeries ranked third at 281 billion won (4.3%).
In the dental field, 'dental implants (per tooth)' accounted for 352 billion won (48.4%), nearly half of the total dental non-covered medical expenses. This was followed by 'crowns' at 194 billion won (26.6%) and 'orthodontics' at 73 billion won (10.0%). In traditional medicine, 'herbal medicine and herbal preparations' accounted for 144 billion won (73.9%), the largest share.
Surge in Spinal and Joint Treatment Materials
The analysis also observed a significant increase in expenses for specific treatment materials. Among the top items, expenses for soft tissue reconstruction materials and epidural adhesion prevention agents saw substantial growth. Additionally, expenses related to non-covered items for cancer patients, such as 'Thymosin Alpha 1,' used in immune injections, also increased significantly, particularly in convalescent and traditional medicine hospitals.
The government plans to tighten management of non-covered items that increase the financial burden on citizens. Earlier, the Ministry of Health and Welfare transitioned physical therapy, the second-largest non-covered medical expense in the medical field, to 'managed benefits' starting July 1 of this year through the establishment of pricing and treatment standards. Furthermore, for extracorporeal shock wave therapy, a framework for managing treatment frequency, intervals, and indications was established through voluntary corrections by the medical community.
Yoo Joo-hun, Director of the Health Insurance Policy Bureau, stated, "We will strengthen management through continuous monitoring of excessive non-covered items that impose a burden on citizens' medical expenses beyond medical necessity. We will also work to expand the provision of non-covered information using reporting data to ensure the public's right to know."
Meanwhile, detailed information on item prices and treatment costs, including the results of this non-covered reporting analysis, can be found on the NHIS website's 'Non-Covered Information Portal.'
* This article has been translated by AI.
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