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Mandatory Health Insurance Verification ID Required for Hospital and Pharmacy Visits?
  • By Shin Min-joo, reporter
  • 승인 2024.06.03 00:10
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▲ Presenting ID at the Hospital as part of the 'Health Insurance Identification Verification System' Implementation (Source: NEWS 1)

The Ministry of Health and Welfare implemented the "Health Insurance Identification Verification System" on May 20th, requiring personal identification, such as an ID card, when visiting hospitals and pharmacies to receive health insurance benefits. According to the National Health Insurance Service, an average of 35,000 cases of health insurance eligibility theft have been detected annually over the past five years. Before the implementation of the identification verification system, individuals could receive health insurance benefits at hospitals and pharmacies by simply providing their resident registration number without any identification check. This has led to frequent cases of people without health insurance coverage using someone else's health insurance benefits.

From now on, anyone who lends or borrows their health insurance eligibility to another person will be subject to a prison sentence of up to two years or a fine of up to 20 million KRW. All improperly used amounts will be recovered. Hospitals or pharmacies that fail to properly verify identification will face fines of 300,000 won for the first violation, 600,000 won for the second violation, and 1 million won for the third violation. However, due to the initial implementation of the system, the imposition of fines will be postponed for three months until August 20th. For identification verification, individuals can present ID cards that include a photo and resident registration number, such as a resident registration card, driver's license, passport, health insurance card, disability registration card, national veterans registration card, alien registration card, or domestic residence report card. Additionally, identification can be verified through joint certificates, financial certificates, and simple certifications like those from Naver or Kakao. Verification services from telecommunications companies or banks are also accepted, as are electronic IDs like mobile health insurance cards and mobile driver's licenses. However, photographed IDs or various certificates cannot be used. In the case of the new passport, which does not contain the back part of the resident registration number, it can be used as an ID if presented with a passport information certificate.

Minors who have difficulty verifying their identity due to the lack of appropriate identification are exempt from the identification verification process. They can continue to receive medical services by providing their resident registration number, as was previously the case. Emergency patients, those with severe disabilities, and pregnant women are also exempt from identity verification. For all others, without proper identification, health insurance cannot be applied, and the patient will have to bear the full cost of medical services. To be reimbursed, they must present their ID, medical bill receipt, and any other required documents within 14 days to receive the health insurance coverage and get the difference refunded.

Meanwhile, there are some negative reactions to the implementation of the Health Insurance Identification Verification System. One concern is the potential issues with the use of mobile health insurance cards, as it is possible to install one person's mobile health insurance card on another person's phone. In response, the National Health Insurance Service (NHIS) has promised to "shorten the login retention time and technically ensure that health insurance cards can only be installed on the phone registered under the holder's name. The NHIS will also monitor suspicious cases to minimize eligibility theft by verifying excessive issuance of certificates. However, there are also concerns about the stability of introducing mobile IDs and criticism regarding the lack of sufficient consultation with the medical community or patient groups before implementing the system. The Korean Medical Association stated, "Identity verification is the inherent duty of the NHIS, which manages the eligibility of health insurance recipients, but it imposes unnecessary administrative burdens and responsibilities on medical institutions that should be focused on patient care. In Japan, the government covers the costs associated with eligibility and identity verification."

What was the situation like on the first day of the system's implementation? Some hospitals faced problems due to a lack of understanding of the new procedures, leading to improper identity verification processes. A Ministry of Health and Welfare official emphasized, "For the smooth implementation of the system, we ask the public to bring their IDs when visiting medical institutions. If you do not have your ID, please use the mobile health insurance card app." In this critical period for the successful establishment of the Health Insurance Identification Verification System, public cooperation is essential. It is hoped that the reliability and fairness of the health insurance system will gradually improve.

By Shin Min-joo, reporter  pinky3167@naver.com

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