{"id":1664,"date":"2026-10-16T00:01:33","date_gmt":"2026-10-15T15:01:33","guid":{"rendered":"https:\/\/iwaw.kr\/en\/2026\/10\/16\/comparing-health-checkup-coverage-limits-and-financial-criteria-by-benefit-category-18ac80edd7\/"},"modified":"2026-10-16T00:01:48","modified_gmt":"2026-10-15T15:01:48","slug":"comparing-health-checkup-coverage-limits-and-financial-criteria-by-benefit-category-18ac80edd7","status":"publish","type":"post","link":"https:\/\/iwaw.kr\/en\/2026\/10\/16\/comparing-health-checkup-coverage-limits-and-financial-criteria-by-benefit-category-18ac80edd7\/","title":{"rendered":"Comparing Health Checkup Coverage Limits and Financial Criteria by Benefit Category"},"content":{"rendered":"


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Health Insurance Health Checkup: How Much Is Really Free? (Support System at a Glance)<\/h2>\n

When receiving an annual or biennial national health checkup notice, the first question that often comes to mind is: “Is it really completely free, or will additional costs arise on-site?” To state the conclusion first, health checkups provided by the National Health Insurance Service are clearly divided into full coverage by the Corporation (100% free) and partial co-payment (10%), depending on the checkup type and the recipient’s age, gender, and income criteria.<\/p>\n

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  1. Basic Support Principles: General Health Checkup vs. National Cancer Screening<\/li>\n<\/ol>\n

    National health checkups are broadly categorized into ‘General Health Checkups’ for verifying fundamental health conditions and ‘6 Major Cancer Screenings’ for early detection of critical diseases, and each operates under a different cost support framework.<\/p>\n

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    • General Health Checkup (0 KRW Co-payment)<\/li>\n<\/ul>\n
        \n
      • Support Rate: 100% fully covered by the Corporation<\/li>\n
      • Target Population: Local subscribers (household heads and household members aged 20 or older), employee subscribers, dependents aged 20 or older, Medical Aid beneficiaries (ages 20\u201364)<\/li>\n
      • Essential basic tests such as physical measurements, vision and hearing, blood pressure, chest X-ray, basic blood tests (fasting blood glucose, liver function, etc.), urine test, and oral examination require absolutely no out-of-pocket costs from the examinee.<\/li>\n
      • Items added according to age and gender (e.g., gastroscopy for ages 40 or older, cervical cancer screening for women, dyslipidemia test, etc.) are also provided free of charge when tested according to statutory standard cycles.<\/li>\n
      • 6 Major Cancer Screenings (Differential Support by Item and Target)<\/li>\n<\/ul>\n
          \n
        • Support Rate: 90% covered by the Corporation \/ 10% co-payment (However, specific cancer types and eligible individuals receive 100% free coverage)<\/li>\n
        • Age and frequency conditions vary depending on the cancer type (stomach cancer, colorectal cancer, liver cancer, breast cancer, cervical cancer, lung cancer), and since the government supports 90% for basic test items, examinees typically need to pay only a minor co-payment of around 10%.<\/li>\n<\/ul>\n
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          1. Comparison at a Glance: Items Fully Covered by the Corporation vs. Co-Payment Criteria<\/li>\n<\/ol>\n

            To help intuitively assess cost responsibilities, the support standards for major checkup types are summarized below.<\/p>\n

            \n\n\n\n\n\n\n\n\n\n
            Checkup Classification<\/th>\nMajor Test Items<\/th>\nExaminee Co-payment<\/th>\nNotes and Detailed Criteria<\/th>\n<\/tr>\n<\/thead>\n
            General Health Checkup<\/td>\nQuestionnaire, measurements, chest X-ray, blood\/urine test, oral checkup<\/td>\n0 KRW (Free)<\/td>\n100% fully supported by the National Health Insurance Service<\/td>\n<\/tr>\n
            Cervical Cancer<\/td>\nPap smear (Women aged 20 or older, 2-year cycle)<\/td>\n0 KRW (Free)<\/td>\nFully covered by the Corporation<\/td>\n<\/tr>\n
            Colorectal Cancer<\/td>\nFecal occult blood test (FOBT, ages 50 or older, 1-year cycle)<\/td>\n0 KRW (Free)<\/td>\nBasic colonoscopy free of charge if fecal test shows a positive result<\/td>\n<\/tr>\n
            Cancer Screening (General)<\/td>\nStomach cancer, breast cancer, liver cancer, lung cancer<\/td>\n10%<\/td>\n90% supported by the Corporation (Free for low-income recipients eligible for the National Cancer Screening Program)<\/td>\n<\/tr>\n
            Non-benefit \/ Optional Items<\/td>\nStomach\/colon sedation fee (sedation care fee), additional ultrasound, comprehensive blood tests<\/td>\n100% out-of-pocket<\/td>\nOptional additional costs incurred upon examinee request<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

            \ud83d\udca1 Key Points Where Additional On-Site Payments Occur<\/p>\n

            Although the basic checkup itself is free or requires only a 10% contribution, separate out-of-pocket expenses may be billed under the following circumstances, so it is recommended to be aware of them prior to booking.<\/p>\n

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            1. Sedation (conscious sedation) care fee: For upper and lower endoscopies, standard (non-sedated) procedures are covered under the support scope, but conscious sedation care costs incurred when undergoing sedation (typically around 50,000 to 100,000 KRW) are non-benefit items and must be fully paid by the individual.<\/li>\n
            2. Therapeutic procedures during examination: When polyps are discovered during a colonoscopy and excised, or when Helicobacter pylori tests or biopsies are performed concurrently, the relevant procedures and biopsy fees are converted to health insurance clinical coverage (covered benefit), resulting in partial medical fees being billed.<\/li>\n
            3. Package add-on tests: If optional items outside the national checkup scope are added\u2014such as brain\/chest CT scans, abdominal ultrasound, or comprehensive blood panels recommended by the hospital\u2014the corresponding expenses are processed entirely as non-benefit services.<\/li>\n<\/ol>\n
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              National General Health Checkup: Fully Supported Items and Examination Scope<\/h2>\n

              The general health checkup supervised by the National Health Insurance Service focuses fundamentally on the early detection of chronic diseases that show few early symptoms, such as hypertension, diabetes, and kidney disease. If you are eligible for the checkup, it is conducted with 0 KRW in co-payments (fully covered by the Corporation), ranging from basic screening to age-specific selective tests.<\/p>\n

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              1. Primary Basic Examination Items (Common to All Ages)<\/li>\n<\/ol>\n

                These are common examination items basically provided to all examinees selected according to their birth year (even or odd years).<\/p>\n

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                • Basic Physical Measurements and Sensory Function Tests<\/li>\n<\/ul>\n
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                  • Height, weight, waist circumference, body mass index (BMI): Calculation of obesity and abdominal obesity risk<\/li>\n
                  • Vision and hearing tests: Measurement of corrected vision and verification of basic hearing loss<\/li>\n
                  • Blood pressure measurement: Primary screening for hypertension via systolic and diastolic blood pressure<\/li>\n
                  • Chest radiography (X-ray)<\/li>\n<\/ul>\n
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                    • Screening for lung diseases including tuberculosis, pneumonia, and thoracic masses<\/li>\n
                    • Blood test (mandatory fasting blood collection)<\/li>\n<\/ul>\n
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                      • Hemoglobin (Hb): Verification of anemia<\/li>\n
                      • Fasting blood glucose: Early screening for diabetes<\/li>\n
                      • Liver function tests (AST, ALT, Gamma-GTP): Review of hepatitis, fatty liver, and abnormal liver function<\/li>\n
                      • Kidney function tests (serum creatinine, e-GFR): Assessment of chronic kidney disease and glomerular filtration rate<\/li>\n
                      • Urine test (urine protein)<\/li>\n<\/ul>\n
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                        • Checking the risk of kidney damage and urinary system diseases through the presence of proteinuria<\/li>\n
                        • Oral examination<\/li>\n<\/ul>\n
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                          • Verification of dental caries and periodontal disease through dentist consultation and visual inspection of teeth and periodontal tissue<\/li>\n<\/ul>\n
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                            1. Tailored Fully Supported Items by Gender and Age<\/li>\n<\/ol>\n

                              To prevent chronic diseases and specific functional decline whose prevalence surges with increasing age, these examination items are provided additionally and free of charge when reaching specific ages according to statutory cycles.<\/p>\n

                              \n\n\n\n\n\n\n\n\n\n\n\n
                              Examination Item<\/th>\nTarget Criteria<\/th>\nCheckup Cycle and Detailed Objective<\/th>\n<\/tr>\n<\/thead>\n
                              Dyslipidemia test<\/p>\n

                              (Total cholesterol, HDL, LDL, triglycerides)<\/td>\n

                              		Men aged 24 or older<\/p>\n

                              Women aged 40 or older<\/td>\n

                              		4-year cycle<\/p>\n

                              Assessment of cardiovascular and cerebrovascular disease risks such as dyslipidemia, myocardial infarction, and arteriosclerosis<\/td>\n<\/tr>\n

                              Hepatitis B antigen and antibody test<\/td>\nAge 40<\/td>\nOnce in a lifetime<\/p>\n

                              Verification of Hepatitis B carrier status and antibody formation (excluding past carriers)<\/td>\n<\/tr>\n

                              Bone mineral density test<\/td>\nWomen aged 54 and 66<\/td>\nOnce at the corresponding age (2 times total)<\/p>\n

                              Early diagnosis of osteoporosis progressing rapidly after menopause<\/td>\n<\/tr>\n

                              Cognitive dysfunction screening test<\/td>\nAged 66 or older<\/td>\n2-year cycle<\/p>\n

                              Early screening for dementia and cognitive decline based on the KDSQ-C questionnaire<\/td>\n<\/tr>\n

                              Mental health (depression) screening<\/td>\nAges 20, 30, 40, 50, 60, 70<\/td>\n10-year cycle (examine once within the corresponding age group)<\/p>\n

                              Mental health assessment via depression scale evaluation<\/td>\n<\/tr>\n

                              Lifestyle evaluation<\/td>\nAges 40, 50, 60, 70<\/td>\nOnce at the corresponding age<\/p>\n

                              Counseling on lifestyle improvement including smoking, alcohol consumption, exercise, nutrition, and obesity<\/td>\n<\/tr>\n

                              Geriatric physical function test<\/td>\nAges 66, 70, 80<\/td>\nOnce at the corresponding age<\/p>\n

                              Assessment of physical functions including fall risk, lower extremity strength, and sense of balance<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

                              \ud83d\udca1 Essential Points to Remember Before Undergoing a General Checkup<\/p>\n

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                              • Maintain fasting for at least 8 hours: For accurate blood glucose levels and blood test results, all food intake including water, coffee, and chewing gum must be discontinued after 9:00 PM the night before the examination.<\/li>\n
                              • Caution regarding early examination in non-applicable years: If specific age\/cyclical tests such as the dyslipidemia test (4-year cycle) are requested individually in a year outside your designated examination cycle, they are excluded from Corporation support and full out-of-pocket expenses may occur; therefore, pre-checking during reservation is essential.<\/li>\n<\/ul>\n
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                                Comparison of Co-payment and Support Limits by 6 Major Cancer Screening Items<\/h2>\n

                                National cancer screenings are operated to improve cure rates by detecting major cancers with high incidence and mortality rates early. Unlike the general health checkup, which is completely free, for the 6 major cancer screenings (stomach cancer, colorectal cancer, liver cancer, breast cancer, cervical cancer, lung cancer), the support limits and co-payment ratios apply differently depending on the characteristics of the cancer type and the examinee’s income level (health insurance premium imposition standards).<\/p>\n

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                                1. Screening Cycles and Cost-Sharing Structures by the 6 Major Cancer Types<\/li>\n<\/ol>\n

                                  The basic principle of national cancer screenings is that the National Health Insurance Service covers 90%, and the examinee pays 10%. However, according to occurrence frequency and national health policies, cervical cancer and colorectal cancer are provided completely free of charge (100% covered by the Corporation) to all eligible individuals.<\/p>\n

                                  \n\n\n\n\n\n\n\n\n\n\n
                                  Cancer Type<\/th>\nTarget Criteria and Cycle<\/th>\nPrimary Basic Examination Method<\/th>\nGeneral Target Co-payment<\/th>\n<\/tr>\n<\/thead>\n
                                  Stomach Cancer<\/td>\nMen and women aged 40 or older (2-year cycle)<\/td>\nGastroscopy (biopsy included)<\/td>\n10% (around 10,000 KRW)<\/td>\n<\/tr>\n
                                  Colorectal Cancer<\/td>\nMen and women aged 50 or older (1-year cycle)<\/td>\nFecal occult blood test (FOBT, stool test)<\/td>\n0 KRW (completely free)<\/td>\n<\/tr>\n
                                  Cervical Cancer<\/td>\nWomen aged 20 or older (2-year cycle)<\/td>\nPap smear<\/td>\n0 KRW (completely free)<\/td>\n<\/tr>\n
                                  Breast Cancer<\/td>\nWomen aged 40 or older (2-year cycle)<\/td>\nMammography<\/td>\n10% (around 5,000 to 10,000 KRW)<\/td>\n<\/tr>\n
                                  Liver Cancer<\/td>\nHigh-risk group aged 40 or older (6-month cycle)<\/td>\nLiver ultrasound + Serum alpha-fetoprotein test<\/td>\n10% (around 10,000 KRW per session)<\/td>\n<\/tr>\n
                                  Lung Cancer<\/td>\nHigh-risk group aged 54 to 74 (2-year cycle)<\/td>\nLow-dose chest CT scan<\/td>\n10% (low 10,000 KRW range)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

                                  Actual 10% co-payments may vary slightly depending on the medical institution category addition rates for clinics, hospitals, general hospitals, etc.<\/p>\n

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                                  1. Criteria for ‘0 KRW (Completely Free)’ Co-payment Support Targets<\/li>\n<\/ol>\n

                                    Even for cancer types where a 10% co-payment basically occurs (stomach cancer, breast cancer, liver cancer, lung cancer), if you meet any of the conditions below, the 10% co-payment is waived and you can receive the screening 100% free of charge.<\/p>\n

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                                    • Medical Aid beneficiaries: All Type 1 and Type 2 beneficiaries<\/li>\n
                                    • Subscribers in the lower 50% of health insurance premiums: Subscribers whose health insurance premium imposition amount is in the lower 50% according to Corporation standards as of November of the previous year (including local and employee dependents)<\/li>\n<\/ul>\n
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                                      • If it is specified as ‘No co-payment’ when checking the screening notice sent annually by the Health Insurance Corporation or on the National Health Insurance Service website (The Health Insurance app), you can undergo all basic items free of charge without the 10% contribution.<\/li>\n<\/ul>\n
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                                        1. Selection Conditions for Liver Cancer and Lung Cancer ‘High-Risk Groups’<\/li>\n<\/ol>\n

                                          Liver cancer and lung cancer do not target the entire general public, but are supported selectively only for high-risk targets whose disease onset risk has been verified.<\/p>\n

                                            \n
                                          • Liver cancer high-risk group (Supported twice a year, once each in the first and second half)<\/li>\n<\/ul>\n
                                              \n
                                            • Those aged 40 or older whose medical treatment history has been confirmed in the Corporation’s electronic records as being in the high-risk group for liver cancer development (liver cirrhosis, hepatitis B virus surface antigen positive, hepatitis C virus antibody positive, or chronic liver disease caused by hepatitis B or C virus) within the 2 years prior to the corresponding year<\/li>\n
                                            • Lung cancer high-risk group (Supported on a 2-year cycle)<\/li>\n<\/ul>\n
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                                              • Heavy smokers among men and women aged 54 to 74 whose smoking history of 30 pack-years or more (e.g., 1 pack per day for 30 years, or 2 packs per day for 15 years) is confirmed through questionnaires or health insurance electronic records<\/li>\n<\/ul>\n

                                                \ud83d\udca1 Cost-Saving Tips Often Missed During Cancer Screenings<\/p>\n

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                                                1. Comply with colorectal cancer screening procedures: For colorectal cancer, the primary fecal occult blood test (stool test) must be conducted first. Only when a ‘positive occult blood (suspected bloody stool)’ reaction appears in the fecal test results can the cost of the secondary colonoscopy be fully supported by the Corporation. If you undergo a colonoscopy directly without the primary test, national screening support benefits will not apply, and non-benefit medical expenses will be billed.<\/li>\n
                                                2. Distinguish between sedation fees and biopsy costs: During a gastroscopy, standard (non-sedated) screening is a 10% co-payment or completely free, but sedation (conscious sedation) care fees are non-benefit items outside the Corporation’s support scope. However, biopsy costs performed when suspicious areas are found during the examination fall under health insurance benefit items, so only a small statutory co-payment is added.<\/li>\n<\/ol>\n
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                                                  Cost Criteria Incurred for Additional Tests and Detailed Examinations<\/h2>\n

                                                  Basic national health checkups (general checkups and cancer screenings) are conducted with full coverage by the Corporation or a minor 10% co-payment; however, from the moment abnormal findings are detected during an examination or the examinee chooses additional tests, the medical billing calculation criteria change completely.<\/p>\n

                                                  From this stage, costs are clearly divided into health insurance-covered ‘benefits,’ fully out-of-pocket ‘non-benefits,’ and ‘confirmation tests’ fully supported by the government on a one-time basis, making it essential to thoroughly understand these upfront criteria in advance.<\/p>\n

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                                                  1. Upon Abnormal Findings in the Primary Checkup: Free Support Criteria for Secondary Confirmation Tests<\/li>\n<\/ol>\n

                                                    If a person is suspected of having a major chronic disease such as hypertension or diabetes from general health checkup results, or if abnormalities are found in the primary colorectal cancer screening, the government fully supports (or partially covers under health benefits) the cost of the subsequent confirmation test on a one-time basis for early diagnosis and treatment.<\/p>\n

                                                      \n
                                                    • Hypertension and Diabetes Confirmation Tests<\/li>\n<\/ul>\n
                                                        \n
                                                      • Eligible Recipients: Examinees suspected of having hypertension (systolic 140 mmHg or higher, or diastolic 90 mmHg or higher) or diabetes (fasting blood glucose 126 mg\/dL or higher) from the primary general health checkup results<\/li>\n
                                                      • Support Scope: Full 100% waiver (0 KRW) of the co-payment for consultation fees and designated tests (blood pressure re-measurement, fasting blood glucose or HbA1c test, etc.) once<\/li>\n
                                                      • Usage Deadline and Location: Applicable when visiting a nearby hospital or clinic (clinic-level medical institutions recommended) with the examination result sheet by January 31 of the following year<\/li>\n
                                                      • Secondary Detailed Examination for Colorectal Cancer (Colonoscopy)<\/li>\n<\/ul>\n
                                                          \n
                                                        • Eligible Recipients: Those who received a ‘positive occult blood (blood mixed in stool)’ result from the primary fecal occult blood test (stool test)<\/li>\n
                                                        • Support Scope: Full coverage of consultation fees and basic examination costs for the secondary colonoscopy<\/li>\n
                                                        • Caution: If the primary stool test is skipped and a colonoscopy is performed directly, this support will not apply.<\/li>\n<\/ul>\n
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                                                          1. Therapeutic Procedures During Endoscopy: Transition to Health Insurance Benefits and Private Health Insurance Criteria<\/li>\n<\/ol>\n

                                                            When a lesion is detected during a standard endoscopy (gastroscopy\/colonoscopy) and therapeutic management is performed, that treatment transitions from the ‘health checkup’ domain to ‘therapeutic health insurance medical care (benefit).’<\/p>\n

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                                                            • Biopsy and Helicobacter pylori Test<\/li>\n<\/ul>\n
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                                                              • If tissue is removed during a gastroscopy or colonoscopy due to suspected inflammation, ulcers, or tumors, health insurance benefits apply, adding a co-payment of around 20,000 to 40,000 KRW.<\/li>\n
                                                              • Colon Polyp Removal (Polypectomy)<\/li>\n<\/ul>\n
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                                                                • When polyps found during the examination are removed immediately, it is classified as ‘surgery (procedure).’ Depending on the polyp size, count, and excision method (endoscopic mucosal resection, snare polypectomy, etc.), a statutory co-payment of around 80,000 to 200,000 KRW is incurred.<\/li>\n
                                                                • Private Health Insurance (Indemnity Insurance) Claim Tips<\/li>\n<\/ul>\n