Patients must now present ID cards to receive health insurance

Patients visiting medical facilities are required to present their ID cards to receive health insurance coverage beginning Monday.

A patient presents her mobile ID card at a hospital in Dongjak District, southern Seoul, to access medical treatment under the national health insurance system. Beginning Monday, patients visiting medical facilities are required to present an ID card to receive health insurance coverage. [NEWS1]

Patients visiting medical facilities are required to present their ID cards to receive health insurance coverage beginning Monday.

Such a measure is in line with the Health Ministry's efforts to reinforce patient identity verification to prevent people from exploiting access to health insurance.

According to the National Health Insurance Service (NHIS), 1,892 people in 111,177 cases have been caught stealing others’ health insurance certificates since 2021.

Instances include a foreigner using another person’s alien registration number for hospitalizations over a four-year period and a Korean national using his acquaintance’s resident registration number to obtain narcotic drugs 87 times in nearly three years starting in 2019.

Both were caught, sentenced to prison and required to reimburse the benefits obtained improperly.

Some patients were caught off guard on Monday when nurses informed them that presenting actual identification documents were necessary to receive health insurance benefits. Previously, patients could access medical treatment under the national health insurance system by simply presenting their resident registration number at hospitals.

“I was aware of the system change through news and social media, but I completely forgot to bring my ID card," one patient said when a nurse asked for her ID card at a hospital near Gongdeok station, western Seoul. Fortunately, she later found her card in her bag.

Below are some frequently asked questions about the implementation and answers provided by the NHIS.

Can a photo of an ID card be used for verification? No, the NHIS does not accept photos or photocopies of IDs as proof of identity. Acceptable forms of identification include national ID, driver's license, passport, disability registration card, certificate of alien registration, national honoree card, mobile ID and health insurance certificate. The NHIS said the certificates or documents must be issued by an administrative agency or public institution, contain a photo and include a resident registration number or an alien registration number. Additionally, if the certificate or document has an expiration date, it must be used while it is still valid.

How are children’s identities verified? Patients under the age of 19 generally do not need to verify their identity, except for referral patients or emergency cases. Referral patients may be exempted from verification with a referral letter only once. However, if they visit the same hospital within six months, they must verify their identity. Patients with severe mobility issues and nursing home residents categorized as long-term care patients are also exempt.

If patients verify their identities, do they still need to fill out personal information when registering at the hospital? Yes, patients still need to fill out their basic information at the hospital to see a doctor, as the process is unrelated to the new identity verification system.

Poster explains that patients visiting medical facilities must present their ID cards to receive health insurance coverage beginning Monday. [SCREEN CAPTURE]

If patients forget their IDs, can they still see the doctor? Yes, Patients can still receive medical treatment, but must pay the full amount. If patients bring their identification card and other documents required by the hospital, such as receipts for medical expenses, within 14 days after the hospital visit, they can be refunded the amount covered by health insurance.

It is recommended to install a mobile health insurance certificate to provide identification.

How can a prescription assigned to someone else be verified? When a patient is unable to receive a prescription due to reasons like being unconscious or lacking mobility, the person receiving the prescription on the patient's behalf is not subject to verification.

Does a patient need to have their identity verified every time they visit the hospital? While first-time patients must be verified, returning patients do not need to be verified again within six months of their visit.

What happens if the hospital does not check identity documentation? If a medical institution fails to verify a patient's identity or their eligibility to receive health insurance, they can be fined up to one million won ($738).

Why did the Health Ministry implement such a measure? To ensure patient safety and prevent ineligible individuals from unfairly receiving benefits through illegal means such as borrowing or stealing identities.

BY HWANG SOO-HYUN,WOO JI-WON [woo.jiwon@joongang.co.kr]