Premature Babies and Congenitally Deformed Babies

  1. Customized Health Service
  2. Mother and Child Health
  3. Premature Babies and Congenitally Deformed Babies

What is a premature baby?

A newborn baby who is born in under 37 weeks of pregnancy or with a weight of 2,500 g or less at the time of birth, and who is deemed by the head of a public health center or a medical institution to be in need of special medical control and protection differing from that of newborn babies born after the 37th week of pregnancy

What is a congenitally deformed baby?

A child patient diagnosed as a congenitally deformed baby whose disease code at a medical institution starts with Q within 28 days of birth and who is hospitalized and receives surgical treatment within 6 months of birth

Income distinction standard table by the number of family members and membership (2019)

Income distinction standard table by the number of family members and membership (2019) - Number of family members,Income classification (KRW),Employment insured,Self-employment insured,Mixed insured
Number of family members Income classification (KRW) Employment insured Self-employment insured Mixed insured
1 3,073,000 99,935 86,261 101,018
2 5,232,000 169,191 174,163 171,897
3 6,768,000 222,133 239,780 226,441
4 8,304,000 272,807 297,628 283,533
5 9,841,000 326,151 355,813 348,036
6 11,377,000 378,988 413,866 410,509

Health insurance deductible: excluding senior long-term recuperation insurance fee How to apply (public health center with jurisdiction over the registered address of the newborn baby):
Parents of infants registered as premature or congenitally deformed are to prepare the necessary documents along with a medical expense assistance application and submit them to the public health center.

For

  • Households with 180% of the standard median income or below (based on health insurance payments)
  • How to calculate the insurance fee: Based on the time at which medical expenses are applied (notified insurance of the immediately preceding month)

    강조Except for case where the 2nd child or later is premature or congenitally deformed (supported regardless of income level)

Cost of support

Premature baby

  • Limited to premature babies hospitalized in an intensive care unit for newborn babies in need of emergency surgery and treatment within 24 hours of birth (Excluding premature babies who are hospitalized in a common newborn unit)

    강조Newborn babies who are hospitalized in NICU but applied with medical charges of a general ward are excluded from subjects of support.

  • Scope of medical expense assistance for premature and congenitally deformed babies: 100% deductible from payments of medical expense receipts and non-payment assistance
  • If the deductible is KRW 1,000,000 or less: 100% deductible for medical expenses and non-payment assistance for the full amount
  • If the deductible is between KRW 1,000,000 and KRW 5,000,000: 100% deductible for medical expenses and 90% of non-payment supported
  • However, the maximum payment by weight shall not be exceeded for the birth of a baby as shown below.
  • Guide on maximum payment by weight at birth of a premature baby
    Guide on maximum payment by weight at birth of a premature baby - Weight at birth,Maximum support,Remarks
    Weight at birth Maximum support Remarks
    2,499gm - 2,000gm KRW 3,000,000

    강조Cases where support is received from private organizations, etc. are excluded from the order of priority

    1,999gm - 1,500gm KRW 4,000,000
    1,499gm - 1,000gm KRW 7,000,000

Congenitally deformed baby

  • Limited to cases of child patients diagnosed as congenitally deformed babies whose disease code at a medical institution starts with Q within 28 days of birth and who are hospitalized and receive surgical treatment within 6 months of birth
  • Subject of support, application for medical expenses, support method (same as support for premature babies)
  • If a baby is born prematurely with a congenital disorder or illness, it is possible to support the baby within the scope of the sum of each of the maximum amounts of support.
  • Applied after completing resident registration for the newborn
  • Medical expense assistance for premature babies and congenitally deformed babies is applied to the public health center with jurisdiction for the residence within 6 months of the date of discharge from the hospital.

Consultation contact

Personnel in charge of premature babies at Regional Health Department +82-2)860-3436