Long-Term Care Copayment Reduction: How a 40% or 60% Discount Works If Your Income Qualifies
When a parent qualifies for long-term care benefits and starts using a nursing home or in-home care, the monthly copayment can be more of a burden than families expect. But if your household income is on the lower side, there is already a system that cuts that copayment by 40% or 60%. The problem is that many families never apply -- they simply don't know the program exists, so they keep paying the full rate. Here is who qualifies and how much it actually saves.
Start with the standard copayment rate
Korea's long-term care insurance covers most of the cost of care, with the user paying only a portion. In-home services (home visits, day and night care) carry a 15% copayment, and facility care (nursing home admission) carries 20% as the standard rate. Basic livelihood recipients pay nothing at all, and the reduced-rate group covered here sits in between -- cutting that 15% or 20% down by another 40% or 60%.
60% reduction -- the largest cut
Medical aid recipients, people already approved for a health-insurance copayment reduction, people facing hardship from a natural disaster, and anyone whose health-insurance premium ranks in the bottom 0-25% nationally -- while also meeting the asset threshold -- qualify for the 60% reduction. For in-home care, that means the standard 15% copayment drops to 6% (40% of 15%).
40% reduction -- the next tier
Households whose health-insurance premium ranks between the 25th and 50th percentile, while also meeting the asset threshold, qualify for the 40% reduction. In-home care's 15% drops to 9%, and facility care's 20% drops to 12%. Because the national health insurance service recalculates everyone's premium ranking every year, a household that didn't qualify last year can become newly eligible this year, and vice versa.
Asset value is checked too
Eligibility isn't decided by premium ranking alone -- property tax-assessed value is checked as well. The assessed value of land, buildings, housing, ships, and aircraft under the Local Tax Act is added up across every household member, and the total must stay under a set threshold to qualify. That means a household with a low health-insurance premium but a high property valuation can still be excluded from the reduction. Since the exact threshold is adjusted every year, the most accurate way to check is the long-term care insurance website (longtermcare.or.kr) or a direct call to the National Health Insurance Service.
In most cases, you don't need to apply separately
When a long-term care eligibility application is filed, the National Health Insurance Service is supposed to check premium and asset records and automatically verify and apply the reduction as a matter of course. That means an eligible household doesn't need to submit a separate "reduction application" -- the lowered copayment rate should already be applied once the care grade is determined. In cases where the agency can't confirm eligibility from its records alone, however, the insured person or a dependent may need to submit a copayment-reduction application directly to the agency.
What to check first if it wasn't applied
If your monthly bill still shows the standard 15% or 20% copayment, there's a chance you qualify for the reduction but it simply wasn't applied automatically. In that case, call the National Health Insurance Service's main line (1577-1000) to confirm your premium ranking and asset status, and file a reduction application if you do qualify but the discount hasn't been reflected. It's reportedly common for eligible families to keep paying the full rate simply because they never checked.
How much difference does it actually make?
Take a household using facility care (a nursing home) under long-term care grade 3, for example. Paying the standard 20% copayment on the full monthly fee typically runs into the high hundreds of dollars. With the 60% reduction, that copayment rate drops from 20% to 8%, so the monthly bill for the same facility falls to less than half. Because the exact amount depends on the facility's grade, region, and meal charges, the most accurate approach is to ask the facility directly for an estimate before and after the reduction is applied and compare the two.
Recheck whenever your grade or income changes
Reduction status isn't permanent once granted -- because health-insurance premiums are recalculated every year, your ranking can shift as well. A household that didn't qualify last year may become eligible this year if income drops, and the reverse can also happen. It's worth checking again whenever a care grade is renewed or around the annual health-insurance premium reassessment.
Steps to remember
① Confirm the baseline copayment rates: 15% for in-home care, 20% for facility care. ② Confirm that a premium ranking of 0-25% qualifies for the 60% reduction and 25-50% qualifies for the 40% reduction, and that asset value is checked as well. ③ Most cases are applied automatically, but if your bill still shows the standard rate, call the agency (1577-1000) to check. ④ If it wasn't applied automatically, submit a copayment-reduction application. ⑤ Recheck your eligibility whenever your health-insurance premium is reassessed.
Separately from the copayment rate, if a family member is admitted to a long-term care hospital, it also helps to know the procedure for requesting a review of questionable non-covered medical charges so you can manage the full medical bill. This article covers general program information only; your exact eligibility and reduction rate should be confirmed with the National Health Insurance Service.
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