On October 1, the Ministry of Health and Welfare convened the 17th Health Insurance Policy Deliberation Committee (HIPDC) meeting for 2026, chaired by Second Vice Minister Lee Hyung-hoon, and reported that a health insurance pilot program for specialized nursing hospitals treating severe rare muscular diseases, such as ALS, will begin in November. The meeting also included reports on plans to enact subordinate regulations under the National Health Insurance Act to provide differentiated health insurance support to regional, essential, and public hospitals, as well as preparations for the full-scale implementation of the sickness allowance program.
The pilot program for specialized long-term care hospitals for severe rare muscular diseases is a follow-up measure to the “Phase 1 Innovation Plan for Health Insurance Coverage” announced by the Ministry of Health and Welfare on September 8. Severe rare neuromuscular diseases, such as Lou Gehrig’s disease, are progressive and intractable; as the disease advances, patients often become dependent on ventilators, tracheostomies, and tube feeding, and require continuous medical care, rehabilitation, and long-term care services. The Ministry of Health and Welfare explained that an appropriate compensation system, taking into account the actual manpower and resources invested, is necessary.
The pilot program will offer four specialized services. “Patient-Tailored Specialized Medical Care Services,” in which a multidisciplinary team comprehensively assesses a patient’s condition to provide customized specialized medical care, nursing, personal care, and communication support; “Short-Term Hospital Bed Services” for patients who find it difficult to return home immediately after acute care or who require medical management while receiving home care; “Emergency Response Services,” which detect and respond to emergencies early in preparation for acute exacerbations such as respiratory muscle paralysis; and “Community Linkage Services,” which bridge health management, life-sustaining treatment, and family support in the community following discharge. The Ministry of Health and Welfare stated that through these measures, it will establish specialized long-term care services tailored to severe rare diseases and a payment reimbursement model, thereby laying the groundwork to alleviate the burden on patients and their families.
The Health Insurance Policy Deliberation Committee also discussed plans to draft subordinate regulations for the National Health Insurance Act, which was amended in May of this year and will take effect in January of next year. The amended law stipulates that medical care benefit costs be paid on a differentiated basis by region and medical institution to address regional disparities in healthcare and promote essential medical care. It also mandates that “public policy benefits” be provided through contracts to maintain the medical functions of regional, essential, and public healthcare systems and to foster inter-institutional cooperation. During the meeting, participants discussed proposals to add “disaster response” as a public policy objective, as well as performance-based reimbursement for medical care benefits, differential reimbursement methods (based on a fixed rate or fixed amount), and the types of public policy benefits, including institution-level reimbursement. Based on these discussions, the Ministry of Health and Welfare plans to draft amendments to the subordinate regulations and announce them for public comment in October.
A report was also presented on the status of the sickness allowance pilot program, which has been underway since July 2022. The sickness allowance is a program that provides income support to help people who are unable to work due to work-unrelated injuries or illnesses receive timely treatment and return to work; it is currently being piloted in eight cities, counties, and districts, including Dalseo-gu in Daegu, Anyang and Yongin in Gyeonggi Province, and Iksan in North Jeolla Province. Evaluation results confirmed that the program effectively encouraged vulnerable workers—such as those at small and medium-sized workplaces with fewer than 30 employees—to take time off, seek timely medical care, and reduce economic anxiety. The Health Insurance Policy Deliberation Committee also discussed plans to build the necessary systems, draft legislation, and gather opinions on specific issues in preparation for the full-scale implementation of the program.
The Ministry of Health and Welfare stated, “We will spare no effort in preparing for the full-scale implementation of the sickness allowance program so that it can establish itself as a system that ensures workers can receive adequate treatment when sick and return to work in a timely manner after recovering their health.”
