Out-of-pocket hospital costs reach 750 billion won in September 2025

Korean patients paid 750 billion won ($561 million) for hospital care not covered by the national health insurance in September 2025, up 9.3 percent from six months earlier. Spending on thymosin alpha-1, an immune-boosting injection used for cancer patients, jumped 67.1 percent from a year earlier.

The Ministry of Health and Welfare and National Health Insurance Service released the data on Friday.

Though Korea’s national health insurance covers most medical care costs, patients generally have to pay the full price for treatments, procedures and hospital services outside its coverage.

All medical institutions, including local clinics, must report such uninsured charges for March to the government; hospital-level institutions must submit another record for September. Those that do not pay a fine.

Hospital-level institutions reported 749.9 billion won in charges for 1,251 uninsured services in September 2025, up 63.5 billion won, or 9.3 percent, from 686.4 billion won that March.

Part of the growth was attributed to the rise in the number of hospitals that submitted data. The number of participating institutions climbed from 4,000 in March 2025 to 4,098 that September. Average charges per institution also increased by 11.38 million won over the six months.

Based on September 2025’s monthly figure, annual out-of-pocket costs for hospital care not covered by national health insurance were estimated at nearly 9 trillion won.

Hospitals accounted for the largest share of the 749.9 billion won at 312.2 billion won, or 41.6 percent. General hospitals followed at 158.7 billion won, or 21.2 percent, and tertiary hospitals accounted for 108.4 billion won, or 14.5 percent.

Tertiary hospitals saw the fastest growth. Their charges for uninsured care in September of last year increased by 39.8 billion won, or 58 percent, compared to September 2024.

Private hospital rooms were the biggest source of uninsured costs in September 2025, with charges totaling 56.1 billion won, or 7.5 percent of the total. Chiropractic-style manual therapy was close behind at 55.2 billion won, or 7.4 percent. Zirconia dental implants accounted for 31.4 billion won, or 4.2 percent, followed by materials used to repair soft tissue at 28.1 billion won, or 3.8 percent.

One treatment recorded a notable rise: thymosin alpha-1, an immune-boosting injection used for cancer patients.

Patients spent 27.4 billion won on thymosin alpha-1 last September, up 11 billion won, or 67.1 percent, from 16.4 billion won in September 2024. It rose from sixth to fifth place among the biggest sources of uninsured medical spending.

“Spending on uninsured treatments for cancer patients, including thymosin alpha-1, increased sharply, particularly at long-term care hospitals and traditional Korean medicine hospitals,” the Health Ministry said.

Thymosin alpha-1 was the single biggest uninsured expense at long-term care hospitals in September 2025 at 12 billion won. It ranked third at traditional Korean medicine hospitals at 8.5 billion won.

At long-term care hospitals, thymosin alpha-1 alone accounted for 26.3 percent of the 45.7 billion won spent on uninsured care last September.

But whether the treatment actually benefits cancer patients remains disputed.

“It’s essentially like water. It has neither any benefits nor any side effects,” an internal medicine specialist said. “Korea is the only country that uses it this extensively.”

The Ministry of Food and Drug Safety is reviewing the clinical effectiveness and safety of thymosin alpha-1 and several other immune-boosting drugs. The review follows a July 2025 decision by the National Evidence-based Healthcare Collaborating Agency not to recommend the treatments.

The Health Ministry is also trying to rein in excessive spending on uninsured care. Since July, the government has imposed standardized prices and treatment guidelines on manual therapy, one of the biggest sources of out-of-pocket medical spending. The ministry plans to keep monitoring treatments that drive up patients’ spending and bring more services under similar controls.

“We will strengthen oversight of excessive uninsured care that goes beyond medical necessity and adds to patients’ financial burden,” Yu Ju-heon, the director of the ministry’s national health insurance policy bureau, said.

BY CHAE HYE-SEON [lee.jiwon10@joongang.co.kr]