Fact · Self-pay
Dental public coverage: South Korea, 2024
Dental Market Radar Editorial Team · Updated · Data as of
Comparability B Confidence high
Cite this
National Health Insurance Service (NHIS), Korea. (2026). Dental public coverage: South Korea, as of 2024-04-30 [Data set]. Compiled by Dental Market Radar. https://dentalmarketradar.com/data/kr/dental-public-coverage/2024/
Permanent URL: https://dentalmarketradar.com/data/kr/dental-public-coverage/2024/. Licensed under CC BY 4.0.
Record
- Value
- National Health Insurance (NHI) covers: (1) scaling once per calendar year for insured persons and dependants aged 19+ (when scaling is the sole purpose; further scaling in the same year is non-covered); (2) for insured persons and dependants aged 65+, clasp-retained partial dentures, resin complete dentures and metal complete dentures (replacement once per 7 years, with exceptions) at 30% copayment (5% near-poor rare/intractable disease, 15% near-poor chronic disease); (3) for insured persons and dependants aged 65+, dental implants for partial edentulism, up to 2 implants per lifetime, 30% copayment (NHIS implant Q&A: bone grafting and other ancillary surgery is non-covered; complete edentulism is excluded and handled under dentures; the Q&A describes PFM crowns, and later zirconia coverage was not verified here). Coverage of other dental care (fillings, extractions, endodontics, orthodontics, cosmetic) was not captured in the sources fetched.
- Unit
- text
- As of
- Accessed
- Revision
- 1
- Confidence
- high
- Method
- reported
- Basis
- other
- Scope
- other
- Comparability
- Comparability B B: close to the metric definition; the difference is noted
- Status
- Latest record for this market and metric
Source quote
스케일링은 만 19세부터 1년에 한 번 건강보험이 적용되는 덕분에 본인 부담률이 줄었다. 19세 이상 건강보험 가입자나 피부양자에 대해 스케일링만을 목적으로 시술하는 경우 1년 주기(매년 1월 1일부터 12월 31일까지)로 1회에 한해 건강보험을 적용하고 있다. 연 1회를 초과할 경우에는 비급여 대상이다. 다만 만 19세 미만의 경우에도 치주 질환 수술을 위한 전 단계의 전악 치석 제거 및 부분 치석 제거에 대해 급여 적용이 가능하다. 만약 올해 스케일링을 받았는지 헷갈린다면 치과 병·의원, 공단 지사 및 공단 홈페이지, 모바일앱(The건강보험)에서 연간 급여 횟수를 확인할 수 있다. 한편 건강보험 가입자 또는 피부양자인 만 65세 이상 고령자들은 노인 틀니와 치과 임플란트에 대해 건강보험 급여를 적용한다. 급여 대상 틀니는 클라스프 유지형 부분틀니, 레진상 완전틀니, 금속상 완전틀니다. 급여 주기는 7년에 1회이나 구강 상태의 심각한 변화로 새로운 틀니가 필요하다는 의학적 판단이 있거나 천재지변으로 틀니가 분실 또는 파손된 경우엔 7년 이내라도 1회에 한해 재제작이 가능하다. 본인 부담률은 요양급여비용 총액의 30%(차상위 희귀난치 5%, 차상위 만성질환 등 15%)이다.
English: Scaling: since age 19, NHI applies once per year (1 Jan-31 Dec) when scaling is the sole purpose; beyond once a year it is non-covered. Insured persons or dependants aged 65+ get NHI benefits for senior dentures and dental implants. Covered dentures: clasp-retained partial dentures, resin complete dentures, metal complete dentures. Cycle once per 7 years (re-making within 7 years once if oral condition changes seriously or denture lost to disaster). Copayment 30% of total benefit cost (near-poor rare/intractable 5%, near-poor chronic etc. 15%).
Locator: NHIS webzine April 2024 "건강보험 혜택", section 1 (scaling paragraph, then 65+ denture and implant paragraph)
Local definition
건강보험 급여: items covered by the National Health Insurance benefit schedule (급여), as opposed to non-covered (비급여) items paid fully by the patient.
Source
National Health Insurance Service (NHIS), Korea: NHIS health insurance webzine, April 2024: 건강보험 혜택 (benefits: scaling, dentures, implants). Registry entry: kr-nhis-webzine-202404.
Notes
Primary text is the NHIS health-insurance webzine of April 2024 (publisher: NHIS). The implant lifetime limit, partial-edentulism rule, PFM crown and 30% copayment come from NHIS "치과임플란트 급여 관련 Q&A" PDF (undated, https://www.nhis.or.kr/static/html/wbma/c/wbmac0221_2.pdf), quote: "보험급여 적용기간 및 인정 개수는 평생 동안 1인당 2개입니다." and "본인부담률은 수가와 식립재료를 합산하여 총진료비의 30%입니다." Schedule may have changed since 2024; re-check HIRA fee schedule before citing as current.
Metric definition
What public (social or national) health insurance pays for in dental care; short text, original scope noted All markets for this metric.
History
| Year | Value | Basis | As of | Comparability | Source | Series break |
|---|---|---|---|---|---|---|
| 2024 | National Health Insurance (NHI) covers: (1) scaling once per calendar year for insured persons and dependants aged 19+ (when scaling is the sole purpose; further scaling in the same year is non-covered); (2) for insured persons and dependants aged 65+, clasp-retained partial dentures, resin complete dentures and metal complete dentures (replacement once per 7 years, with exceptions) at 30% copayment (5% near-poor rare/intractable disease, 15% near-poor chronic disease); (3) for insured persons and dependants aged 65+, dental implants for partial edentulism, up to 2 implants per lifetime, 30% copayment (NHIS implant Q&A: bone grafting and other ancillary surgery is non-covered; complete edentulism is excluded and handled under dentures; the Q&A describes PFM crowns, and later zirconia coverage was not verified here). Coverage of other dental care (fillings, extractions, endodontics, orthodontics, cosmetic) was not captured in the sources fetched. | other | Comparability B | NHIS health insurance webzine, April 2024: 건강보험 혜택 (benefits: scaling, dentures, implants) |
Please also cite the original source above.
Same metric in other markets
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