Indemnity Health Insurance Abroad: First-Gen Exceptions ======================================================= Standardized indemnity health insurance does not cover treatment costs at medical institutions abroad. Exceptions for some first-generation policies, overseas medical coverage under travel insurance, and the rules for proportional reimbursement of treatment costs after returning to Korea are separate issues. - People with standardized indemnity health insurance should check whether they have separate insurance that covers overseas medical costs. - Some first-generation indemnity health insurance policies sold through September 2009 cover overseas medical costs, depending on their terms. - If treatment in Korea after returning is covered by multiple indemnity health insurance policies, insurers split the payment according to the policy terms. - If you stayed abroad for at least 3 consecutive months, you can check whether you qualify for a refund of your indemnity health insurance premiums. - If you switched an older indemnity health insurance policy to a different product, check the terms currently in effect rather than your original enrollment date. Standardized indemnity health insurance does not cover treatment costs at overseas medical institutions. To prepare for medical care abroad, check whether your travel insurance covers overseas medical expenses. Exceptions may apply to some first-generation indemnity health insurance policies, depending on their terms. The reimbursement rate depends on the terms of the policy you hold. You can check it through your insurer's policy lookup service. Does indemnity health insurance cover hospital bills abroad? Standardized domestic indemnity health insurance does not cover medical expenses incurred at overseas medical institutions. Indemnity health insurance reimburses the amount you actually pay for medical expenses covered under the policy terms. Having a domestic policy does not, by itself, mean that treatment abroad is covered. The Samsung Fire & Marine Insurance indemnity health insurance FAQ also states that only treatment at domestic medical institutions is covered. Check overseas medical expense coverage separately when buying travel insurance. Confirm that the coverage is included in your policy certificate. Samsung Fire & Marine Insurance indemnity health insurance guide Item to check What it means Document to check Coverage area Whether domestic or overseas medical institutions are covered Policy terms Covered expenses Which costs of illness or injury treatment are covered Policy certificate and terms Coverage amount The limit payable under that coverage Policy certificate Deductible The portion of covered expenses you must pay Policy terms Overseas medical expense exceptions for first-generation policies Some first-generation indemnity health insurance policies sold through September 2009 cover overseas medical expenses. Standardization began in October 2009. Policies taken out before September 2009 should therefore also be checked. The General Insurance Association of Korea describes a case in which a first-generation policy reimbursed 40% of overseas medical expenses. However, first-generation policy terms varied by insurer. That rate cannot be applied to every older policy. General Insurance Association of Korea consumer consultation case Some policy terms apply the payment criteria used when health insurance does not apply. Policies that limit coverage to treatment at domestic medical institutions are assessed differently. Check the coverage conditions for inpatient and outpatient treatment separately. Check the name of the indemnity health coverage currently in force on your policy certificate. Find the provisions concerning overseas medical institutions in that policy's terms. Check whether the exclusions include any geographic restrictions. Tell your insurer the type of treatment and expected expense items, and ask it to confirm coverage. Keep a record of the applicable provisions and the claim documents the insurer tells you to submit. Conditions by place of treatment Falling ill abroad does not, by itself, rule out coverage under domestic indemnity health insurance. Overseas medical bills and medical bills incurred in Korea after your return are assessed separately. Check which insurance and policy terms apply to each treatment. Situation Coverage to check first What to watch for Treatment for an illness at an overseas hospital Travel insurance coverage for overseas medical expenses due to illness Check whether you have the coverage and what it excludes Treatment at a local hospital after an injury abroad Travel insurance coverage for overseas medical expenses due to injury Check whether the accident and treatment are covered Treatment in Korea after an injury abroad Domestic indemnity health insurance and travel insurance coverage for domestic medical expenses If the same treatment costs are covered by both, check proportional reimbursement Claiming overseas medical bills under an older indemnity health policy The first-generation policy terms currently in force Check the overseas coverage provisions and reimbursement rate Treatment in Korea after your return for an illness unrelated to the trip Domestic indemnity health insurance Check the travel insurance requirement that the illness occur during the trip Domestic treatment after your return is a separate claim from overseas hospital bills. For travel insurance, you must also check the condition that the illness or injury occurred during the trip. Check the applicable policy terms for the period during which treatment is covered and when coverage ends. Samsung Fire & Marine Insurance overseas travel insurance FAQ Comparing travel insurance and domestic indemnity health insurance Overseas medical expense coverage under travel insurance addresses the gap in overseas coverage under domestic indemnity health insurance. Illness and injury may be covered separately. You must also check whether consultation fees, hospitalization costs, and medication costs are covered under the policy terms. Category Domestic indemnity health insurance Travel insurance coverage for overseas medical expenses Travel insurance coverage for domestic medical expenses Main place of treatment Domestic medical institutions Overseas medical institutions Domestic medical institutions Conditions to check Illness and injury conditions in the policy terms Illness and injury conditions during overseas travel Illness or injury during travel and conditions for domestic treatment Hospital bills incurred abroad Excluded under standardized policies Reimbursed according to the terms if you have the coverage Not covered Hospital bills in Korea after your return Reimbursed according to the terms Not covered under overseas medical expenses Reimbursed according to the terms When coverage overlaps Proportional reimbursement among indemnity coverages Check for overlap with other indemnity coverages Proportional reimbursement with domestic indemnity health insurance A travel insurance rider for domestic medical expenses may overlap with your existing indemnity health insurance. If your existing coverage is sufficient, check whether you can leave out that rider. Compare the scope of coverage and deductibles as well. Proportional reimbursement means that policies covering the same loss divide the payment between them. Even if you have multiple policies, you cannot receive more than your actual loss. The amount each insurer pays depends on factors such as the coverage amount and deductible. Samsung Fire & Marine Insurance explanation of indemnity coverage and proportional reimbursement Why you should check your current policy terms, not just your original enrollment date If you switched to a different indemnity health insurance product, check the terms that currently apply. Having originally enrolled in a first-generation policy does not mean overseas coverage remains in force. Distinguish between your original policy certificate and your current policy details. Fifth-generation indemnity health insurance products were launched starting May 6, 2026 (South Korea). The changes concern the coverage structure for covered medical care and for non-covered care involving serious and non-serious conditions, among other things. The launch of a new product alone does not mean overseas coverage under existing policies has expanded. Financial Services Commission guide to the launch of fifth-generation indemnity health insurance The name of your current indemnity health coverage and the applicable policy terms Any history of switching to a product from another generation Whether the policy terms changed when you renewed Exclusions concerning overseas medical institutions Premium discounts and overseas medical expense coverage are separate items to check. Simplified enrollment conditions for products designed for people with pre-existing conditions do not imply overseas coverage either. Check the actual coverage provisions rather than the product name. Documents to prepare if you receive treatment abroad Get documents from the local medical institution that show the treatment you received and the amount you spent. It may be difficult to obtain the same documents again after you return. Follow your insurer's overseas medical expense claim instructions for the final list of documents to submit. Request a medical certificate or treatment confirmation showing the diagnosis and treatment. Keep hospital receipts and an itemized statement of costs. If you were prescribed medication, keep the prescription and medication receipts. Ask your insurer whether proof of entry and exit is required. Check whether translations and original documents are required before filing your claim. Preparing the documents does not guarantee payment. The insurer will also review factors such as the coverage period and treatment details. If you are claiming under an older indemnity health policy, check the applicable overseas coverage provisions as well. Premium suspension and refunds for extended stays abroad If you stayed abroad for at least 3 consecutive months, you can check whether you qualify for a refund of your indemnity health insurance premiums. The Financial Supervisory Service explained this system in a press release dated July 16, 2025. Check the requirements for suspending premium payments before departure separately from those for receiving a refund after your return. If you stay abroad for an extended period (at least 3 consecutive months), you can receive a refund of your indemnity health insurance premiums for that period. The wording above comes from the Financial Supervisory Service's “Consumer Guidance Based on Major Dispute Cases: Points to Note About Indemnity Health Insurance.” Check the conditions that apply to your policy before applying. If you have already canceled the policy, ask your insurer separately whether a refund is possible. Financial Supervisory Service press release, posted by the Korea Insurance Research Institute Situation What to check Before an extended stay abroad Requirements for suspending premium payments and conditions concerning enrollment in overseas medical expense insurance If you continued paying premiums during your stay Documents proving the consecutive period abroad and the period eligible for a refund When returning to Korea or entering temporarily When domestic coverage resumes and how to apply If you have already canceled the policy Whether a refund can be processed for a canceled policy This system does not reimburse overseas hospital bills. You must arrange coverage for treatment abroad separately. When applying to suspend premium payments, check whether coverage will also be suspended. Common mistakes about overseas medical expense coverage If you check only whether you have insurance, without checking the place of treatment and any riders, it is easy to misunderstand what is covered. Compare the items below with your policy certificate and terms. You can also use the same items when asking your insurer for answers. Common assumption What to check I have indemnity health insurance, so overseas hospital bills are covered Standardized indemnity health insurance excludes overseas medical institutions A first-generation policy will pay 40% of overseas treatment costs Whether your current policy terms cover treatment abroad and the conditions for each expense I bought travel insurance, so medical expenses are included Whether you actually have coverage for overseas medical expenses due to illness and injury If I have multiple policies, each will pay the full treatment cost Proportional reimbursement for the same loss and coverage limits I was injured abroad, so indemnity health insurance also excludes treatment after I return The specific policy terms that apply to domestic treatment costs Premiums paid during an extended stay abroad are refunded automatically The refund application and the process for proving your stay abroad FAQ Q. Can I claim hospital bills from abroad under standardized indemnity health insurance? A. Standardized indemnity health insurance does not cover treatment costs incurred at medical facilities abroad. Check whether a separate policy, such as travel insurance, includes coverage for medical expenses abroad. Q. Should I also check an indemnity health insurance policy I took out in September 2009? A. Policies sold through September 2009 are generally classified as first-generation. However, the date you took out the policy alone cannot establish whether it covers treatment abroad. Check the terms currently in effect and the policy's conversion history. Q. Does first-generation indemnity health insurance cover 40% of medical expenses abroad? A. Some older policies apply a 40% reimbursement rate to medical expenses abroad. This rate does not apply to all first-generation policies. Check the provisions for overseas coverage and the conditions for inpatient and outpatient treatment with your insurer. Q. If I'm injured abroad and receive treatment after returning to Korea, will it be covered? A. Treatment received at a medical facility in Korea is assessed under the terms of your indemnity health insurance policy. Coverage for medical expenses in Korea under travel insurance may also apply. If both policies cover the same treatment costs, check whether proportional reimbursement applies. Q. Can I receive payment for treatment costs from both travel insurance and indemnity health insurance? A. If indemnity coverage under both policies applies to the same treatment costs, the insurers split the payment according to the policy terms. You cannot receive duplicate payments that exceed your actual expenses. Q. If I already have indemnity health insurance, can I leave out the rider for medical expenses in Korea from my travel insurance? A. If your existing indemnity health insurance provides sufficient coverage, you can check whether you can leave out the rider for medical expenses in Korea. First, compare the scope of coverage and out-of-pocket costs under both policies. Check coverage for medical expenses abroad separately. Q. Are medications prescribed abroad also covered? A. Medication costs may be covered if they qualify for reimbursement under the terms of your coverage for medical expenses abroad. Keep the prescription and medication receipts. Check specific exclusions and limits with your insurer. Q. Can I get a refund of the indemnity health insurance premiums I paid during a long stay abroad? A. If you stayed abroad for at least 3 consecutive months, you can check whether you qualify for a refund. Ask your insurer what documents you need to prove your stay and what conditions apply to your policy. If you have already canceled the policy, check separately whether a refund is possible. Q. If I switch from first-generation indemnity health insurance to another policy, will my overseas coverage continue? A. Coverage is determined by the policy currently in effect and its terms. You cannot assume that overseas coverage from when you first took out the policy will continue after the switch. Check the provisions concerning medical facilities abroad in the policy you switched to. Sources - Samsung Fire & Marine Insurance Direct Indemnity Medical Expense Insurance Product Information and FAQ: https://direct.samsungfire.com/m/mall/MP030404_001.html?ver=880 - General Insurance Association of Korea Consumer Consultation Case: If You're Considering Switching to Fourth-Generation Indemnity Medical Insurance, Be Sure to Compare This, June 2024: https://www.knia.or.kr/file-manager/104953 - Samsung Fire & Marine Insurance Direct Overseas Travel Insurance Product Information and FAQ: https://direct.samsungfire.com/mall/PP030701_001.html?ver=203 - Samsung Fire & Marine Insurance's Good Insurance Dictionary: Compensation for Actual Loss and Proportional Compensation: https://product.samsungfire.com/v2/html/customer/07/F_070_010_019.html?show-element=mmList - Financial Services Commission Announcement on the Launch and Sale of Fifth-Generation Indemnity Medical Insurance, May 6, 2026: https://www.fsc.go.kr/no010101/86831 - Financial Supervisory Service Consumer Precautions Based on Major Dispute Cases: Precautions Regarding Indemnity Medical Insurance, July 16, 2025: https://kiri.or.kr/PDF/weeklytrend/20250721/trend20250721_5.pdf Images - A clinician checks a man's forearm bandage in an exam room beside his blue suitcase.: https://injoys.com/rails/active_storage/blobs/proxy/eyJfcmFpbHMiOnsiZGF0YSI6MjkzMjYsInB1ciI6ImJsb2JfaWQifX0=--c3e6cb5d78fd5a81a9b446d065b68b574ef9ea14/ai-8b55db05.webp - A woman wearing an ankle brace practices walking between therapy rails with a physiotherapist's help.: https://injoys.com/rails/active_storage/blobs/proxy/eyJfcmFpbHMiOnsiZGF0YSI6MjkzMzIsInB1ciI6ImJsb2JfaWQifX0=--69a4c7a0fc4e621ca9e0fd47d40f63aea9f59bc1/ai-6e4243b8.webp --- Category: Knowledge Base Source: https://injoys.com/en/articles/medical-expense-insurance-overseas-coverage-rules License: cc_by Translation-Status: reviewed