Injoys
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 |
If multiple policies cover treatment after returning home, insurers divide the payment under their 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
