진료셈 - 외래진료 횟수·본인부담

There is a rule that applies only to those who frequently visit hospitals.

Appendix 2 of the Enforcement Decree of the National Health Insurance Act stipulates that if the annual number of outpatient visits exceeds a certain limit, the individual must bear 90% of the total medical benefit costs for any treatments exceeding that threshold. This means that someone who usually pays 30% at clinics, 40% at hospitals, and 50% at general hospitals suddenly has to pay 90%.

The problem is that no one counts "how many times I have visited this year."

The "medical count" is a tool that counts those visits directly.

■ One line for each visit

By simply selecting the date and type of institution, the cumulative number of visits for the year is recorded. If you label the place you visited, the next time, a single chip captures the exact same information as the previous visit. The medical fee is low if you know it, but it is not necessary to know.

■ Taking a receipt

When you take a picture of a medical receipt or select one from a photo, the machine reads the text and displays candidates for the total medical fee, date, and institution name on a chip. You simply press the correct chip to save it. The photo is neither saved nor sent.
■ Annual Cumulative Curve

The number of visits accumulated since January grows as a curve, and the days when the baseline is exceeded, along with the year-end projection based on the current pace, are plotted together.

■ Calendar & Statistics

The calendar fills in the cells for the days of treatment, and clicking on a date displays the record for that day. It counts the number of visits by month, co-payments, and breakdowns by type of institution and frequently visited location.

■ Next Appointment Notification

If you enter a follow-up appointment date, it notifies you at 8:00 AM that day and counts how many times that appointment will be this year.

■ How Many Are Left Until the Baseline

Along with the remaining number of visits, it indicates when and on which month the baseline will be exceeded at the current pace.

It also counts the number of visits by the end of the year if the baseline is met.

■ How Much Changes When an Overpayment is Applied

For cases where medical fees have been recorded, it displays the total paid at the usual rate and the total calculated by applying a 90% overpayment rate side by side,

showing the difference. The rates by institution type were taken directly from Annex 2 of the Enforcement Decree.

** ■ I may not be eligible in the first place

Children and pregnant women are immediately excluded from this rule, while for the disabled, rare and incurable diseases, and severe diseases, those who have been officially notified are excluded.

If you check this box, the excess amount will not be counted from the next time you turn it on.

■ Records for that year

The number of the treatment remains assigned. Cases corresponding to the excess amount are marked separately.

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· It is an on-device tool. The recorded data remains only within the device and is not sent anywhere.

· It does not ask for identity information such as name, resident registration number, or bank account number. There is no login required.

· Since the standard number of times is a value that can change, it is not stored within the app but is updated remotely.

If there is no network connection, it runs on the last received value.

⚠️ It is an unofficial reference tool. It is not affiliated with any institution and does not act as a substitute for applications, inquiries, or connections.

The actual co-payment varies depending on the treatment details, special calculation exceptions, and whether a reduction is applied. The exact amount must be verified with the relevant agency.

■ Official Sources

· https://www.law.go.kr/법령/국민건강보험법시행령

· https://www.nhis.or.kr