the burden of caregiving expenses of KRW 3.7 million per month will now be shared by the state. we explain the key points of the caregiving support policy that will be implemented from 2025, who will be covered by 70% of health insurance (salaried) and under what conditions, the introduction of the third shift, and everything else that will change, using examples to make it easy to understand.
"How would your life change if one of your family members fell ill?"
this question is no longer a myth: the moment a family member needs care due to a sudden accident or illness, everything in our lives is turned upside down. in addition to the suffering of the patient, the remaining family members enter a caregiving tunnel with no end in sight. But what weighs heaviest on the shoulders of patients and their caregivers is the very real barrier of care costs.
faced with costs that can run into the millions per month, many families crumble, leading to tragic choices. that's why the government has finally fallen on its sword: a new policy to 'ease the burden of care costs' has been announced.
today, I'm going to break down the government's new caregiving support policy - "Paying for Care" - from top to bottom: who will be eligible, when, what benefits will be available, and what we should be prepared for, as it could turn the dreaded phrase "caregiving bankruptcy" into hope.
1. "Caregiving bankruptcy"... 3.7 million won per month, no longer the family's responsibility
1.1. A tunnel with no end in sight, the reality of caregiving hell (case-centered)
mr. Kim, an office worker in his 40s, loses sleep every night because of his mother, who recently collapsed from a brain hemorrhage. as a dual-income couple with young children, she can't be by her mother's side 24 hours a day. they eventually decided to hire a caregiver, but the cost of 120,000 to 150,000 won per day, or more than 3.7 million won per month, is a huge bomb for an ordinary middle-class family, far exceeding the average monthly income of a household with a member aged 65 or older (2.24 million won).
"We can't afford it even if we cut back on one of our children's classes and eliminate the couple's pocket money," Kim says, adding, "We're running a negative bank account, but I don't know how long we can keep it up." kim is not alone: 65.2% of the 1,000 caregivers surveyed cited "paying for care" as the most challenging aspect of caregiving.
the cost of caregiving isn't just a burden on the household budget; it's a major contributor to family breakdown. young caregivers are quitting their jobs or giving up their education because they can't afford caregiving expenses, and "caregiving bankruptcy" has become a reality, with people dipping into savings and insurance, taking out loans, and even selling their homes. even more tragically, a horrifying new term has emerged: "caregiving homicide," in which family members who are exhausted by long-term caregiving either kill their loved ones or make the extreme choice together.
until now, caregiving in South Korea has been the sole responsibility of individuals and families. private care expenditures of over 10 trillion won per year are a testament to this. but now there are calls for society to share this heavy burden, and the government has responded.
2. what is the government's 'pay for care' policy?
2.1. The key is 'health insurance coverage', which means 70% support for caregiving expenses
the core of the government's measures is, in a word, 'salarization of caregiving expenses'. until now, caregiving expenses have been a "non-benefit" item not covered by health insurance, meaning that unlike hospital bills and medication, patients or their guardians had to pay 100% of the cost without any support from the government.
"Paying for care" means converting these expenses into "salary" items covered by health insurance. once the policy is implemented, the National Health Insurance Organization will cover 70% of the care costs, and the patient will only be responsible for 30%.
how will this change our lives? let's look at a very specific example: if a day's care costs 150,000 won, you used to have to pay the full 150,000 won, but now you only have to pay 30%, or 45,000 won. over the course of a month (30 days), that's a reduction from 4.5 million won to 1.35 million won. The government expects the burden of caregiving expenses to drop significantly from an average of over 3.7 million won per month to around 600,000 won to 800,000 won after the policy is implemented. This is a real hope for people to escape the fear of 'care bankruptcy'.
2.2. From when and who will benefit?
this is the most important question: This groundbreaking caregiving support policywill be fully implemented from the second half of next year.
however, not all patients will be eligible for this benefit. The government has clarified who is eligible to receive support in order to focus limited resources where they are most needed. the benefit will be prioritized for "seriously ill patients" admitted to "medical-oriented nursing hospitals," meaning that whether I or my parents are eligible depends on which hospital they are in and what their condition is.
3. will I or my parents be eligible? (Breaking down the eligibility criteria)
3.1. Difficult conditions? Criteria for selecting 'medical center nursing hospitals'
the government will not apply the care fee support to all of the approximately 1,400 nursing hospitals in the country. Instead, it will designate hospitals that meet strict criteria as "medical center nursing hospitals" and will only benefit patients who are admitted to them. we aim to designate up to 500 hospitals within the government's term.
the selection criteria include
high standards of medical and nursingcare: Do they meet standards for doctor and nurse staffing and provide high quality treatment and care?
proportion of severely ill patients: Does the organization treat at least a certain percentage of severely ill patients with high medical needs, such as dementia or Parkinson's disease?
transparent cost structure: Does it not overburden patients with unnecessary non-payment items?
regional equity: To ensure that benefits are not concentrated in metropolitan areas, rural nursing homes are also considered if they meet certain criteria.
this selection process is not just about reducing costs; it is also a strategy to encourage nursing homes to improve the quality of their services and facilities through the powerful incentive of subsidized care. In other words, the government is using this policy to distinguish between high-quality, patient-centered nursing homes and those that are not, and to level up the overall nursing home system. for patients and their caregivers, this means that they will have a more reliable criteria for choosing a hospital.
3.2. Which patients are recognized as 'seriously ill'?
not everyone will be eligible just because they are admitted to a 'medically-focused care hospital' - their condition must be 'severe'. while the specific criteria have not yet been finalized, it is generally expected that this will include patients with
severely chronically ill: patients with dementia , Parkinson's disease, stroke (cerebral infarction/bleeding) sequelae, etc. who are unable to move around on their own and require constant medical attention and care
high medical needs: Patients who are on a ventilator , have severe pressure ulcers, etc. and require intensive care
long-term care Tier 1 and Tier 2 patients: patients recognized as having the highest care needs by the long-term care insurance for the elderly
the government plans to introduce an external adjudication system to periodically assess patients' conditions and ensure that benefits go to those who truly need medical care.
4. will the quality of care improve? 'Three shifts of caregivers' and workforce issues
4.1. From 24/7 to an '8-hour, 3-shift' system
the new caregiving support policy is not just about providing money, but also about system reforms that fundamentally change the quality of caregiving services. the biggest change is the mandatory "three shifts of caregivers.
until now, a single caregiver often slept in the patient's room and cared for the patient around the clock, leading to extreme fatigue and burnout, which in turn led to a decline in the quality of care.
in a "medical center nursing hospital" under the new policy, caregivers will work three eight-hour shifts per day. based on a four-bed ward, there will be one caregiver for every four patients. This will ensure that caregivers are well-rested and can provide more intensive and specialized care during their scheduled shift. for patients, this means reliable care from professionals who are always on top of their game.
4.2. Shortage of caregivers, are 'foreign caregivers' an alternative?
but here's where we run into a huge challenge. three shifts would require three times as many caregivers as we have now, even by simple math. according to government estimates, at least 80,000 new caregivers would be needed to fully implement the policy. how do you get this many workers when there is already a severe shortage of caregivers?
the government's key solution is the active introduction of "foreign caregivers. the plan is to expand the caregiving workforce market, which is currently limited to Chinese compatriots (F-4 visas for overseas Chinese and H-2 visas for visiting workers), to other countries such as Southeast Asia, and to improve the visa system.
of course, this is not an easy task. language and cultural differences, the absence of a systematic education and training system, and quality of service management issues are just a few of the challenges that need to be addressed. But if these issues are not addressed, the good policy of "making caregiving pay" could run aground on the reef of a labor shortage. In other words, it's no exaggeration to say that the success of the Welfare Ministry's caregiving pay policy will depend on how well the Ministry of Justice's visa policy and the Ministry of Employment and Labor's labor supply policy work together.
5. what remains to be done: healthcare financing and the future of nursing homes
5.1. At a cost of trillions of won per year, is our health insurance okay?
the promise of "70% of care costs covered" requires a huge amount of funding. the government estimates that about 6.5 trillion won will be spent on health insurance over the next five years.
while this is welcome news, it also raises concerns, as Korea is already aging at the fastest rate in the world, raising warning lights about the depletion of health insurance finances. While it is a necessary policy, it is difficult to ensure the sustainability of the system without a concrete plan and social consensus on how to stabilize this huge cost. This is why complementary measures such as increasing the co-payment rate according to the length of hospitalization are being discussed to prevent unnecessary long-term hospitalization.
5.2. Only selected hospitals, not all nursing homes?
while the majority of Koreans support the policy of paying for nursing care, the nursing hospital industry is not happy. the Korea Nursing Hospital Association and others are concerned about what to do with the remaining 800 to 900 nursing hospitals besides the 500 designated by the government.
they argue that the government's support for selecting these hospitals could end up making them more difficult to manage, which could lead to large-scale restructuring and threaten the healthcare ecosystem. this is something that the government should listen to as it moves forward with its policies, as policies that are meant for patients and caregivers can lead to further polarization among hospitals and the failure of rural or small hospitals.
6. caregiving Expense Support, TOP 5 Most Frequently Asked Questions (FAQ)
Q1: Does this policy apply to all hospitals? A : No. It will only apply to critically ill patients admitted to up to 500 "medical center nursing hospitals" selected by the government based on strict criteria. it does not apply to general hospitals or nursing homes that are not designated by the government.
Q2: Do I need to apply separately to be eligible? A : The detailed process will be finalized in the future. however, basically, if you are hospitalized in a designated "medical center nursing hospital," the hospital will assess your severity and if you qualify, you will likely be automatically linked to the health insurance benefit without a complicated application process.
Q3: Will my out-of-pocket expenses increase for longer stays? A : Yes, they may. in order to prevent unnecessary long-term hospitalization (social hospitalization) of patients with low medical necessity, the government is considering increasing the co-payment rate by 10-20% for patients hospitalized for a certain period of time (e.g., 180 days).
Q4: What is the difference between "integrated nursing care" and "nursing care"? A : "Integrated nursing care" is a system in which nursing staff are responsible for nursing care in acute care hospitals (university hospitals, general hospitals, etc.), and it is a service that does not require a guardian or personal caregiver to be present in the patient's room. on the other hand, the "pay for care" policy is focused on nursing hospitals and differs in that professional caregivers are separately employed, but their costs are covered by health insurance.
Q5: Is there any support I can get before the policy is implemented? A : For low-income crisis households who have become unable to make ends meet due to a sudden illness or accident, the current Emergency Welfare Support System can provide some support for medical and care expenses. income and property criteria must be met, so it is recommended that you contact your local municipal welfare center to check your eligibility.
conclusion: First steps towards the 'socialization of care', hopes and challenges
the government's decision to pay for caregiving is a very important and meaningful first step towards stopping the tragedy of "care bankruptcy" and making caregiving no longer the responsibility of individuals and families, but the responsibility of society. however, this hope can only become a reality if we successfully tackle the huge challenges of securing stable financing and addressing the caregiving workforce shortage.
what do you think of the new caregiving payment policy? feel free to share your family's caregiving experience or your hopes for the policy in the comments. your feedback will help us create better policies. don't forget to subscribe to our blog and add us as a neighbor to get the fastest and most accurate welfare policy news!