Health Insurance Coverage for Percutaneous Mitral Valve Repair in Severe Mitral Regurgitation — Effective July 31
Source material is a Korean government announcement (in Korean).
Starting July 31, health insurance will cover 'percutaneous transcatheter mitral valve repair using a clip,' reducing medical costs that reached up to 50 million won to about 1.4 million won for patients eligible for the severe disease copayment reduction program (산정특례).
Key facts
| Effective date | July 31 |
|---|---|
| Covered procedure | Percutaneous transcatheter mitral valve repair using a clip (클립을 사용한 경피적 경도관 승모판 재건술) |
| Previous cost | About 40–50 million won paid out of pocket as a non-covered service |
| Cost after coverage | Total treatment cost about 28.3 million won at tertiary general hospitals; out-of-pocket cost for severe disease copayment reduction program (산정특례) recipients about 1.4 million won |
| Primary severe mitral regurgitation | For patients deemed inoperable through integrated cardiac care (심장통합진료), a 5% copayment rate under the severe disease copayment reduction program (산정특례); for patients at high surgical risk, 50% under selective benefits (선별급여) |
| Secondary severe mitral regurgitation | When the integrated cardiac care team unanimously agrees the procedure is needed, 5% under the copayment reduction program (산정특례) for ventricular disease, 80% under selective benefits (선별급여) for atrial disease |
| Estimated patient population in Korea | About 25,000 people, as of 2025 |
| Inquiries | Ministry of Health and Welfare Insurance Benefits Division (보험급여과), 044-202-2734 |
Last checked:
The Ministry of Health and Welfare (보건복지부) is newly listing 'percutaneous transcatheter mitral valve repair using a clip' as a health insurance benefit item for patients with severe mitral regurgitation (승모판 폐쇄부전) who show little improvement from existing surgery or drug treatment, effective July 31. Until now, this procedure was performed as a non-covered service, requiring patients to pay about 40 million to 50 million won out of pocket, but after health insurance coverage begins, the out-of-pocket cost for patients eligible for the severe/rare disease copayment reduction program (산정특례) will drop to about 1.4 million won, out of a total treatment cost of about 28.3 million won at tertiary general hospitals. The covered population and copayment rate vary by disease type, and the government is also strengthening compensation for integrated cardiac care (심장통합진료).
Summaries below are factual notes based on government announcements and primary sources — not evaluations or opinions.
FAQ
When does health insurance coverage begin?
It takes effect starting July 31.
How much is the out-of-pocket cost?
Out of a total treatment cost of about 28.3 million won at tertiary general hospitals, the out-of-pocket cost for patients eligible for the severe disease copayment reduction program (산정특례) is about 1.4 million won. The copayment rate varies by disease type — 5%, 50%, or 80%.
What is mitral regurgitation?
It is a condition in which the mitral valve (승모판) fails to close properly due to aging, congenital abnormalities, or other causes, causing blood to flow backward from the left ventricle. Over the long term it can lead to heart failure, so appropriate treatment is needed.