When a parent gets a long-term care grade and starts home visits or day care, the first question is how much the family pays each month. Under Korea’s Long-Term Care Insurance Decree Art. 15-8 the copay is 15/100 for home-based care and 20/100 for facility care. Act Art. 40 says care above the monthly limit is paid entirely by the recipient, medical aid type 1 recipients pay nothing, and low-income recipients get reductions within 60/100, which the ministry’s notice splits into 60% and 40%. From 1 October 2026 the home-care monthly limits run from 2,512,900 won for grade 1 to 676,320 won for the cognitive support grade. Enter the grade and this month’s care cost to see the copay.
1. Home-based care 15%, facility care 20% (Decree Art. 15-8).
2. Anything above the home-care monthly limit is yours in full — grade 3’s limit is 1,528,200 won.
3. A 60% reduction gives 6% at home and 8% in a facility; 40% gives 9% and 12% (our sums) — medical aid type 1: 0 won.
Calculator
Updates as you type. Home-based care: 15% within the grade’s monthly limit, everything above it is yours. Facility care: 20% (limit not checked). Reductions of 40% and 60% follow the MOHW notice; fractions of a won dropped (our rounding). Welfare equipment is outside these limits.
Act, Decree and notices
| Type | What the source says | Worth noting (ours) |
|---|---|---|
| Act Art. 40(1) | Recipients of long-term care benefits (other than special cash benefits) pay part of the cost as the Decree provides | No copay on cash benefits such as family care allowance |
| Act Art. 40(2) | Medical Aid Act Art. 3(1)1 recipients pay no copay | Type 1 basic livelihood recipients |
| Act Art. 40(3) | Care outside the scheme, the difference for care chosen differently from the certificate, and care above the monthly limit are paid entirely by the recipient | Over the limit = 100% yours |
| Act Art. 40(4) | Medical aid types 2–9, people with income and property below the notice amount, and people in hardship from disasters get graded reductions within 60/100 | Steps are in the notice |
| Decree Art. 15-8 | Home-based care: 15/100 of the cost / facility care: 20/100 | — |
| Reduction notice Art. 2(1) | Medical aid types 2–9, people with a health insurance copay reduction, disaster hardship, and health premium rank 0–25% (employees: property test) get a 60/100 reduction | 15% × 0.4 = 6% (ours) |
| Reduction notice Art. 2(2) | Health premium rank over 25% up to 50% (employees: property test) get a 40/100 reduction | 15% × 0.6 = 9% (ours) |
In short (our sums), a 60% reduction means paying 6% at home (40% of 15%) and 8% in a facility (40% of 20%); a 40% reduction means 9% and 12%. Medical aid type 1 recipients pay 0 won within the limit.
The ministry sets the premium-rank cut-offs by the end of January each year and sends them to the NHIS (notice Art. 2(4)). The NHIS decides which band a household is in, so the calculator lets you pick it.
2026 home-care monthly limits — benefit cost notice Art. 13
| Grade | Monthly limit (notice) | 15% if fully used (ours) |
|---|---|---|
| Grade 1 | 2,512,900 won | 376,935 won |
| Grade 2 | 2,331,200 won | 349,680 won |
| Grade 3 | 1,528,200 won | 229,230 won |
| Grade 4 | 1,409,700 won | 211,455 won |
| Grade 5 | 1,208,900 won | 181,335 won |
| Cognitive support | 676,320 won | 101,448 won |
The limit applies to home-based care other than welfare equipment (Rule Art. 22(1)). Notice Art. 13 leaves out of the limit items such as long-distance travel costs for home visits, transport and bathing add-ons for day care, and doctor’s opinion and visiting-nurse order fees. The limit runs from the 1st to the last day of each month; if care first starts mid-month or moves from a facility to home, the full month’s limit applies, and if the grade changes mid-month the higher grade’s limit applies. A facility’s limit is a daily cost times the days in the month (Rule Art. 22(2)); we did not set out the daily amounts.
Three sums — our examples
| Case (ours) | You pay | Worth noting (ours) |
|---|---|---|
| Grade 3, home care 1.7m won, standard | 401,030 won | 15% of the 1,528,200 won limit = 229,230 + 171,800 over |
| Same, 40% reduction | 309,338 won | 9% = 137,538 + 171,800 over — no reduction on the excess |
| Same, 60% reduction | 263,492 won | 6% = 91,692 + 171,800 over |
| Grade 1, home care 2m won, standard | 300,000 won | Within the limit — NHIS pays 1,700,000 |
| Grade 2, facility 2m won, standard | 400,000 won | Facility 20% |
Leaving the excess unreduced is our plain reading of Act Art. 40(3) (“entirely”). Grades and how to apply are in long-term care grades.
When the reduction is withheld — notice Art. 2-2
Rank-based reductions (60% item 4 and 40%) are not applied to regional members who move their registered address to an elderly care facility, or to former dependants who become single-household regional members while sharing an address with the former supporting employee — with exceptions such as earlier reductions or no family ties.
Checklist
- ☐ Home 15%, facility 20%
- ☐ The grade’s monthly limit — excess is all yours
- ☐ Ask the NHIS whether a 60% or 40% reduction applies
- ☐ Give the provider the reduction paperwork (Rule Art. 35)
- ☐ Mid-month grade change: higher limit
Questions that remain
Are meal ingredients or upgraded rooms inside the 15%?
Act Art. 40(3) says care outside the scheme is paid in full. We did not list which items are non-covered.
I handed in the reduction papers late.
Rule Art. 35 allows 7 days (excluding holidays) from applying for care in urgent cases, and has the NHIS repay any share it should have borne.
Sources
- Korean law database (law.go.kr) — Long-Term Care Insurance Act Art. 40 — source (current text, effective 26 May 2026, Act No. 21690; checked 27 October 2026). Copay, type 1 exemption, three full-payment cases, reductions within 60/100.
- Korean law database — Enforcement Decree Art. 15-8 — source (effective 12 May 2026, Decree No. 36325; checked 27 October 2026). 15/100 and 20/100.
- Korean law database — Enforcement Rule Arts. 22, 34, 35 — source (effective 12 December 2025, MOHW Ordinance No. 1138). Limits by notice, hardship, paperwork and 7 days.
- Korean law database — Notice on long-term care copay reductions — source (effective 1 December 2021, MOHW Notice No. 2021-283). 60% and 40% groups, exclusions.
- Korean law database — Notice on long-term care benefit standards and costs, Art. 13 — source (effective 1 October 2026, MOHW Notice No. 2026-189; checked 27 October 2026). Monthly limits by grade (table), exclusions, monthly period, excess paid in full.
- Not read. Facility daily costs, the non-covered list, the yearly rank cut-offs, the welfare equipment limit.
- What we added. The “worth noting” column and the Korean everyday gloss.
Where to check further
- NHIS long-term care insurance — reduction decisions and providers’ claims.
Written on 27 October 2026. The content is from the source; the glosses are ours.
