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Medical Services

Specialized Referral

A specialized referral is a system that allows patients who are eligible for government-funded medical care to receive treatment at specialized hospitals when, based on a specialist’s opinion and considering the medical staff, facilities, and equipment of the relevant VHS Hospital, it is determined that treatment at the VHS Hospital is difficult.

Target

Among those eligible for full government coverage of medical expenses at VHS Hospitals (excluding those eligible for reduced-cost treatment)

If a patient with an infectious disease, or suspected of having an infectious disease, who cannot be appropriately treated within the VHS Hospital
If treatment at the VHS Hospital is difficult due to a rare, intractable, or severe disease
If treatment is difficult due to the absence of a medical department or insufficient facilities at the VHS Hospital
However, those who registered after July 1, 2012 and were classified as Disability Rating 7, and those who registered after June 23, 2016 and were classified as having a mild disability rating for actual or potential aftereffects of defoliants (including second-generation), Disability ratings 12–14 among persons injured in the May 18 Democratization Movement, and Disability rating 7 among persons injured while performing special missions, are required to pay 10% of medical expenses when receiving treatment at medical institutions other than their designated hospital for injury treatment.

Specialized Referral Treatment Procedure

If the attending physician determines after examination that treatment at the VHS Hospital is not possible, referral for specialized treatment is permitted only with the approval of the hospital director.

01. ConsultationTreatment at a VHS Hospital
02. Decision to Provide Specialized Referral TreatmentIf treatment is not possible at the VHS Hospital, the attending specialist issues a Specialized Referral Medical Treatment Application
03. Guide on ReferralGuidelines for referral treatment (referral team), scope of support, and claim procedures
04. Consultation and ClaimIndividual medical expense claims, receipts, detailed statements, etc.
05. Review of Medical ExpensesReview of claimed medical expenses (Review Division)
06. Payment of Medical ExpensesAfter the review of claimed medical expenses is completed, the finalized amount is transferred to the individual’s designated bank account

Request for Payment of Medical Expenses

After making payment in advance to the designated medical institution or pharmacy, please prepare the following documents and submit your application:

Original receipt for medical expenses
Billing statement for medical expenses
Original receipt for prescription drugs (the prescription attached)
Diagnostic results for special examinations (e.g., CT, PET-CT, MRI, ultrasound) for outpatient visits
Verification of the use of a higher-level hospital room
Bank account in the applicant’s real name (for receiving pension)

Medical expenses not covered during specialized referral treatment (Detailed information will be provided separately at the time of referral application.)

Medical expenses (or examination fees) for conditions not referred to by the VHS Hospital, or expenses for treatment beyond the approved period
Medical expenses incurred due to the patient or guardian voluntarily changing the medical institution
Arbitrary non-covered medical expenses not specified under the Rules on Standards for Health Care Benefits Covered by National Health Insurance
Room rate difference for using a higher-level hospital room (only recognized for up to 7 days from the start of hospitalization when the standard room is unavailable; excludes special/private rooms)
All costs related to the donor incurred by the organ transplant surgery
Items classified as non-covered under Article 9(1) of the Rules on Standards for Health Care Benefits Covered by National Health Insurance
Costs for dental prosthetic materials, assistive devices, issuance fees for medical certificates, nursing care fees, telephone charges, medical supplies purchased from specialized medical supply companies or shops, and materials purchased outside domestic medical institutions or pharmacies
Other cases as separately determined by the Minister of Patriots and Veterans Affairs