More than 2,300 clinic-level medical institutions in Seoul did not submit any health insurance claims during the first half of 2025, according to newly released data from the Health Insurance Review and Assessment Service. The information, provided to Rep. Baek Jong-heon (Busan, Geumjeong) of the National Assembly’s Health and Welfare Committee on October 13, reveals that a total of 2,304 clinics failed to file insurance claims between January and June this year. This marks a significant increase—approximately 50%—compared to the same period in 2022, when only 1,540 clinics reported no health insurance billing.
The majority of these cases are concentrated in Seoul’s Gangnam district, an area widely recognized for its thriving cosmetic surgery industry. Notably, plastic surgery and general practice clinics dominate the list of institutions with zero insurance claims. The data shows that within Gangnam, 79% of orthopaedic clinics (358 out of 452) and 42% of general practitioners (311 out of 741) did not report any health insurance billing during the first half of the year. While orthopaedic clinics typically provide treatments for conditions such as fractures or scars—services usually eligible for insurance claims—the high percentage opting out suggests a primary focus on procedures not covered by public health insurance, such as cosmetic and aesthetic surgeries.
Implications for Public Health Policy and Medical Service Trends
Representative Baek’s office noted that most clinics abstaining from health insurance claims are likely specializing in cosmetic and plastic surgery. These procedures remain outside the scope of South Korea’s national health insurance system, highlighting a growing sector within urban healthcare that operates largely outside public reimbursement channels. The trend raises questions about access to insured medical services and the evolving priorities of healthcare providers in metropolitan areas like Seoul.
General practitioners are traditionally expected to deliver basic medical care covered by national health insurance. However, the substantial portion choosing not to submit claims may reflect broader shifts in service offerings or patient demand for uninsured treatments. Policymakers and healthcare analysts are now examining whether this surge could impact overall public health outcomes or signal changes in business models among urban clinics.
The Health Insurance Review and Assessment Service will continue monitoring these developments as authorities consider future adjustments to healthcare regulations and insurance coverage. The dramatic rise in non-claiming clinics underscores both the popularity of elective procedures and potential challenges for ensuring equitable access to essential medical care.
Related topics:
