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‘본인부담상한제’ 허점 속에 불만 목소리 커진다
작성자 관리자 작성일 2021-09-03 조회수28


<h3 class="heading" style="font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; margin-top: 1px; text-transform: none; font-weight: 400; color: rgb(30,30,30); padding-bottom: 0px; font-style: normal; text-align: left; padding-top: 0px; padding-left: 0px; margin-left: 1px; orphans: 2; widows: 2; display: block; letter-spacing: -0.05em; line-height: 1.375; padding-right: 0px; background-color: rgb(255,255,255); margin-right: 1px; text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; text-rendering: optimizelegibility"><strong><span style="font-size: 24px">&lsquo;본인부담상한제&rsquo; 허점 속에 불만 목소리 커진다</span></strong></h3><br /><br /><br /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">과도한 의료비 지출에 따른 가계 부담을 줄이기 위해 정부가 본인부담상한제를 시행하고 있지만 제도의 애매함 속에 피해자 불만도 늘고 있다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">환자가 진료 후 부담한 본인부담금을 다음해 8월 사후 지급받기 때문인데, 병원비를 쓸 때와 나중에 환급받을 때 사이 공백이 존재하면서 보장이 제대로 되지 못한 것이다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">뿐만 아니라 보험사가 사후환급금을 이유로 보험금 지급을 거절하거나 삭감하는 경우도 나타나면서 분쟁 가능성이 커지는 상황이다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">◇초과환급금, 다음해 8월&nbsp;지급...시차 따라 보장 공백</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">1일 관련 업계에 따르면 지난해(1월1일부터 12월31일까지) 적용됐던 본인부담상한액 초과금에 대한 환급이 지난달부터 시작됐다. 국민건강보험공단에 의하면 총 166만 643명에게 2조2471억원을 환급하며 1인당 평균 13만원의 혜택을 제공한다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">본인부담상한제는 연간 본인일부부담금(비급여, 선별금여 등은 제외) 총액이 개인별 상한 금액을 초과하는 경우 그 초과 금액을 건강보험공단이 대신 부담하는 제도다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">적용 방법으로는 사전급여와 사후급여가 있는데, 사전급여는 동일한 요양기관에서 진료를 받고 지급한 본인부담금 총액이 584만원(올해 기준)을 넘을 경우 초과 금액을 병&middot;의원에서 공단으로 청구하는 방식이다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">반면 사후급여는 환자가 여러 병&middot;의원에서 진료를 받고 부담한 연간 본인부담금을 다음해 8월말 최종 합산하고 보험료 수준에 따른 본인부담상한액을 넘는 경우 초과 금액을 공단이 환자에게 돌려주는 형태다.</span><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><br /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><br style="font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify" /><span style="font-size: 16px; font-family: &quot;맑은 고딕&quot;, 굴림, &quot;Malgun Gothic&quot;, Dotum; color: rgb(51,51,51); text-align: justify"><span style="font-family: arial, helvetica, sans-serif"><a href="http://www.fins.co.kr/news/articleView.html?idxno=90216" style="font-size: 12px; font-family: &quot;??&quot;; color: rgb(116,116,116); line-height: 16px; text-decoration-line: none"><font color="#202020">후략</font></a></span></span><br /><br /><br /><br style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial" /><span style="font-size: 16px; font-family: &quot;Apple SD Gothic Neo&quot;, &quot;Helvetica Neue&quot;, Roboto, &quot;Noto Sans KR&quot;, &quot;Malgun Gothic&quot;, dotum, Arial, sans-serif; white-space: normal; word-spacing: 0px; text-transform: none; float: none; font-weight: 400; color: rgb(30,30,30); font-style: normal; orphans: 2; widows: 2; display: inline !important; letter-spacing: normal; background-color: rgb(255,255,255); text-indent: 0px; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial">출처 : 보험매일(<a href="http://www.fins.co.kr">http://www.fins.co.kr</a>)</span>
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