The National Health Insurance Support System for Diabetes Consumables and Management Devices in South Korea: Status, Challenges, and Policy Directions

Effective diabetes management depends on continuous self-care, and access to consumables and management devices is critical.In Korea, the National Health Insurance (NHI) introduced a support scheme for diabetes consumables in 2011 and has gradually expanded its coverage to include a broader range of consumables and management devices, thereby strengthening financial protection for patients.As coverage expanded, the program also expanded in scale.By 2024, total claims for diabetes consumables and management devices reached approximately KRW 112.2 billion.Despite this expansion, the system continues to face structural limitations arising from its reimbursement-based cash benefit design rather than in-kind coverage.The requirement for upfront payment and subsequent reimbursement, together with claims procedures that are more complex than those for standard healthcare benefits, imposes substantial administrative burdens on both patients and healthcare providers, thereby limiting effective utilization.Utilization patterns also vary depending on policy awareness and administrative capacity.Socioeconomic and digital disparities are evident in the utilization of advanced technologies such as continuous glucose monitoring systems and insulin pumps.International experience suggests that in-kind coverage, eligibility criteria grounded in clinical necessity, and systematic integration with education and care management programs can improve accessibility, equity, and clinical outcomes of diabetes care.These findings indicate that Korea' s current model does not sufficiently address accessibility, equity, and longterm sustainability.To maximize health outcomes and reduce disparities, diabetes support policies should transition toward an integrated management framework that aligns financial coverage with clinical needs, patient education, and coordinated care delivery.In particular, consideration should be given to transitioning the current reimbursement-based support scheme toward in-kind coverage within the NHI benefit framework.