For a planned visit using Korean National Health Insurance (NHIS) at a tertiary general hospital, a doctor’s referral is generally required, subject to exceptions. The receiving hospital’s appointment and document instructions also matter. Start by identifying the institution, the department you hope to visit, and whether you will use NHIS, private insurance, or self-payment.
Understand what the referral is for
The NHIS care-benefit explanation separates care into two phases: institutions other than tertiary hospitals, followed by tertiary hospitals. For the second phase, it describes a referral slip from the doctor who assessed the patient first, explaining the need for tertiary care.
The referring doctor assesses whether tertiary care is needed; asking for a letter does not guarantee a referral. NHIS also lists exceptions, including family medicine and emergency care. Those exceptions have conditions, so ask which requirements apply to your planned specialist visit.
Check whether the institution is designated as a tertiary hospital; a university name alone does not confirm that status. The clinic and hospital types guide explains these labels and how they relate to NHIS rules.
Check the hospital’s instructions before arranging the visit
Hospitals give their own instructions for obtaining and submitting a referral. These examples were checked on 28 October 2026:
- Seoul National University Hospital’s registration page tells NHIS patients to bring a referral for insurance application, with an exception for family medicine appointments. It describes obtaining one through another hospital or an assessment by its family medicine doctor. That family medicine consultation requires advance booking and is charged separately.
- Konkuk University Medical Center’s outpatient guide tells patients on its NHIS pathway to have the referral ready before making an appointment and to bring it for the visit. It also describes a family medicine route requiring advance booking and a separate consultation charge.
Keep the hospital name, payment route, and department beside the document instructions you receive.
Check requirements for your insurance or self-pay visit
Use this worksheet for a planned appointment. Its purpose is to identify what remains to be confirmed, rather than decide an individual’s insurance entitlement.
| Situation | Question to resolve with the receiving team |
|---|---|
| You expect to use NHIS for a tertiary-hospital specialist visit | Is a referral required for this department and visit, or does a specific exception apply? |
| You already have a referral | Is this document acceptable for the intended department? How recent must it be, and should you bring an original or a copy? |
| You have a letter or records from overseas | Are these needed for clinical review, and what separate document is required for the NHIS route? |
| You will use private insurance or pay yourself | What intake documents does this service require, and what payment arrangements need confirmation? |
| You have been directed to family medicine first | Is a separate assessment appointment needed, what will it cost, and what happens after that assessment? |
Ask the hospital to confirm document acceptance, the appointment, and payment arrangements separately, and save each answer. If a requirement is missing, ask how that affects registration and payment before attending.
Send a focused referral enquiry
You can adapt this message without attaching medical or identity documents to an initial general enquiry:
I would like to arrange a planned visit with [department] and expect to use [NHIS / private insurance / self-payment]. I currently have [a referral / overseas medical records / no referral]. Please confirm the referral requirement for this appointment, the acceptable document and language, and when and where to provide it.
If an initial assessment is needed, please explain how it is booked and whether it involves a separate consultation charge.
Record the hospital’s reply and the date you received it. Follow its official document-submission instructions when records are requested. If you are unsure which team should receive the enquiry, the guide to international centres and regular departments explains the difference in booking routes.
This guide covers preparation for planned care. It does not determine personal NHIS eligibility or whether a clinician should issue a referral.