There are several types of prescriptions that people living with type 1 diabetes can get in Korea.
They may differ a bit depending on the type or size of hospital issuing them, but as a rough guide, below is a quick overview of the types available so far.
To get insulin from a pharmacy, a prescription is necessary. Glucose monitors, pen needles, test strips etc can be bought without a prescription, but they need to be bought at full price and no refund is possible if they are bought without a valid prescription.
There are 4 types of prescriptions that can be issued by a doctor:
- Prescription for medicine (including insulin)
- Prescription for consumables (syringes, needles etc) – up to 180 days
- Prescription for cgms, insulin pumps – max 1 year for cgm and max 5 years for pumps
- Prescription for sensors – up to 100 days
Prescription for medicine (insulin)
Insulin prescriptions are similar to all medicine prescriptions. They have the personal and hospital information at the top, then the insulin details at the bottom.
Unless you are getting your insulin at a big hospital directly, or a pharmacy that is associated with a bigger hospital, pharmacies cannot open insulin boxes to give you individual pens, therefore doctors need to prescribe insulin pens in multiples of 5 each time. Some doctors unfamiliar with diabetic patients might write down 2 or 3 pens at a time, so to avoid being rejected by the pharmacy be sure to double-check the amount.
If there are several different types of medicines listed on the prescription, they all have to be picked up at once – a prescription cannot be reused to get the other half of the medicine not picked up the first time. The pharmacy also gives out a receipt that is often needed when people have private insurance as well. If you don’t have private insurance, this paper isn’t needed but it does show the price breakdown, with insurance costs and personal costs.
Prescription for diabetes consumables
The first prescription is for diabetes materials such as test strips, lancets, pen needles etc. These can be prescribed for a maximum of 180 days at a time. At the top is always the personal information, followed by a section that must be checked.
In this case, there is a checkbox for type 1 diabetes as well as options for some people with type 2 diabetes. For T1d, the consumables are refunded at 90% of the price, whereas for T2d it is often reduced or sometimes not applicable at all, depending on the type of prescription, hence it is important all details are checked and the right box is ticked.
Next is the section with the consumables. Depending on what was discussed with the doctor, several of these might have a checkmark. This changes each time depending on what is needed but it is important that the right box is ticked, otherwise no refund is possible. So for example, if test strips and lancets are checked but you also buy pen needles which wasn’t checked – you won’t be able to get a refund for those pen needles. Therefore carefully think what is needed and let your hospital team know so they can check all the boxes as needed.
It is also important to check the time period the prescription is valid for – the first one is often 30 says, followed by 90 days after, but this can depend a bit on your personal circumstances. At the end is the hospital’s information as well as the stamp and date.
Be sure all is properly dated, signed or stamped and all the relevant boxes are checked before you leave the hospital.
Unlike the medicine prescription, not all consumables have to be bought at once. Especially prescriptions with a longer date are designed to cover you with consumables for the time period stated, so they don’t need to be bought at once.
Prescription for cgm trasmitter or insulin pump
The next prescription can be used for cgm transmitters (such as Dexcom) or insulin pumps.
At the top is again the personal information, followed by details that need to be confirmed and one of them must have a checkmark. These fields include several ways to prove why someone is registered as a person living with type 1 diabetes; such as c-peptide test or antibodies test. Under (2) the box for insulin usage should be checked too.
Next there are boxes for either cgm or insulin pump, the time frame the prescription is valid for, as well as the next appointment date. As before, the hospital information, date and stamp is at the end.
Insulin pump prescriptions can last for up to 5 years and transmitter prescriptions can be issued for up to 1 year.
Prescription for continuous glucose monitors (sensors)
The last prescription is for cgm sensors or, in the case of Freestyle Libre, for flash glucose monitors. Sensor prescriptions can be issued for up to 100 days, but at the beginning the very first prescription is usually for 30 days only.
As before, the top includes personal information, followed by a list of things that must be checked. Although the people at NHI always try to be helpful, there is often a lot of confusion in regards to which boxes must be checked and especially in regards to the online refund process, ALL details must be completed. Therefore it is best to talk to your doctor and have ALL the fields checked and filled in.
The prescription period is listed as before, followed by a list of cgm sensors or flash monitors to choose from. Be sure the right sensor has a checkmark and that the prescription period is acccurate.
The last part again includes the hospital information, signature or stamp and the date of the prescription. Be sure to keep this form until you plan to apply for your refund with the National Health Insurance System. You can find further details under NHIS.
Some hospitals have started to sell cgms directly, processing the refund on your behalf, which makes it possible to pay just the 30% personal contribution as opposed to paying the full amount and applying for refund later. Hospitals offering this service are few and far between but it is worth asking your doctor about it.
Pharmacies are also able to process refunds on your behalf in some cases. They will need your prescription and your registration card. You can then buy pen needles, test strips etc. at the reduced rate if you do not wish to go through the process of buying everything online. In regards to Libre sensors however, pharmacies are unable to process the refund in advance for you, but might be able to do the process for you after you pay full price. Check with your local pharmacy in regards to what they can and cannot help with first, as not all are willing to help out.
Due to social distancing measures introduced during the corona outbreaks, it is currently possible to renew prescriptions without visiting a doctor. Depending on the type, items can be bought between 14 – 30 days early.
How early it can be applied for depends on which sensor is used, and the original renewal date does not change. For example, the last refund period finished on January 10th and a new refund can be applied for for sensors bought from January 11th, but a sensor is needed by January 3rd, it can already be bought and refund can be applied for. The new date for the next validity period will still be January 11th, as we do not get more sensors in a year, we just apply for refund early. In summary:
- original refund period: November 10th – January 10th
- new refund period starts: January 11th – April 11th
- Sensor set 1 bought: November 14th (within original refund period)
- Sensor 2 bought: January 2nd (refund applies to new refund period)
- New refund period start date: January 11th and then April 11th again
Libre sensors can be bought up to 30 days before the end of the current prescription. As long as 68 days have passed since the last time a sensor was bought, a new sensor can be bought directly from the pharmacy and an NHI refund can be applied for using the purchase receipt.
Dexcom sensors can also be bought up to 30 days early. The normal prescription time is usually 90 days for dexcom, so as long as 60 days have passed, a new Dexcom sensor can be bought. For transmitters, they can only be applied for 14 days before the new prescription date, so 76 days after the last one was bought.
As the date and refund process are a bit confusing, NHI recommends to call them to check the date. They usually send a text message with the next date from which a new prescription refund can be applied for, but to avoid having to bear the full cost alone, it is best to call them and double check. The English helpline can be reached at 1577-1000.