Is Teeth Cleaning Covered by NHIS in Korea?
What NHIS Covers for Teeth Cleaning
Under NHIS:
✅ Dental scaling (tartar/plaque removal) once per year
- Covered for adults aged 19 years and older who are enrolled in NHIS.
- The scaling must be for oral health purposes (prevention or treatment of gum disease), not purely cosmetic cleaning.
👉 This coverage was introduced to promote periodontal (gum) health and reduce oral disease burdens.
How Much You Pay With NHIS
- NHIS helps pay for most of the cost.
- You usually pay a co-payment around 30% of the treatment cost, often about ₩15,000–₩30,000 out of pocket for teeth cleaning with insurance.
- The rest is covered by NHIS and processed by the dentist directly — no separate claim filing needed.
Important Conditions & Rules
🗓 Once Per Year Limit
NHIS covers scaling only once per calendar year (January 1 to December 31). If you already received covered scaling earlier in the year, any additional cleaning will not be covered and is treated as non-insured (비급여).
📌 Age Criteria
- Coverage normally begins at age 19+.
- For people younger than 19, scaling may be covered only if part of periodontal disease treatment, not as routine cleaning.
🦷 Medical Necessity
Scaling has to be done for a dental health reason (e.g., tartar removal, gum disease prevention/treatment). Cosmetic cleaning without clinical indication may be charged fully out of pocket.
What’s Not Covered
✖ Cosmetic dental cleanings beyond basic scaling
✖ Frequent or quarterly cleanings (beyond the once-annual NHIS benefit) — these are non-insured services and paid fully out-of-pocket
How It Works at the Clinic
- Visit a dentist and show your NHIS eligibility (for foreigners, ARC and NHIS enrollment).
- Dentists will determine whether scaling qualifies for insurance coverage.
- You pay your co-insured share right after the service.
- NHIS handles the rest directly with the clinic.
Tips to Maximize NHIS Scaling Coverage
✅ Track when you last had covered scaling — only 1 per year under NHIS.
✅ Ask the dentist: “Is this scaling covered by NHIS or non-insured?”
✅ If you want more frequent cleanings for cosmetic reasons, ask for separate pricing for non-insured cleanings.
Summary
- ✔ Yes, teeth cleaning (scaling) is covered by NHIS for adults once per year.
- ✔ You pay a small co-payment (~₩15,000–₩30,000).
- ✔ Coverage applies to preventive/treatment purposes, not cosmetic only.
- ✖ Additional cleanings beyond one per year are typically non-insured and fully paid by you.
