Situation 1:
Michelle, an international student, will be studying in Hualien County to obtain her degree and hopes to gain a better understanding of the National Health Insurance.
Q1: How and when can I obtain the NHI (National Health Insurance) card?
A1: NHI stands for National Health Insurance, which is necessary for all individuals living in Taiwan. Of course, the process of obtaining NHI depends on your residency status as a foreigner living in Taiwan. Let's break down how and when you can get NHI!
If you've come to Taiwan to study at a university, getting NHI is quite straightforward. It's important to remember that foreigners can obtain NHI only after living continuously in Taiwan for six months on an ARC (Alien Resident Certificate), but you are allowed to leave the country once for up to 30 days during this 6-month period. After these six months, your university will collect insurance fees for each semester upon registration. As a student, you'll only need to pay the insurance fee, which is 826 NTD as of 2024, and then wait for notification from the university that your card is ready for collection. Insurance fees are collected from September to February in the first semester and from March to August in the second semester.
International students can be employed part-time in Taiwan. In this case, students with a steady part-time job should be registered in the program as employees through their employers. Don't forget to inform your university about this. The university will reimburse you a portion of the insurance fee you've already paid.
If you are seasonally employed, meaning you are a full-time student who only works during summer and winter vacations for fewer than 3 months and returns to school when classes resume, you do not need to change your enrollment status during the period of employment.
A foreign worker must be registered in the National Health Insurance Program from the first day of employment. Therefore, those working in Taiwan are not subject to the six-month waiting period. Your employer should register you and be responsible for paying your insurance (formerly known as the "insurance registration organization").
If you're a company chairperson or owner, you need to set up your own insurance registration unit. If you have another primary job, you can be insured through that company or agency without enrolling as a responsible person.
If you're employed but don't have a fixed employer, like being a member of an occupational union, a farmers' or fishermen's association, or are actively involved in farming or fishing, you should enroll in the National Health Insurance through your respective union or association.
If you are working two jobs at the same time, then you should be registered in the NHI program through your main employer. Your main employer is the one where you work more hours; if the hours are similar, then income can be the deciding factor.
If you are unemployed and qualify as a dependent, you should be registered in the NHI program through your employed spouse or direct blood relatives.
If you cannot be enrolled through your spouse or direct blood relatives, you are required to enroll in the program at the local administrative office where your household is registered, under the identity of a "regional citizen."
If you are an unemployed veteran or a dependent of a deceased veteran, then you can enroll in the program through the administrative office where your household is registered under the identity of "veteran."
For more information, please feel free to ask or refer to the NHI handbook (click the specific link below).
Q2: What medical services are covered by the NHI?
A2: The National Health Insurance (NHI) in Taiwan covers a wide range of medical services, such as:
The medical payments include diagnosis, assessment, laboratory tests, consultations, surgical procedures, anesthesia, prescriptions, supplies, therapies, nursing care, and covered hospital accommodations. Essentially, all essential healthcare services are included in the system.
Q3: How can I understand the cost of services under NHI in advance?
A3: Under Taiwan's National Health Insurance (NHI), patients are required to make co-payments for medical services, including hospital visits, outpatient care, prescription drugs, and various medical procedures.
Let's see a breakdown of typical co-payments for various medical services under NHI!
Visiting a hospital or clinic with a referral:
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Co-payment for Medical Center with referral is fixed at 170 NTD.
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For Regional Hospital it is 100 NTD.
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For District Hospital it is 50 NTD.
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And for Clinic it is 50 NTD.
Visiting a hospital directly without a referral costs more:
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Co-payment for Medical Center without referral is fixed at 420 NTD.
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For Regional Hospital it is 240 NTD.
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For District Hospital it is 80 NTD.
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And for Clinic co-payment remains fixed at 50 NTD.
For visiting dentist and traditional Chinese clinics, the co-payment is fixed at 50 NTD regardless of the level of medical institution.
For patients with a disability identification, the basic co-payment is charged at the Clinic rate (NT$50) regardless of the level of medical institution visited by the patient.
The following situations are regarded as visits with referral:
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Follow-up visits within one month of a medical visit with a referral sheet, limited to a maximum of four times.
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The first follow-up visit after outpatient surgery, emergency surgery, or discharge from the hospital.
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The first follow-up visit within six weeks after childbirth.
Therefore, the co-payment for such visits is charged according to the standards of medical visits with referral, and hospitals may issue relevant certificates for patients. During a course of treatment, patients only need to pay the co-payment for their initial visit (excluding rehabilitative physical therapy and Traditional Chinese Medicine traumatology).
Emergency Care Co-payment Standard:
Near-poor Households/Individuals with Disabilities:
Co-payment cost for outpatient prescribed drugs
Regular prescriptions:
If the cost of the medication is equal to or less than 100 NTD:
If the cost of the medication is equal to or greater than 101 NTD:
In all levels of medical institutions, an additional 20% will be charged for every 100 NTD. For example, if the price of medication is in the 101-200 NTD range, then the co-payment is 20 NTD; if in the 201-300 NTD range, then the co-payment is 40 NTD.
In Clinics and District Hospitals:
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If the medication cost starts from 1001 NTD, the upper limit for co-payment is reached, and the co-payment is fixed at 200 NTD.
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In Regional Hospitals and Medical Centers:
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If the medication cost is in the range from 1001-1500 NTD, the co-payment is fixed at 200 NTD.If the medication cost starts from 1501 NTD, the upper limit of co-payment is reached at 300 NTD.
Refillable prescriptions:
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In Clinics: Patients are exempted from the co-payment.
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In District Hospitals, Regional Hospitals, and Medical Centers: The first time filling a refillable prescription follows the same rules as outlined above for regular prescriptions. From the second refill onwards, patients are exempted from the co-payment.
For Traditional Chinese medication co-payment, the same system as that of Clinics is used. Costs under 100 NTD are exempt; for costs equal to or greater than 101 NTD, an additional 20% will be charged for every 100 NTD. At Dental Clinics, outpatient prescription drug expenses are exempted from co-payment.
Emergency Care Prescription:
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For Clinics and District Hospitals: 150 NTD
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For Regional Hospitals: 400 NTD.
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For Medical Centers: 750 NTD.
I hope now you have a better understanding of how to calculate the cost of medical services under NHI. Feel free to ask more questions or refer to this webpage (click the specific link below).
Q4: What services are completely free under NHI?
A4: With NHI, you can access a wide range of medical services at very affordable prices, and some services are fully covered! However, it's always a good idea to ask your doctor or a consultant at the hospital/clinic about which services will be covered.
Let's break down what kind of services can be fully covered under NHI:
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Basic Medical Examinations: These are routine tests to check your health, like measuring blood pressure, checking cholesterol levels, and assessing kidney function through urine tests.
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Preventive Services like Vaccinations and Screenings: This includes vaccines to protect against diseases like measles, mumps, and rubella, as well as screenings for diseases like cancer or diabetes. These screenings aim to catch health problems early for easier treatment.
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Essential Surgeries: These surgeries are necessary to treat a medical condition and improve health or save lives. For example, removing an appendix, fixing a broken bone, or treating a serious infection.
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Hospital Stays in General Rooms: This means staying in a hospital room shared with other patients (one room with 3 beds or more) and having basic facilities. General rooms provide standard care for conditions that don't require intensive monitoring or specialized equipment.
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Some Prescription Medications: Certain medicines prescribed by doctors are fully covered by NHI, so patients can get them from the pharmacy without paying anything. These often include essential medications for common conditions like high blood pressure, diabetes, and infections. Medications with a cost below 100 NTD will be fully covered or will require a 10 NTD co-payment.
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Dental care: Most medications prescribed by dentists are fully covered by the National Health Insurance (NHI). However, it's important to note that full-mouth anesthesia is not covered. Also, you have the right to receive two dental cleanings per year fully covered, allowing the general public to get dental calculus removal. People with tooth decay may be eligible, depending on a dentist's evaluation, for fluoride varnish treatment. As long as the cavity does not reach the pulp (where the tooth's nerves and blood vessels are located), it can be fully covered by the National Health Insurance (NHI).
Generally, the National Health Insurance (NHI) will cover the extraction of wisdom teeth, supernumerary teeth, and impacted teeth. However, extractions for corrective purposes (teeth that are intact and without decay problems) will not be covered by NHI.
Medical expenses in Taiwan are relatively inexpensive, so don't worry about spending a lot of money when seeing a doctor. Therefore, don't be afraid to go to the hospital.
Q5: In which hospitals can I utilize NHI services, specifically at Hualien hospitals?
A5: Here is the list of hospitals in Hualien in Chinese (the English version will be posted and updated later).
But if we talk about the most popular hospitals in Hualien where you can definitely get assistance in English, then we can list these hospitals:
Q6: Is it possible to receive NHI consultation in English?
A6: Yes! It is possible to receive NHI consultation in English! The back of the NHI card has a hotline number for inquiries: 0800-030-598, or by mobile phone call 02-412-8678. Calling the number is free of charge.