Ministry outlines proposed changes to NHI co-payments – 台北時報
The Ministry of Health and Welfare on Wednesday issued a notice on adjustments to co-payments for medical services provided under the National Health Insurance (NHI) system.
The publication of the notice is followed by 14 days in which public comments on the draft amendment to the National Health Insurance Act (全民健康保險法) can be submitted.
The proposed changes would mean people pay 20 percent of fees for outpatient prescription drugs covered under the NHI, with a cap of NT$300 (US$10.54) per outpatient visit, up from NT$200.
Photo: Lin Hui-chin, Taipei Times
The proposed new regulations say that people would be required to pay 10 to 20 percent for medical tests or diagnostic examinations if the cost exceeds NT$500, or if they visit a regional or district hospital, or medical center, with payments to be capped at NT$100 to NT$400 per outpatient visit.
The NT$500 threshold for co-payments would be an increase from NT$200.
In addition, the co-payment ceiling for people with mild illnesses seeking emergency treatment at a medical center, the largest type of hospital in Taiwan, would increase from NT$550 to NT$800, while people with serious illnesses seeking emergency treatment at a medical center would have their co-payment reduced from NT$450 to NT$300.
The proposal still exempts people with chronic illnesses who receive more than 28 days of medicine in their second and third refills of “chronic illness refill prescriptions” from co-payments.
The ministry scrapped a proposal requiring co-payments of NT$100 from such people for the second and third refills.
If everything goes well, the new rules would take effect in the first half of this year, National Health Insurance Administration (NHIA) Director-General Lee Po-chang (李伯璋) said.
About 8.46 million people, or 36.7 percent of Taiwan’s population, would not be affected by the revised regulations, while about 5.28 million people, or 22.9 percent of the population, would spend NT$10 to NT$200 more a year for medical services, Lee said.
The adjustments are expected to increase annual NHI revenue by NT$10.72 billion, with NT$4.3 billion from co-payments for prescription drugs, NT$6.3 billion for medical checks and tests, and NT$120 million from emergency treatment, Lee said.
People with NHI “catastrophic illness” cards would still be exempt from co-payments, he said.
The NHIA proposed the amendment last month after a review of the co-payment system for NHI-covered services.
The system last year had an estimated deficit of NT$77 billion.
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