Adjusted co-payment plan for NHI medical services unveiled – Focus Taiwan News Channel
Taipei, March 16 (CNA) The Ministry of Health and Welfare (MOHW) 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 a 14-day period in which public comments on the draft amendment to the National Health Insurance Act are invited.
Under the draft amendment, patients will pay 20 percent of fees for outpatient prescription drugs covered under the NHI, with a cap of NT$300 (US$10.51) per outpatient visit, up from the current NT$200.
The proposed new regulations state that patients are required to pay 10 percent-20 percent for medical tests or diagnostic examinations if the cost exceeds NT$500 and if they visit a regional/district hospital or medical center, with their payments to be capped at NT$100-NT$400 per outpatient visit. The NT$500 threshold for charging co-payments has been increased from the current NT$200.
In addition, the co-payment ceiling for patients with mild illnesses seeking emergency treatment at a medical center, the largest type of hospital in Taiwan, is set to increase from NT$550 to NT$800, while patients with serious illnesses seeking emergency treatment at a medical center will have their co-payment reduced from NT$450 at present to NT$300.
However, the draft amendment still exempts patients with chronic illnesses who receive more than 28 days of medicine in their second and third refills of “chronic illness refill prescription” from paying a co-payment for the medication.
The ministry decided to scrap a proposal requiring such patients to pay a co-payment of NT$100 for both the second and third refills.
If everything goes well, the new rules will take effect in the first half of this year, according to Lee Po-chang (李伯璋), director-general of the National Health Insurance Administration (NHIA).
About 8.46 million people, or 36.7 percent of Taiwan’s population, will not be affected by the revised regulations, while about 5.28 million people, or 22.9 percent of the population will spend NT$10-NT$200 more a year for medical services, Lee said.
The adjustments are expected to increase annual revenue for the NHI program by NT$10.72 billion, including NT$4.3 billion from co-payments for prescription drugs, NT$6.3 billion for medical checks and tests and NT$120 million for emergency treatments, according to Lee.
However, NHI “catastrophic illness” cardholders will still be exempted from co-payments, Lee added.
The NHIA proposed the draft amendment last month after conducting a review of the co-payment system for NHI-covered health care services with the amount of medical services covered by the insurance system rising dramatically, resulting in a deficit estimated at NT$77 billion last year.
(By Chang Ming-hsuan and Evelyn Kao)
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