To uphold patients' rights to medical autonomy and informed decision-making, the National Health Insurance Administration (NHIA) has expanded the scope of National Health Insurance coverage for Advance Care Planning (ACP) consultation fees. Starting from May 1, 2025, this policy is expected to benefit approximately 1.8 million people.
Director-General Chung-Liang Shih of the NHIA stated that ACP allows individuals, while still mentally competent and able to express their wishes, to make decisions in advance regarding their future medical care in the event they lose the ability to communicate. Since July 1, 2024, the NHI has provided a one-time lifetime reimbursement for ACP consultation, specifically for hospitalized patients with designated illnesses who retain decision-making capacity. For those who complete and sign an advance directive, the NHI reimburses 3,000 points. As of the end of March 2025, a total of 51 medical institutions have submitted claims for 155 cases.
To encourage individuals to proactively plan for end-of-life medical care, the eligibility criteria for the "ACP Consultation Fee" have been expanded. In addition to the original eligible groups—patients meeting hospice and palliative care admission criteria, individuals with mild dementia (Clinical Dementia Rating of 0.5 to 1), patients diagnosed with conditions listed under Article 14, Paragraph 1, Subparagraph 5 of the Patient Right to Autonomy Act, and participants in the Integrated Home-Based Medical Care Program—starting from May 1, 2025, coverage will also include (1) patients aged 65 or older with catastrophic illnesses, and (2) patients aged 65 or older with multiple chronic diseases enrolled in either the NHI Family Physician Integrated Care Program or the NHI Holistic and Community-Based Care Program for Regional Hospitals.
Furthermore, ACP consultations will no longer be limited to inpatient settings but will also be available in hospital outpatient clinics and primary care clinics, thereby improving accessibility to advance medical decision-making services and supporting the right to a dignified end-of-life experience.
The NHIA emphasizes that ACP is a vital component in safeguarding medical human rights and patient autonomy. It also allows family members to understand the patient's true wishes in advance, reducing the emotional burden and uncertainty associated with making medical decisions on behalf of their loved ones. By respecting and supporting patients' choices, ACP helps to build a more compassionate and dignified end-of-life care system that honors the patient's right to a peaceful and respectful passing.