Basic Outpatient Copayment (effective from April 15, 2017)

Note:

1. For patients with a disability identification, the basic copayment is charged according to the rate of a clinic (NT$50) regardless of the hierarchy of medical institutions the patient visits.
2. The following situations are regarded as visits with referral: follow-up visits of no more than four times within one month of a medical visit with a referral sheet, the first follow-up visit after an outpatient surgery, an emergency surgery, or being discharged from a hospital, and the first follow-up visit within six weeks after giving birth. Therefore, the copayment for such visits is charged as per the standards of medical visits with referral and the hospitals may issue relevant certificates for the patients. 

• During a course of treatment, the patient only needs to pay the copayment for their first visit (except for rehabilitating physical therapy and traumatology of traditional Chinese medicine).

Emergency Care Copayment (effective from July 1, 2023) 

Outpatient Prescription Drug Copayment (effective from July 1, 2023)

• When filling out a refillable prescription for patients with chronic illnesses (prescriptions for 28 days or more) for the first time, a copayment will be charged for such drugs along with other regular outpatient prescription drugs that the insured receives at the same time.
• The copayment for outpatient prescription drugs is exempted for an insured who meets one of the following criteria:
  • Receiving dental healthcare;
  • Receiving healthcare services that are categorized as “case payment” by the Pharmaceutical Benefit and Reimbursement Scheme;
  • Low-income households, near-poor households, and individuals with disabilities filling out a refillable prescription for patients with chronic illnesses (prescriptions for 28 days or more);
  • Filling out a refillable prescription for patients with chronic illnesses (prescriptions for 28 days or more) prescribed by a Western medicine primary healthcare facility or a traditional Chinese medicine outpatient care;
  • Filling out for the second or the third time a refillable prescription for patients with chronic illnesses (prescriptions for 28 days or more) prescribed by a hospital. 

• Outpatient Rehabilitation (Including Traumatology of Traditional Chinese Medicine) Copayment

If you receive outpatient rehabilitating physical therapy or traditional Chinese medicine traumatology treatments, a copayment of NT$50 will be charged for each session during a course of treatment starting from the second visit (except for rehabilitating physical therapy treatments classified as“medium–complex” and “complex”).

• Exemptions are applicable for the following situations:

1. The rehabilitating physical therapy treatment is classified as “medium–complex”, which refers to receiving three or more medium treatments for a total of fifty minutes or more; this category comprises 14 treatments including electrical muscle stimulation.
2. The rehabilitating physical therapy treatment is classified as “complex” and must be performed by a professional therapist; this category comprises 7 treatments including balance training. The treatment can only be prescribed by a rehabilitation specialist doctor.