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Whenever a doctor wants to recommend a course of treatment that is not covered under the National Health Insurance program, the physician must first have the patient’s approval before proceeding.

If you have any doubts or questions about items listed as “out-of-pocket items” and related expenses on your itemized bill, please ask the medical institution. You may request the health care provider to check on the matter or call the NHIA’s free service hotline at 0800- 030-598. We have service agents who can speak English.

The following items are not covered under the National Health Insurance program, as per Article 51 of the National Health Insurance Act,

  1. Medical service items on which the expenses shall be borne by the government according to other laws or regulations.
  2. Immunization and other medical services on which the expenses shall be borne by the government.
  3. Treatment of drug addiction, cosmetic surgery, non-posttraumatic orthodontic treatment, preventative surgery, artificial reproduction, and sex conversion surgery.
  4. Over-the-counter drugs and non-prescription drugs that should be used under the guidance of a physician.
  5. Services provided by specially designated doctors, specially registered nurses and senior registered nurses.
  6. Blood, except for blood transfusion necessary for emergent injury or illness according to the diagnosis by the doctor.
  7. Human-subject clinical trials.
  8. Hospital day care, except for psychiatric care.
  9. Food, other than that provided through tube feeding, and balance billing on hospital rooms.
  10. Transportation costs, registration fees, and costs of obtaining certificates or medical records.
  11. Dentures, artificial eyes, glasses, hearing aids, wheelchairs, canes, and other equipment not required to actually treat the patient.
  12. Other treatments and drugs officially announced by the relevant authorities as not being covered under the National Health Insurance system.