National Health Insurance Administration Ministry of Health and Welfare

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Medical Institutions' Charges for Items Not Covered by NHI Shall Be in Accordance with Related Principles

  The public shall be aware that medical services provided by contracted medical institutions must be in line with the three principles below, whether they are NHI covered items or not:

  1. Information Disclosure: Contracted medical institutions shall put up announcements regarding out-of-pocket items and related details in clinic rooms, on bulletin boards or at the counter.
  2. Patients to Be Informed in Advance: During the process of surgery, examination and treatment, service providers cannot ask patients if they would like to use items not covered by NHI unless under emergency or unexpected circumstances.
  3. Issuance of Official Receipts for Charges: The amounts of charges for NHI covered medical items, out-of-pocket medical items and non-medical items shall be specified in the receipt.

  Medical services partially covered or not covered by NHI are listed in the table below:

Item

Content

NHI Partially Covered Items

Currently, 6 items partially covered by NHI are "prostheses", "double-chambered pacemakers with adjustable pacing rate", "drug-coated stents", "artificial hip joints made of special materials" (2 items) and "function-specific artificial intraocular lens". Please visit the NHI website (www.nhi.gov.tw) for related information.

Items are not  covered  by NHI

Article 39 of NHI Act provides that charges for the following items are not included in NHI coverage:

  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-post-traumatic orthodontic treatment, preventative surgery, artificial reproduction, and sex conversion surgery;
  4. Over-the-counter drugs and non-prescription drugs which 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 those which are to be tube feeding and balance billing for wards;
  10. Transportation, registration fee, and certificate for the patient;
  11. Dentures, artificial eyes, spectacles, hearing aids, wheelchairs, canes, and other treatment equipment not required for positive therapy;
  12. Other treatments and drugs promulgated by the Competent Authority not to be covered.

  • Date:2011-06-02