New National Health Insurance co-payment rules to take effect in July

Taipei, June 27 (CNA) Several changes to co-payments for emergency care and prescription drugs covered by Taiwan’s National Health Insurance (NHI) program will take effect on July 1.

The NHI co-payment hikes will primarily affect regional hospitals and medical centers and will allow such medical facilities to better treat patients in serious emergency situations, with rare diseases or in need of critical care, the NHI Administration said in a statement released on June 21 .

The revised co-payment rules are also designed so as to encourage patients with chronic diseases whose conditions have been stabilized to use their local clinics, the statement said.

The co-payment for patients seeking emergency care at clinics, and district hospitals in their communities will remain at NT$150 (US$4.83), the NHI Administration said.

However, the co-payment will be raised from NT$300 to NT$450 for those visiting a regional hospital, and from NT$550 to NT$750 for those who visit a medical center.

For example, the National Taiwan University Hospital on Zhongshan South Road in Taipei is a medical center, while its Jin-Shan Branch in New Taipei is classified as a district hospital, according to its website.

For prescriptions costing NT$100 or below, co-payments for patients at clinics and district hospitals will still be free.

However, an NT$10 surcharge will be added to the price of prescriptions at regional hospitals and medical centers.

Patients are still required to pay 20 percent of the costs exceeding NT$100, but total co-payments are still capped at NT$200.

The 20 percent co-payments also apply to patients at regional hospitals and medical centers but the cap will be raised to NT$300.

Refillable prescriptions remain free at clinics, but patients will be charged co-payments for the first prescription under the same rules applied to hospitals and medical centers, the NHI Administration said.

However, for low-income families, or individuals with disabilities, the co-payment for drug prescriptions will still be capped at NT$200. Their co-payments for emergency care remain NT$550.

Patients whose co-payments are waived, such as unemployed veterans, policemen, firefighters, coast guards, certain military personnel and alternative servicemen, or anyone seeking medical service for serious illness, childbirth or at medical facilities in various areas or on offshore islands, will not be affected, according to the NHI Administration.

In addition, as the Special Act for Prevention, Relief and Revitalization Measures for Severe Pneumonia with Novel Pathogens introduced in late February 2020 amid the global spread of COVID-19 is set to expire on June 30, the government will stop subsidizing Chingguan Yihau (清冠一號), a locally developed traditional herbal formula for COVID-19, the Minister of Health and Welfare Hsueh Jui-yuan (薛瑞元) said last Friday.

Meanwhile, the Centers for Disease Control (CDC) reported a surge of enterovirus infections which peaked at 13,273 during the week ending June 10, and the Advisory Committee on Immunization Practices under the health ministry suggested parents take their children to be vaccinated against such infections that could lead to deadly complications.

As of June 17, the CDC recorded four children under the age of 5 who developed serious complications after contracting enterovirus with no fatalities in 2023, compared to 2022’s three severe cases, including one death.

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