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Taiwan:Health ministry to increase co-payments in national health insurance scheme

Source: Asia Insurance Review

The Ministry of Health and Welfare (MOHW) has issued a notice on adjustments to co-payments for medical services provided under the national health insurance (NHI) system.

The revisions will affect about 5.28m people, or 22.9% of the population, who will spend NT$10-NT$200 ($0.35-$7.05) more a year for medical services, according to Lee Po-chang, director-general of the National Health Insurance Administration (NHIA).

The adjustments are expected to increase annual revenue by NT$10.72bn for the NHI programme. Before proposing the changes, the NHIA conducted a review of the co-payment system for NHI-covered healthcare services. The scheme operated at a deficit estimated at NT$77bn last year.

Under the proposed changes, patients will pay 20% of fees for outpatient prescription drugs covered under the NHI, with a cap of NT$300 ($10.50) per outpatient visit, up from the current NT$200, reported Central News Agency.

The proposed new regulations also state that patients are required to pay 10-20% for medical tests or diagnostic examinations if the cost exceeds NT$500 and if they visit a regional/district hospital or medical centre, with their payments to be capped at NT$100-NT$400 per outpatient visit. The NT$500 threshold for charging co-payments has been increased from the current NT$200.

In addition, the co-payment ceiling for patients with mild illnesses seeking emergency treatment at a medical centre, the largest type of hospital in Taiwan, is set to increase from NT$550 to NT$800, while patients with serious illnesses seeking emergency treatment at a medical centre will have their co-payment reduced from NT$450 at present to NT$300.

However, the draft amendment still exempts patients with chronic illnesses who receive more than 28 days of medicine in their second and third refills of "chronic illness refill prescription" from paying a co-payment for the medication. The ministry decided to scrap a proposal requiring such patients to pay a co-payment of NT$100 for both the second and third refills.

The publication of the notice is followed by a 14-day period in which public comments on the draft amendment to the National Health Insurance Act are invited. If everything goes smoothly, the new rules will take effect in the first half of this year.

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