NHIA Announces Proposed Fee Adjustments 健保部分負擔變革 慢箋.檢驗檢查將收費

The Ministry of Health and Welfare announced the draft proposal to adjust patient co-payments for medication. Additionally, co-payments for emergency room visits will also be increased.

Some patients with chronic diseases go to the hospital to receive medication, but they do not take them on time, resulting in a waste of medicine. To conserve medical resources, the National Health Insurance Administration announced on the 16th a draft proposal to adjust patients' co-payment. This includes the first dispensing of continuous prescriptions for chronic diseases. The adjustment will be based on general medicine payments. There will be no medication co-payments at local hospitals and clinics for medication under NT$100. A 20 percent co-payment will be charged on patients for medication above NT$100 or receiving medication at regional hospitals or medical centers, with an upper limit of NT$200 to NT$300. Medication for chronic diseases will also be based on this structure, but only for the first prescription. The second and third prescriptions are exempt from this structure.

Lee Po-chang, Director-General, National Health Insurance Administration: “We think the first time, the patient should pay user fees. For the 2nd and 3rd time, we return to a structure where the patient is dependent on long-term medication use. Therefore, we don't charge co-payments to reduce the burden on the people.”

Co-payments for emergency room visits have also been adjusted. If it is a mild cold or grade 4 to 5 mild symptoms, an ER visit at a medical center will cost a patient NT$800. Inspection fees are currently exempt. However, in the future, they will be under the same fee structure as medication co-payments. Patients who come to medical center ERs without a referral will be charged 20 percent of the fee, with a limit of NT$400.

Lin Ya-hui, Executive Director, Taiwan Healthcare Reform Foundation Council: “The new system will actually punish patients also. People have to go to the ER during holidays because clinics are closed.”

The NHIA emphasized that implementing medical classification will encourage local hospitals to open on holidays for people with medical needs. This will allow medical centers and regional hospitals to return to acute and critical care work. There is a 14-day notice period for this draft proposal as opinions from all walks of life are collected. If it goes well, it can be implemented as soon as the first half of this year.