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HOME > Medical Services > Applications for emergency injury and illness

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Applications for emergency injury and illness
 
 
 

Medical fees
The reimbursement of NHI prepaid medical fee includes the reimbursement of medical fee for emergency injury and illness; reimbursement of medical fee for special situation; and reimbursement of annual co-payment exceeding the maximum of statutory prepaid medical fee. Applicants must submit the following documents and/or receipts upon the application.

 
Emergency injury and illness
Emergency injury and illness

Classification

Getting medical services from non-contract medical institution in Taiwan

Getting medical services from medical institutions overseas (including China)

Application criteria

The patient is unable to get medical services from contract medical institutions in an emergency, including delivery.

Getting medical services from a legally registered medical institution overseas out of an emergency situation, including delivery.

Required documents and/or receipts

  1. Reimbursement application form
  2. Receipt originals and fee breakdown sheet
  3. Medical certificate or transcript of medical record

 

  1. Reimbursement application form
  2. Receipt originals and fee breakdown sheet
  3. Medical certificate or relevant documents (a certified Chinese translation is required if not in Chinese or English)
  4. Photocopy of the department and entry record regarding the case
  5. A power of attorney if the applicant is still overseas

A certified Chinese translation for all documents is required if they are not in Chinese or English
Documents issued by medical institutions in China must be certified or authenticated as from 1 April 2006 (hospitalization/discharge day)

Responsible unit

BNHI branch with jurisdiction over the location of medical institutions where services were obtained.

BNHI branch with jurisdiction over the location of the employer (applicant).

Application deadline

6 months from the access day or discharge

6 months from the access day or discharge

Condition of rejection

※No application for reimbursement is considered for getting medical services, including delivery, from a non-contract medical institution not in an emergency situation

※No application for reimbursement shall be made for those who have plans to receive surgery or treatment overseas (including China)

 
 
 
Special situation
Getting medical services from contract institutions in Taiwan
Special situation

Application criteria

Getting medical services from non-contract medical institution in Taiwan

Getting medical services from medical institutions overseas (including China)

Required documents and/or receipts

  1. Reimbursement application form
  2. Receipt originals and fee breakdown sheet
  3. Medical certificate or transcript of medical record
  4. Certification of co-payment exemption (required for insured qualified for co-payment exemption)

Insured applying for reimbursement of occupational injury and/or illness covered in the labor insurance shall prepared valid documents and apply for reimbursement to the Labor Insurance Bureau

  1. Reimbursement application form
  2. Receipt originals and fee breakdown sheet
  3. Medical certificate or transcript of medical record

 

Responsible unit

BNHI branch with jurisdiction over the location of medical institutions where services were obtained.

BNHI branch with jurisdiction over the location of medical institutions where services were obtained.

Application deadline

6 months from the clearance of debts

6 months from the clearance of debts

Condition of rejection

No application for reimbursement shall bemade for the following circumstances accountable for the insured:

  1. Insured has forgotten to bring the NHI card or certification of co-payment exemption.
  2. 2.Insured fails to submit the NHI card or certification of co-payment exception to claim back the fees from the medical institutions with 7 days from the emergency medical services or hospitalization.

No application for reimbursement shall be made for the following circumstances accountable for the insured:

  1. Insured has forgotten to bring the NHI card or certification of co-payment exemption.
  2. Insured fails to submit the NHI card or certification of co-payment exception to claim back the fees from the medical institutions with 7 days from the emergency medical services or hospitalization.
 
 
 
Exceeding the statutory annual maximum
Exceeding the statutory annual maximum

Classification

The co-payment for hospitalization during the year exceeds 10 % the average national income of the year, i.e. the maximum amount for 2005 is NT$43000.

Application criteria

The accumulative amount of co-payment exceeds NT$43000 for 2005, including 30 days for acute ward or 180 for chronic ward each time.

Required documents and/or receipts

1.Reimbursement application form
2.Receipt originals and fee breakdown sheet

Responsible unit

BNHI branch with jurisdiction over the location of the medical institution hospitalized for the first time

Application deadline

Before the end of next June

Condition of rejection

1.Co-payment for hospitalization in acute ward exceeding 30 days or chronic ward exceeding 180 days each time.
2.Items not covered by the NHI.

 
 
 

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