The Taiwanese National Health Insurance scheme is run by the Ministry of Health and Welfare. It is closely modelled on the UK’s NHS and the Canadian health scheme. It is a single payer system with close to universal coverage, with around 99% of Taiwan’s citizens covered, and if you are a resident, then enrolment in the scheme is compulsory and there are penalties for non-compliance.

Anyone who does not enroll is subject to a fine of NT$3,000 to NT$15,000 (US$100 – 500). You will also be required to pay the full premium, starting from the date you should have been enrolled. No benefits will be offered before the premiums are paid in full.

The NHI differs from the British equivalent in that it is not free at the point of delivery, and you will need to make co-payments of around 20-30% for treatment and then claim for reimbursement. A typical co-pay cost is around NT360 (about $12).

The state imposes a cap on co-payments, however, so there will be a limit to how much you have to pay. For example, caps on hospital stay coinsurance for acute ward stays totaling fewer than 30 days or chronic ward stays of fewer than 180 days during the year have been set at NT$39,000 (US$1298) for a single hospital stay for a particular condition, and at a cumulative NT$65,000 (US$2163) for the entire calendar year.

92% of Taiwanese hospitals are in the public sector, which is partly funded from payroll contributions and partly from the state and taxes (tobacco levies, for instance). Around 6.2% of the country’s GDP is put into healthcare.

Working expats are entitled to enrol in the system, if employed or self employed, once they have been in residence for six months and have a resident’s card.

Your employer will register you, but you will need to supply the following:

• application form
• photo (2-inch)
• the copy of the front and back side of your ARC

If you are self-employed you will need to register yourself.

You will then be issued with a ‘Health IC’ smart card. Placed in a chip reader, this will enable medical personnel to pull up your health records from MediCloud, Taiwan’s cloud-based data storage system. This is used to track GP visits, medical procedures, drug prescriptions or allergies, catastrophic diseases and organ donation consent.

You can also register with My Health Bank, which which allow you to access your own records and prescriptions.

The state health insurance system covers:

• primary care
• secondary care
• emergency treatment
• some prescription medication
• home nursing care
• Traditional Chinese Medicine (TCM)

However, some medical care is not covered:

• vaccinations
• birth control
• over-the-counter medications
• hearing aids
• addiction recovery

Anyone classified as disabled must pay co-payments of NT$50 (US$1-2) for any medical care, regardless of the type of medical institutions they visit. If you have a chronic illness, check for any prescription charge exemptions.

As a retiree, you will not be covered by state medical insurance: only working expats are entitled to enrol. You will therefore need to take out private insurance cover.

If you are a newly admitted student or a transfer student, and you have an ARC and have resided in Taiwan for more than six months, you must enroll in the NHI program. You will have to pay the insurance fee during the registration in each semester. The insurance fee for students enrolled in NHI is NT$4,494 (US$149) per semester/ NT$749 (US$25) per month (note that the Insurance Premium Payment is subject to change). You can apply to enroll in the NHI through your educational establishment.

You may choose to take out private cover as well.

Your dependents can be covered by your insurance if they have had continuous residence in the country for six months.

This applies to spouses, minor children, and children over 20 who are unable to live independently due to physical or mental disability.

If you are unemployed, you are entitled to participate in the National Health Insurance program through the insurance registration organization of one of your relatives, after the six-month continuous residence period.

Basic dental treatment is covered by the NHI.

This will depend on your salary, but it is capped at varying rates. With an insured cap of NT$182,000 and no dependents, your monthly NHI will be around NT$2,681 (around US$90). The premium borne by your employer will be NT$9,115 (US$303).

Like many nations, Taiwan’s population is ageing, imposing an increased burden on national healthcare. Waiting times can be lengthy, and in addition, you often do not require a referral from your GP to a specialist, so there are often long queues for specialist appointments. The government has been trying to restrict the deficiencies in the gatekeeping system, by encouraging patients to seek primary care treatment first rather than going straight to a specialist, and imposing higher out of pocket costs for non-referrals.

Doctors say that they are overstretched and Taiwanese hospitals are overcrowded: patient demand is overwhelming the system, due in part to ease of access.

However, a number of medics in the public system also have private practices on the side. Some clinics in Taiwain will only treat expats.

In addition, although medical treatment itself is of a high standard, some aspects of care may not be commensurate with those in the West: for instance, you may have to provide your own bedding in public hospitals. Thus many expats opt for private cover in addition to their NHI coverage.

Primary and hospitalization costs, plus elective procedures such as cosmetic surgery, corrective optical treatment and dental implants, will all be covered.

Many expats opt for private cover, with a medical evacuation clause in case they prefer to be treated outside the country.

You also have the option of paying out of pocket: medical costs in Taiwan are substantially lower than in the West. However, if this involves hospital stays, then costs can swiftly escalate.

This will depend on factors such as your age and any pre-existing conditions, and the kind of package you opt for (obviously, a more expensive insurance package will give you more a extensive range of treatment and facilities). As so many variables have an effect on the cost of international private medical insurance it becomes very difficult to give accurate estimates without knowing the full details of the coverage required.

However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

Many of the big international providers cover Taiwan, including:

• Allianz
• Cigna
• Pacific Prime

全民健康保險- National Health Insurance scheme/NHI