Taiwan Healthcare FAQ 台灣健保常見問題

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Taiwan has recently received a lot of press for its great response to the Covid-19 outbreak. But Taiwan has had a world class universal healthcare system for decades, known as National Health Insurance (NHI). People have long been coming to Taiwan for "medical tourism," due to Taiwan's low cost and high quality medical care. In this article we will answer common questions about Taiwan's healthcare system and why it is perhaps the best in the world.

Please note that some of the answers below are anecdotal based on personal experience using National Health Insurance in Taiwan, and are for reference only.

Q: When and how did Taiwan's universal healthcare system start?
A: Taiwan's National Health Insurance system started in 1995, and was modeled after medicare in the USA, but for the entire population. Taiwan's government studied and modeled the best parts of healthcare systems from many different nations. 

Q: What kind of healthcare does Taiwan have?
A: Taiwan's healthcare system is classified as single payer compulsory social insurance plan, with a centralization of funds.  This means that it has universal healthcare for all 23 million people in the island, and almost everyone in Taiwan must join the program and pay monthly fees for its use. 
Some other fun facts about Taiwan'[s healthcare:

• 99% of the population is covered
• Subsidies are available for low income earning families and disabled people
• Taiwan has an average life expectancy of80 years
• Infant mortality rates are 4 deaths per 1,000 live births
• There are1.6 physicians per 1,000 people in Taiwan
• There are 6 hospital beds per 1,000 people in Taiwan
• Administrative costs for the health system are the lowest in the world (2%)

Q: How do I qualify for National Health Insurance in Taiwan?

• Be a Taiwan citizen
• Have an ARC card
• Be a dependent of someone with an ARC card
• Even if you do not have work, you can still join NHI if you have an ARC card and register with the NHI bureau as unemployed. 

Q: How do I get an NHI card?
A: NHI cards are electronic IC cards that carry the health information of the person. 
​To get an ARC, you need a work permit or other visa that is valid for over six months. After you receive your ARC, you need to apply for an NHI card from the NHI bureau. 

Q: Is it easy to see a doctor in Taiwan?
A: Yes, small clinics are everywhere in major cities, as well as many large hospitals.
However, clinic and hospital coverage is few and far between in mountain areas and on outer islands. 

Q: Do most doctors speak English in Taiwan?
A: Yes, most doctors speak English and have to deal with foreign patients daily, especially in large cities. Also, to be certified they must pass rigorous tests in English and Latin.
Some doctors have also studied overseas and speak perfect English.
However, in my experience most nurses or assistants at clinics cannot speak or understand English very well, and you may get a worried look if you walk in the door. 

Q: Are Taiwanese doctors corrupt?
A: In general no, they are all paid from the National Health Insurance system and you do not need to pay an extra red envelope to get care. However some doctors try to push treatment not covered by NHI for extra revenue.

Q: Are there long wait times for doctors in Taiwan?
A: No, you can see a doctor at any small clinic within half an hour or sooner. Most of the time I am done with a walk in clinic within ten minutes.
You might wait more than an hour on weekends or at large public hospitals.

Q: Are there enough doctors per capita?
A: Yes, there are about 2 doctors per 1,000 people.

Q: Are there enough hospital beds per capita?
A: Yes, there are about 6 hospital beds per 1,000 people.

Q: How much does it cost to get stitches in Taiwan?
A: It cost me 700 NT to get about 7 stitches in my forehead with NHI.

Q: How much does it cost to give birth in Taiwan?
A: It usually costs about 10,000-20,000 NT to give birth with NHI in Taiwan. However if you are part of Taiwan's labor pension system you can get a birth stipend that more than covers this amount.

Q: Is it safe to give birth in Taiwan?
A: Yes, perhaps safer than giving birth in the USA! The healthcare standards here are very high, and infant and mother mortality rates are very low compared to the rest of the developed world.

​How much does National Health Insurance (NHI) cost for normal citizens?
This depends on your status and salary amount. National health insurance payments are taken out of monthly salary, while a portion of the amount is paid by the company and the government. Employees contribute about 30%, companies contribute about 60%, and the government contributes about 10%.
Salary contributions are based on asalary grade table set by the NHI bureau. The table also charges extra for up to three dependents (further dependents are free).

Below is an example of contributions for a monthly salary of 60,000 NT:

Employee (No Dependents)​	Employee & 1 Dependent​	Employee & 2 Dependents​	Employee & 3 Dependents or more​	Company Contribution	Government Contribution
855 NT	1,710 NT	2,565 NT	3,420 NT	2,701 NT	451 NT

Q: How much does Taiwan's healthcare system cost for the whole country?
A: Healthcare in Taiwan costs about $752 USD per capita per year, and about 6% of GDP.

Q: What does Taiwan's National Health Insurance cover?

• Most preventive medical services
• Most prescription drugs
• Most dental services
• Chinese medicine
• Home nurse visits 
• Hospitalization fees for shared hospital rooms with three other patients (4 person room)
• Part of some medical devices

Q: What is not covered by Taiwan's National Health Insurance?

• Chemotherapy
• Prolonged treatments over a month long
• Flu medicine (only 800 NT without NHI)
• Private hospital rooms
• Some costs for prolonged hospital stays
• 4D embryo scans and other pregnancy tests
• Planned births (planned C-sections)
• Braces
• Tooth implants
• Full numbing or sleeping gas during dental procedures
• Other specific surgery types or treatments

Q: Do I need additional insurance beyond NHI?
A: Generally no, NHI should cover all normal ailments. But personally I do have extra insurance because I know that NHI does not cover most cancer treatment, and may not cover large or prolonged procedures. 

Q: How much is a normal copay in Taiwan?
A: About 150-200 NT (5 - 7 USD).
There may also be co-payments for drugs depending on their price. 

Q: How much is it to see a doctor without NHI coverage?
A: It cost me a total of 500 NT (15 USD) for a diarrhea shot and antibiotics one time when I had the stomach flu while travelling in Taiwan without NHI. 

Q: Do I need to wear a surgical mask when visiting clinics in Taiwan?
A: Currently during the Covid-19 crisis, yes. Also it is good manners in Taiwan to wear a mask if you are sick. 

Q: What is the difference between hospitals and clinics in Taiwan?
A: Clinics should be your first contact when getting sick. They are usually small and do not have the same capacity as hospitals, but are also faster and cheaper.
If your ailment cannot be cured at a clinic, the clinic can refer you to a hospital which has more resources. 

Q: What are the main pros and cons of Taiwan's health system?
Pros:

• Cheap 
• Effective
• Everyone is covered

Cons:

• Large cities have more doctors and hospitals per capita than rural areas
• Revenue is not completely covering costs, casting doubt on long term survival of the system

Have any more questions about NHI?

• Check out the NHI ebook here. 
• Contact the NHI bureau here, or call them at +886-2-2706-5866

Thanks for reading! In conclusion I want to add that even though NHI doesn't cover everything, it is the fastest, cheapest, and most effective medical system I have ever heard of, and one of the major reasons I chose to live in Taiwan. 

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