The Ministry of Health and Welfare in the evening of March 16 previewed a draft amendment to the National Health Insurance Act. National Health Insurance Administration (NHIA) Director General Lee Po-chang in a telephone interview on the same day said that the draft amendment is set to commence a 14-day notice-and-comment period and could be implemented in the first half of the year at the soonest, provided that stakeholder communications and adjustments progress smoothly.
The amendment aims to establish a copayment of up to 20 percent of the cost of drug prescription, with the maximum capped at NT$300. For refillable drug prescriptions, the amendment had previously called for an additional NT$100 in copayments for patients picking up refillable drug prescriptions for the second and third time at regional hospitals and medical centers. However, the change was met with opposition from hospitals and has since been scrapped. Instead, copayments will no longer be required when picking up refillable drug prescriptions for the second time.
As for medical examinations and tests, copayments of 10 percent to 20 percent of the cost of examination and tests will be charged, amounting to increased costs of NT$100 to NT$400 per visit. In addition, patient who visit medical centers without a referral will be subject to a copayment no larger than NT$400. The amendment also raised the threshold at which copayments are waived for medical examinations and tests at primary care clinics and local hospitals from NT$200 to NT$500.
For emergency care, the copayment remains at the same level according to planning by the NHIA, with visits to primary care clinics and local hospitals set at NT$150. The copayment for patients designated with Level four and five triage have been raised from NT$550 to NT$800. For Level one and two triage patients, the copayment has been reduced from NT$450 to NT$300.
According to the NHIA, following the copayment adjustments, around 36.7 percent of beneficiaries, or 8.46 million people, will not be affected by the changes, with around 22.9 percent, or 5.28 million people subject to additional copayments of NT$10 to NT$200. As for National Health Insurance finances, the additional copayments are expected to contribute an additional funding of NT$4.3 billion for drug prescriptions, NT$6.3 billion for medical examination and tests, and NT$120 million for emergency room visits. The NHIA emphasized that patients with severe and catastrophic illnesses will continue to be waived from copayments.
[2022-3-16/CNA]
