Please pay attention to the new system of medical treatment and medication for the burden of health insurance

        The health insurance system in Taiwan has improved the convenience of seeking medical treatment. Many people are accustomed to visiting large hospitals and receiving medication whenever they feel unwell, and Zhang Dahua is also one of them. Recently, he discovered that there are new regulations for the "partial burden" of health insurance, but he is not clear about the details of the adjustments and their impact. This issue of 'Legal Column' has compiled 7 major Q&As, let's take a look together!

        Q1: Why is there a "partial burden" on health insurance?

        A1: When people go to clinics or hospitals for medical treatment, although the national health insurance can share the medical expenses, they must also pay a portion of the expenses themselves, which is called "partial burden". This is mainly based on the concept of "user payment", hoping to remind the public to cherish medical resources and guide correct medical behavior.

        Q2: Why should we implement the new system?

        A2: In order to gradually practice graded medical treatment and effectively use medical resources, the Ministry of Health and Welfare will, from July 1, 2023, draw up and implement a new adjustment plan for the cost borne by health insurance according to different levels of medical institutions such as grass-roots clinics, regional hospitals, regional hospitals and medical centers, so as to maximize the use of resources. The new plan can be mainly divided into two parts: "outpatient drugs" and "emergency medical treatment", which are adjusted as follows:

                Q3: When Zhang Dahua goes to the hospital for treatment due to a general illness and follows the doctor's instructions to go to the designated pharmacy to receive medication, how will the new cost burden be calculated?

        A3: The new system will charge a portion of the burden fee based on the level of the medical institution issuing the drug. Among them, grassroots clinics and regional hospitals will maintain the original fee, while regional hospitals and medical centers will increase the upper limit of the portion of the burden amount.

        Q4: Zhang Dahua suffers from chronic diseases and goes to the hospital for treatment. When he receives the prescription at the designated pharmacy according to the doctor's instructions, how will the new cost burden be calculated?

        A4: Patients can open a continuous prescription for chronic diseases at a grassroots clinic (with medication prescribed for more than 28 days) and maintain a free fee. However, if they go to a medical center, regional or regional hospital for treatment, the first adjustment will be changed to the same fee as regular drugs, and after the second adjustment, the fee will be waived. We hope to encourage patients with stable conditions to seek medical treatment at grassroots clinics.

        Q5: How to calculate the new cost burden when Zhang Dahua goes to the hospital for emergency treatment?

        A5: Grassroots clinics and regional hospitals will maintain their original fees, while medical centers and regional hospitals will increase their fees to retain emergency resources in large hospitals for critically ill patients and alleviate overcrowding.

        Q6: If Zhang Dahua holds the qualification of a middle and low income household, will some of the expenses borne be affected?

        A6: No. In order to protect the medical rights and expenses of middle and low income households, the new scheme will not affect them, and the same applies to those who hold Disability certificates; In addition, those who suffer from major injuries, childbirth, seek medical treatment in mountainous and outlying areas, as well as low-income households, veterans, children under three years old, police, fire, sea patrol and air crew members, oil patients, and substitute service men who were originally subsidized by other units, belong to the current statutory exemption from partial burden and will not be affected in this new partial burden system.

        Q7: What if there are any questions about the new system of partial burden?

        A7: You can consult and track the latest news from the Health Service Department through the following contact information or scan the QR Code:

        Health insurance consultation service hotline: dial 0800-030-598 or 4128-678 for local calls (no area code required); Call 02-4128-678 on your phone.

        Health insurance resources: partial burden zone https://bit.ly/3CTkrYe Medical classification institution inquiry https://bit.ly/4338ZDZ Health Insurance Department Line@ https://bit.ly/44pnSBY Health Insurance Autotoll App https://bit.ly/46vFL3B .

        Source: Central Health Insurance Agency of the Ministry of Health and Welfare

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