This Act is enacted to promote the health of all nationals, to administer national health insurance (hereinafter referred to as “this Insurance”) and to provide health services.
This Insurance is compulsory social insurance. Benefits shall be provided during the insured term under the provisions of this Act, in case of illness, injury, or maternity occurred to the beneficiary.

Terms used in this Act are defined as follows:
1.Beneficiary: refers to the insured and his/her dependents.
2.Dependents:
(1)The insured’s spouse who is not employed.
(2)The insured’s lineal blood ascendants who are not employed.
(3)The insured’s lineal blood descendants within second degree of relationship who are either minor and not employed, or majority but incapable of making a living, including those who are in school without employment.
3.Premium withholder: Refers to the individual from whom premium is withheld according to the Taxation Law.
4.Benefit payments: refers to the remainder of total medical benefit payments minus the self-bearing medical fees of the Insured based on the Act.
5.Insurance budget: Refers to the insurance benefit expenditures and reserve funds that should be established or added.
6.Medical Visit Advice: Refers to understanding the insured’s medical visit practices, providing appropriate medical and health education, and arrangement and assistance of medical visit when the insured has been found to duplicate medical visits, undergo repetitive visits, and use inappropriate treatment.

The government should at least shoulder 36 percent of the remainder of the annual insurance budget minus promulgated revenues.
According to law, the government should include in the budget 36 percent of the deficit remainder of the annual insurance budget minus promulgated revenues, wherein the Competent Authority shall draw up a budget to cover the deficit.

The Competent Authority of this Insurance shall be the Ministry of Health and Welfare.

The National Health Insurance Committee (hereinafter referred to as the “NHIC”) shall be in charge of the following tasks:
1.Review of premiums;
2.Review of the scope of benefits;
3.Coordination of drafting and allocation of medical benefit payments;
4.Study and interpretation of insurance laws and policies;
5.Other supervisory functions pertaining to the insurance matters.
When the review and coordination done by the NHIC in the previous paragraph find a reduction in insurance revenues or increase in insurance expenditures, it should as the Insurer to present a proposal for resource allocation and financial balance to reviewed or coordinated jointly.
When the NHIC reviews and coordinates matters relevant to the Insurances, it should make public its agenda seven days before the meeting and the meeting minutes within ten days after the meeting. Before reviewing and coordinating major matters, it should gather information on public opinion and if necessary, organize related activities involving the public.
the NHIC is made up of the insured, employers, insurance medical service providers, experts, reputable public figures, and representatives from relevant agencies. Representatives from premium payers should not be less than one-half of the total number of NHIC members, while representatives from the beneficiaries should not be less than one-third.
The Competent Authority shall determine the number of members, how they are selected, meeting regulations, self-disclosure of representative’s interest, and disclosure to the public.
Matters reviewed and coordinated by the NHIC should be approved by the Competent Authority or presented to the Executive Yuan for approval. Matters approved by the Executive Yuan should be sent to the Legislative Yuan for future reference.

The insured, the group insurance applicant, premium withholder and the contracted medical institution should apply for a review to settle disputes against the insurer. They may file administrative appeal or administrative lawsuit if they disagree with the review results.
The National Health Insurance Dispute Mediation Committee shall perform the task of reviewing such disputes.
The Competent Authority shall determine the scope of the abovementioned disputes, application for review or deadline for submission of documents, procedures, as well as the review methods and process.
The National Health Insurance Dispute Mediation Committee shall publicize the dispute review results periodically via publication of government gazette, Internet or other proper methods.
The publication of the dispute review results referred to in the preceding paragraph shall be made only after the information of individuals, juridical persons or groups has been de-identified through coding, anonymizing, masking part of the information or other methods, and no longer identifiable.