Chapter 4 Insurance Benefits and Payment for Medical Expenses
Article 59
District hospitals, regional hospitals and medical centers set forth in Paragraph 1 of Article 43 of the Act refer to those district hospitals, regional hospitals and medical centers which have been evaluated and designated by hospital accreditation conducted by the competent authority.
Article 60
Where a beneficiary receives outpatient care service, emergency care service or home-care service in a resource depletion area according to Paragraph 4 of Article 43 of the Act, the self-bearing amount may be reduced by 20%.
Article 61
As the Competent Authority announces the beneficiary’s self-contributed amounts for outpatient service under Paragraph 3 of Article 43 of the Act, it may set the amounts based on the average outpatient service expenses of the preceding year among all hospitals and clinics, subject to the limit of the ratios prescribed in Paragraph 1 of the same article.
Article 62
The number of days of hospitalization referred to in Paragraphs 1 and 2 of Article 47 of the Act means the number of days of hospitalization each time. Days stayed in acute ward or chronic ward of each time shall be counted separately. The number of days of hospitalization for those who are re-hospitalized in the same hospital for the same illness within fourteen days shall be counted together.
The maximum of self-bearing hospitalization expense for the beneficiary as provided in Paragraph 2 of Article 47 of the Act shall be six percent of the average national income per capita for one time of hospitalization or ten percent of the average national income per capita for a period of one year regardless of whether it is the same illness.
The average national income per capita referred to in the preceding paragraph shall be determined by the Competent Authority by referring to the average national income per capita of the most recent year announced by the Directorate-General of Budget, Accounting and Statistics of the Executive Yuan.
Article 63
The expenses to be borne by the insured in Category 5 under Articles 43 and 47 of the Act shall be paid to the Insurer periodically by the competent authority in charge of social welfare in the Central Government under Article 49 of the Act.
The expense to be borne by the insured prescribed in Item 1 of Subparagraph 6 of Paragraph 1 of Article 10 of the Act according to Articles 43 and 47 of the Act may be paid to the Insurer periodically by the Veterans Affairs Council.