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Chapter Law Content

Title: National Health Insurance Act CH
Category: Ministry of Health and Welfare(衛生福利部)
Chapter 2 The Insurer, The Beneficiary, and The Group Insurance Applicant
Article 7
The Insurer of this Insurance shall be the National Health Insurance Administration, Ministry of Health and Welfare, which will administer the insurance business.
Article 8
Any national of the Republic of China must meet one of the following requirements in order to become the beneficiaries of this Insurance:
1.Those who have previously subscribed to this Insurance within the last two years and have a registered domicile in Taiwan, or having established a registered domicile for at least six consecutive months in the Taiwan area prior to subscription of this Insurance;
2.The following individuals who have established a registered domicile in the Taiwan area at the time of becoming a subscriber:
(1)Civil servants or full-time and regularly paid personnel in governmental agencies and public/private schools;
(2)Employees of publicly or privately owned enterprises or institutions;
(3)Employees other than the insured prescribed in the preceding two items but are otherwise employed by particular employers;
(4)Newborns in the Taiwan area;
(5)Spouse and offspring of government officials assigned abroad.
Individuals who have previously subscribed to this Insurance and have gone abroad before this revision was promulgated on January 4, 2011 should immediately established residency and subscribed to this Insurance the first time they return to the country one year after the revision has been implemented. They will not be subject to the six-month restriction of subparagraph 1 of the previous paragraph.
Article 9
With the exception of individuals mentioned in the previous article, any person who has an alien resident certificate in the Taiwan area must meet one of the following requirements in order to become the beneficiaries of this Insurance:
1. Those who have established a registered domicile in Taiwan for at least six months.
2. Those with a regular employer.
3. Newborns in the Taiwan area.
Article 10
The insured shall be classified into the following six categories:
1.Category 1
(1)Civil servants or full-time and regularly paid personnel in governmental agencies and public/private schools;
(2)Employees of publicly or privately owned enterprises or institutions;
(3)Employees other than the insured prescribed in the preceding two items but are otherwise employed by particular employers;
(4)Employers or self-employed owners of business;
(5)Independently practicing professionals and technicians.
2.Category 2
(1)Members of an occupational union who have no particular employers, or who are self-employed;
(2)Seamen serving on foreign vessels, who are members of the National Seamen’s Union or the Master Mariners’ Association.
3.Category 3
(1)Members of the Farmers’ Association or the Irrigation Association, or workers aged over fifteen who are actually engaged in agricultural activities;
(2)Class A members of the Fishers Association who are either self-employed or have no particular employers, or workers aged over fifteen who are actually engaged in fishery activities.
4.Category 4
(1)Military servicemen whose compulsory service terms are over two months or who are summoned to serve in military for more than two months, military school students who receive grants from the government, military servicemen’s dependents who lost their support recognized by the Ministry of Defense, and military decedent’s families who are receiving pensions due to the death of their decedents.
(2)Men at age for enlisting in the military, who are currently in military-substitute service.
(3)Those who are serving sentences in correctional institutions or receiving punishments from police and military court-martial. However, this is not applicable to those who are serving sentences of less than two months or are under parole.
5.Category 5
Members of a household of low-income families as defined by the Social Support Law
6.Category 6
(1)Veterans, household representatives of survivors of veterans;
(2)Representatives or heads of household other than the insured or their dependents prescribed in subparagraphs 1 to 5 and the preceding item of this subparagraph.
The standard for identification and qualification of the workers actually engaged in agricultural activities under item (1) of subparagraph 3 and the workers actually engaged in fishery activities under item (2) of subparagraph 3 shall be established jointly by the central agricultural competent authority and the Competent Authority.
Article 11
The insured classified in Category 1 may not opt for classification in Category 2 or Category 3. The insured classified in Category 2 may not opt for classification in Category 3. The insured classified in Categories 1 to 3 may not opt for classification in Category 4 to 6. However, Class A members of the Fishers Association who hire 10 or less than10 laborers for ocean fishing and are actually engaged in fishery activities starting from January 21, 2002, should be classified as Category 3.
Those who qualified as the insured shall not subscribe to this Insurance as dependents.
Article 12
The dependents of the insured in Article 2 shall subscribed to or withdraw from this Insurance together with the insured. However, this rule shall be inapplicable to situations including but not limited to domestic abuse, which are recognized by the Competent Authority as difficult for dependents to subscribe to or withdraw from this Insurance together with the insured.
Article 13
The following persons are not covered by this Insurance and shall be withdrawn from it if they have subscribed to this Insurance:
1.Those who have been missing for six months or more;
2.Those who are not qualified under Articles 8 or 9.
Article 14
The commencement of the insurance shall take effect from the date of occurrence of such qualifications specified in Articles 8 or 9.
The termination of the insurance shall take effect from the date of occurrence of the previous article.
Article 15
The group insurance applicants for the different Categories of the insured are as follows:
1.For the insured in Categories 1 and 2, the group insurance applicants shall be the agencies, schools, enterprises, institutions, or employers, which they work for, or unions where they hold membership. Nonetheless, the group insurance applicants that cover the insured in the Ministry of Defense shall be designated by the Ministry of Defense.
2.For the insured in Category 3, the group insurance applicants shall be the lowest-level Farmers Association, Irrigation Association or Fishers Association to which they belong, or located at the place where the insured have their household registered.
3.For the insured in Category 4, the group insurance applicants are as follows:
(1)For the insured in item 1, subparagraph 4, paragraph 1, article 10, the group insurance applicants shall be designated by the Ministry of Defense.
(2)For the insured in item 2, subparagraph 4, paragraph 1, article 10, the group insurance applicants shall be designated by the Ministry of Interior.
(3)For the insured in item 3, subparagraph 4, paragraph 1, article 10, the group insurance applicants shall be designated by the Ministry of Justice and by the Ministry of Defense.
4.For the insured in Categories 5 and 6, the group insurance applicants shall be the village (township, municipal, district) administration offices of their registered domiciles; provided, however, the public or private social welfare service institutions may be the group insurance applicants for the insured who lives therein.
The insured prescribed in item 2, subparagraph 6, paragraph 1 of Article 10, and their dependents may, upon consent of the group insurance applicants of the insured in another category who live together with the above insured and their dependents, use such units as their group insurance applicants, provided that the premium shall be calculated separately according to the provision of Article 23.
The group insurance applicants prescribed in subparagraph 4, paragraph 1 of this Article shall set up special units or agents to administer relevant matters of this Insurance.
For anyone who is covered under Category 6 and undergoing vocational training or exam-taking training at a government-registered institution, such training institution or agency shall be the group insurance applicant.
The group insurance applicant has failed to make the premium payments for more than two months, the Insurer may contact another group insurances applicant to administer matters related to this Insurance.
The group insurance applicants shall subscribe to the Insurer for coverage within three days from the date on which the beneficiaries meet the conditions of this Insurance and shall withdraw from the coverage within three days from the date of occurrence of the cause of the withdrawal.
Article 16
The Insurer must produce and distribute a national health insurance card with electronic information processing function to store and send information on the insured. However, the card may not store any information not used for medical care purposes as well as those unrelated to the insured receiving insurance medical services.
The Insurer shall charge a fee for changing or replacing the abovementioned card; it shall also determine the production, replacement, changing, type and use of stored and sent information, management of the card’s use as well as other relevant matters, which shall be announced after being approved by the Competent Authority.