National Health Insurance again

This is probably a question for Mr. Hartzell:

I am the foreign manager of the branch office of an international company. I have an ARC (3 year validity) since 19 August 2002. I was told that I could choose whether or not I wanted to join the National Health Insurance, and I chose not to because I have an international health and accident insurance.

Now, somebody else tells me that I do have to join NHI. That’s a bit confusing :frowning:

And if I join, should I still keep that international insurance after the contract expires in a couple of months or would NHI be sufficient (I think I asked that question before but didn’t get an answer)?

Any useful information?

Thanks, Iris

Q13: Is there any penalty if one refuses to enroll in the NHI?

Ans: The NHI program is a compulsory insurance. Anyone who is eligible for the NHI should enroll in the program. Those who refuse to enroll in the NHI will be fined the amount between NT$ 3,000 and NT$ 15,000. The enrollment will be retroactive to the first day when a person becomes eligible. However, until the required premium or penalty is fully paid, the coverage will not come into effect. Written notices with specific time limit within which the overdue amount should be paid will be sent to the insured or the Group Insurance Applicant. Prolonged overdue accounts will be dealt with through legal means.

( …source is from the FAQ button at the top …)

Yes, NHI participation is compulsory. You must join upon the date when you become eligible. If you wait a year to join, you will still be charged for that year’s premiums.

As to whether you should retain other international (or home country) health insurance when enrollling under NHI, that is something for you to discuss with that insurer. Important points to consider would be whether the insurer will allow you so-much per visit for out-patient services in Taiwan, so much per hospital stay, etc., and/or if official receipts (in English) have to be given. How much paperwork is necessary to file a claim?

Also, does the insurer cover you when travelling internationally? That might be attractive and desirable if you travel frequently.

Under what conditions is it compulsory? When you have an ARC or when you are employed here and your salary is paid here?

I have the joining family residency visa (JFRV) and will soon have the Open Work Permit. I work freelance, pay tax and have private medical insurance/life insurance which covers ‘big things’ (operations etc.).

Do I have to pay for NHI? If you pay it yourself, in other words not via a company who pays for most of it, that comes to around NT$2500 a month, which is why I chose not to pay it.

For small stuff (fillings and cold medicine etc.) it is still pretty cheap to pay it yourself. If it is illegal not to have NHI why do hospitals/clinics make provision for people like me to see a doctor and just pay the appropriate non-NHI rate?

Also, if I want to join the NHI again (after about 3 years) I would have to backpay all the missed payments. Or, maybe I am misinformed (?)

Thanks in advance for anyone’s comments on my situation.

You really do need to back pay missed payments, the same applies for Taiwanese too.
Actually you should be able to connect your insurance to your wife and just pay $600 NT per month, that is if you say you’re “not working”, sure you have an OWP but that doesn’t mean that you are earning anything, it just means that you can have a job.
The insurance office where I live didn’t ask any questions about work at all. But I did have to pay for my missed payments.

I wonder how much communication there is between departments. If I get the Open Work Permit, is the NHI Bureau going to send me an ‘invitation’ to join the NHI (“and pay over 3 years missed payments while you’re at it”)?

For how long has it been compulsory for foreigners to join the NHI? I’ve only just found about that! I figured it was optional considering it’s much more expensive to pay by yourself.
I know the law is the law and we all have a duty to find out for ourselves what the laws are regarding the NHI, but I just assumed that foreigners without an employer could just “pay as they played” (at a much higher rate, btw). Boy, was that a bad assumption!

Last question- has anyone (foreign) ever been pursued for missed NHI payments? (hope not!)

Thanks in advance.

If you get the open work permit based on being married to an ROC national or having permanent residency, you (by definition) already have RESIDENCY, hence you are already eligible for NHI coverage.

In the past however I have heard that perhaps there is a six month “ineligibility period” initially if you can absolutely prove that you have no employment.

In regard to the mandatory nature of NHI, it was always that way from the beginning. I seem to recall that NHI started in March 1995.

VI. Labor and Health Insurance

  1. All ROC citizens and foreign laborers holding an ARC must be enrolled in the National Health Insurance Program.
  2. Those foreign laborers employed in an establishment with more than five laborers must enroll in the Labor Insurance Program through the employing organization.
  3. Health insurance premium shall be 4.25% that of the insured amount; Labor Insurance premium shall be 6.5%. Premiums for occupational accident insurance varies by profession and can range between 0.09-3%. Payment of occupational accident insurance premiums is the sole responsibility of the employer.
  4. Payment of health insurance premiums for foreign laborers shall be as follows: employer pays 60%, government pays 10%, employee pays 30%.
  5. Foreign laborers hired as household help shall have the option of joining the Labor Insurance Program.
  6. All rights and responsibilities concerning insurance for foreign laborers shall be governed by the Labor Standards Law as well as Labor Insurance regulations.

Source: ROC Labor Standards Law concerning wages, hours, leave and holidays

Note: The term “foreign laborers” in this law does include white-collar employees.

Another note: The Bureau of Labor Insurance is currently taking action against rotten employer Interface Global because the company has failed to pay Labor Insurance for its employees for over a year. It hasn’t paid its National Health Insurance contributions, either.

In my last job I was forced to pay for Labour insurance + NHI for years. Yearly the total was over 15,000NT and I only used to visit the dentist for the twice yearly cleaning - clearly not worth the money I put into it. I wouldn’t object to simply paying the NHI but if I have to pay the Labour insurance as well then I don’t want either. (Labour insurance came to half of the money I had to pay out each year).

If we have an APRC and are unemployed (or paid in cash) can’t we just apply for NHI alone and pay the min of 600nt pm?

I hate socialism!

Only 15000 NT$ a year?

That’s what you pay each month in Belgium! Well, … almost.

I just don’t get why you have to pay missed payments if you want to join the NHI again. During the three years of not paying NHI (because I’m self-employed) I paid my own way. Each visit to the docs was therefore much more expensive.

There is now no incentive for me to go legit again because it would cost me over NT$100,000. That would be a bitter pill to swallow. Gulp.

Reading the NHI law, I don’t see anything saying this is mandatory. When it was introduced, I was told by my company that it was optional. I chose to take it and I paid it from that time till I was laid off in April.

Now, there might be a difference in translation between the Chinese + English texts but the following words don’t exist in this document: mandatory, obligatory, or must.

My point here is that the word “may subscribe” is used. May emplies I can choose to join or not. The word “must” on the other hand means I don’t have any choice in the matter.

Can somebody pass me a link to the specific law or passage (Chinese or English) that says I must pay NHI? Since obviously, the the english copy on the NHI page is either badly translated or it is after all a voluntary scheme.

Article 10

Any national of 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 or having established a
    registered domicile for at least four consecutive months in the Taiwan area prior
    to subscription of this Insurance;

  2. Having established a registered domicile in the Taiwan area at the time of
    becoming a subscriber to this Insurance and qualified as the insured under items
    (1) to (3), subparagraph 1, paragraph 1 of Article 8;

  3. Newborns having had domicile registration at the time of subscription to this
    Insurance in the Taiwan area, and qualified under Article 9 as the dependents of
    the insured.

Any person who has not met the requirements in the preceding paragraph and has an alien resident certificate in the Taiwan area and qualified as the insured under Article 8 or those qualified under Article 9 as the dependents of the insured,upon fulfilling a four-month minimum residency requirement, may subscribe and become covered by this Insurance. Any person qualified as the insured under items (1) to(3), subparagraph 1, paragraph 1 of Article 8 shall not be subject to the four month requirement.

I think there must be thousands of people who are eligible to pay but don’t, either because they can’t or won’t.

I am guessing that the NHI Bureau does not pursue them because it just isn’t practical. Just by telling people that it is mandatory is enough to make sure that most people cough up.

Even if you could quibble over the meaning and wording of the Chinese, I don’t think you would get very far if you wanted to be a test case. You might succeed in getting them to change the wording so that it was watertight. Sadly, you gotta pay it. Nice try though.

Maybe “eligible” in Chinese translations of regulations may not have the same meaning as some native English speakers expect.