National Health Insurance legalities

QUESTION:

I am wondering what position most foreigners are taking with respect to this issue: A few years ago a law was passed regarding the National Health Insurance program that makes it compulsory for all foreigners to pay National Health Insurance contributions.

ANSWER:

Actually, there may be some misunderstanding on your part here. The National Health Insurance program is compulsory for everyone, both local ROC citizens and foreigners alike, retroactive to your date of eligibility.

It has been that way since its initial inception in March 1995.

Hence, there has never been any possibility of having foreigners “excluded” from the coverage if they meet eligibility requirements. The revision to the National Health Insurance Law which was put into affect in July, 1999, did however broaden the base of persons eligible, so that now more foreigners are eligible for participating in the program than before.

However, it must be remembered that our lobbying on this issue in 1997, 1998, and 1999 was in direct response to the cries of many foreigners (some of whom are married to local citizens) that they were unable to participate under the old eligibility rules.

Obviously, if you qualify for coverage, it is advisable to sign up and get your NHI Health Card, and use it from time to time. You do not save any money by delaying entrance into the program.

In general I feel that many local Chinese persons face much greater difficulties in dealing with the NHI than foreigners do. One problem that continually comes up is when a Chinese person leaves Taiwan to go overseas to live for an extended period. Often as not, no one bothers to notify the BNHI of this event, and several years down the road when this person comes back to Taiwan and gets employed or otherwise tries to get back in the NHI program, he finds that he never left the program and now owes three years or more of back payments. The argument that “I never used a Health Insurance Card even once over the past three years” is irrelevant from the point of view of the BNHI. Participation in the program, and payment of “dues” is mandatory.

This typically does not happen to foreigners because when they leave, they leave, and in many cases they quit their job, where their participation in the NHI was based, and so their residency permission and NHI coverage is already cancelled.

Over the past two years I have continually introduced recommendations to the Legislative Yuan’s Health and Welfare Committee that each person in the NHI program be given a unique “medical record number”, which would replace the arbitrary and random system used by many hospitals and clinics at present. Whether there will be any action taken on this during the next year or two remains to be seen.

I think that with the introduction of NHI IC-cards in mid-2002, we will see much confusion generated because foreigners do not have a standard “I.D. number”. My unique “medical record number” would serve to alleviate this problem to some extent.