A lot of Taiwanese who are covered by National Health Insurance also pay for secondary coverage through a private insurance company.
My question is what does National Health Insurance not cover? According to my gf, if you need an operation it isn’t covered by NHI. So if I get into an accident and need emergency surgery is this covered? Does anyone know anything about this?
What exactly is covered and what is not?
It is difficult to say. NHI has been changing the rules over the last couple of years due to budget issues.
There are some medicines that are not covered by NHI.
A private or semi-private room is not covered (you pay the difference).
I know that people do buy Cancer insurance, but I am not sure on whether that is through NHI, supplemental to NHI, or what.
Accidents should be covered by other insurance (like your car insurance in your example), but I am not sure of the details.
Not sure what she is saying about the operations, though. That doesn’t seem right.
These are some that I know. Personally, I don’t know of too many people who buy extra medical insurance, though. Usually, it seems to be life or income insurance.
Actually, your girlfriend is right. The NHI really only covers basic doctor visits and checkups, etc. Anything more than that, such as overnight hospital stays, operations, etc., is not covered. I was hospitalized twice last year, and had to pay some things out-of-pocket. Now, this is Taiwan, so it wasn’t too expensive, but I’m breathing easier since I signed up with a private insurance company for secondary health insurance, as well as life and accident insurance, which cost about 11,000NT a year in premiums for several million NT in coverage. Even if I never need it again, 11,000NT annually is a pretty cheap price to pay for the peace of mind.
Wow. They should really inform foreigners about that. I wouldn’t have known.
So it’s nothing like Canada.
Yeah. Better than the States, though. Yay, socialized medicine.
What no co-pays in Canada?
What I’ve been led to believe is…In Taiwan it is technically illegal to have private insurance for reimbursed items. You can get insurance for non-reimbursed items and you can get accident insurance - but not health insurance a la the US.
Co-pays are also technically illegal for all items except pacemakers
Reimbursement depends upon indication and is uneven in its application due to the arbitrary and opaque process used to decide what gets reimbursed and what doesn’t. Many times more advanced proceedures and items are not reimbursed, but the lower cost ones are: one example would be repairing a hernia with a suture is reimbursed, but using a mesh which will allow you to recover faster, with less pain and with a lower likelyhood of causing another hernia elsewhere is not. Same with bare metal vs. drug eluting stents…and the list goes on.
There is a global budget here like in Canada since 2002. The budget was capped as of 2002 and can grow no faster than 4% p.a. Any overage has to be funded by the hospital itself. Also, the gov. is coming back to hospitals and cuting funds that they are owed by up to 25%. so hospitals are discovering the revenue potential of patient pay items and the parking lot (don’t laugh - the parking lot and cafeteria are big earners for hospitals under a global budget)
There is no ‘gatekeeper’ so that you can get to a specialist very quickly, however, he’s got 30 patients to do in a morning (mine did today) so your mileage may vary as he’s got about 10min to spend with you.
Great thread. I hope someone who knows can provide a source.
Some sites that might offer a few clues:
chinapost.com.tw/cp/health20 … 1101-1.htm
(Especially the section on major and chronic diseases)
I have work-based insurance through China Life that covers the big things. I would recommend anyone who is living here long-term to get private coverage that protects you in case of emergencies. The NHI here is very good in many ways, but it is not all-inclusive.
We have additional life, accident and medical coverage. I think it’s around NT$20,000/year each. Not a lot for some peace of mind. Plus, some of it goes into some kind of investment program. Mutual funds or something. Not too sure of the details.
What other countries in the world have Universal Health coverage?
I just assumed that everthing (within reason) would be covered by NHI.
If I get hit by a car walking down the street and am hospitalized for a few months what am I up against financially?
I’m going to look into getting more coverage.
This is scary. For all these years I thought that I was in the clear in case of medical emergency.
[quote=“aervanath”]Actually, your girlfriend is right. The NHI really only covers basic doctor visits and checkups, etc. Anything more than that, such as overnight hospital stays, operations, etc., is not covered. [/quote]I don’t think this is correct, at least as regards operations. When my friend got his knee done, the NHI subsidized the operation. My friend only paid a small percentage of the full cost.
MRI scans and the like are also covered.
I do have additional insurance though and though I can’t exactly remember what’s covered I think a daily allowance to cover hospital stays is included.
Can anybody elaborate on the dental converage by NHI? I know it covers teeth cleaning/checkup every half year…fake teeth isn’t covered apparently…orthodontal/cosmetic work is not covered…anything else?
I am in the process of having some fairly major dental work done, spread out over a couple of months. So far I’ve had four X-rays, two old fillings removed, a total clean, three new fillings, dentine medication (not exactly sure what that is, but never mind) and next Monday is root canal time (I can’t wait!). I pay NT$50 for each visit and the only thing I’ll have to pay for on top of that is a crown if the dentist is unable to rebuild my tooth after the root is extracted. It’s almost worth flying from the UK to get all this done.
You’re right, cosmetic work isn’t covered, but pretty much anything else that’s done “in-house” is.
I am in the process of having some fairly major dental work done, spread out over a couple of months. So far I’ve had four X-rays, two old fillings removed, a total clean, three new fillings, dentine medication (not exactly sure what that is, but never mind) and next Monday is root canal time (I can’t wait!). I pay NT$50 for each visit and the only thing I’ll have to pay for on top of that is a crown if the dentist is unable to rebuild my tooth after the root is extracted. It’s almost worth flying from the UK to get all this done.
You’re right, cosmetic work isn’t covered, but pretty much anything else that’s done “in-house” is.[/quote]
I really love the fact that dental is covered under NHI in Taiwan, as opposed to Canada where you have to fork out your own money if you are not under any private/employer plan…
[quote=“Taffy”]You’re right, cosmetic work isn’t covered, but pretty much anything else that’s done “in-house” is.[/quote]Generally, inlays aren’t. I have four nice bits of gold in my mouth that cost me a total of 28,000NT. But even if I’d gone for the slightly less durable tooth colour option I think it would have cost me a fair bit.
I have posted on expat private medical insurance [url=http://tw.forumosa.com/t/intl-health-insurance-for-taiwan-expats-not-covered-by-nhi/571/42
I was recently admitted to a hospital for surgery(tonsilectomy). The bill said it would have cost around 45 000 NT without NHI but I paid around 9 000 NT. My private insurance then paid me 25 000 NT. This included a four night stay at the hospital. I was in a semi-private room so this added 1200NT per night onto my bill. If I had not had the semi-private room the bill would have been around 4 000NT.
As far as I know most surgery is covered by NHI with the exception of cosmetic surgery.
[quote=“navillus”]I was recently admitted to a hospital for surgery(tonsilectomy). The bill said it would have cost around 45 000 NT without NHI but I paid around 9 000 NT. My private insurance then paid me 25 000 NT. This included a four night stay at the hospital. I was in a semi-private room so this added 1200NT per night onto my bill. If I had not had the semi-private room the bill would have been around 4 000NT.
As far as I know most surgery is covered by NHI with the exception of cosmetic surgery.[/quote]
While I still have not located an official list of benefits for NHI coverage, my experience was similar to the one above.
Just had necessary, but elective (non-emergency) surgery. Got info at two hospitals. Was given the same story twice (imagine that). In short, many surgeries are covered. Probably anything that is considered “necessary”. Hernia repair, for example, is something that is considered necessary. In that case, the patient pays a percentage. Oddly, that percentage, which ranges from 10% to 30%, is based on the length of hospital stay. Under 30 days is 10%. Then I think it is 31-60 days at 20%, and 61-90 days at 30%. After the “30 day” figure, I’m not sure. I saw it briefly on a hospital form.
Vasectomy would be a good example of something that is considered “unnecessary” and is not covered. For those procedures, the patient pays 100% of the bill.
If you have something “unnecessary” done while also getting “necessary” surgery, it seems like you don’t get charged for all of the common stuff a second time (operating room, light bulbs, nurses’ pension fund, etc). The hospitals are quite adept at mixing both types of procedure and figuring out what you need to pay. My bill seemed accurate … and pleasantly small, even without private supplemental insurance coverage.
Also, someone asked about payment for rooms, private or otherwise. Simply put, a 3-person room is covered by NHI, subject to that percentage scale mentioned above. A private room is not. Patients pay for private rooms. However, I would suspect that the cost of the private room would be reduced by what NHI would have paid for the 3-person room.
I hope that sheds a bit more light on this. If anyone comes across an official list/explanation in writing about what is and isn’t covered, that would be great new thread to make into a wiki or a sticki or a …
NHI doesn’t pay for TEVA sandals.
Not even the Diadora’s that look like TEVA’s.
The Diadoras are pretty good though.
[quote=“navillus”]I was recently admitted to a hospital for surgery(tonsilectomy). The bill said it would have cost around 45 000 NT without NHI but I paid around 9 000 NT. My private insurance then paid me 25 000 NT. This included a four night stay at the hospital. I was in a semi-private room so this added 1200NT per night onto my bill. If I had not had the semi-private room the bill would have been around 4 000NT.
As far as I know most surgery is covered by NHI with the exception of cosmetic surgery.[/quote]
That’s quite interesting. I noticed recently that fully private en-suite rooms run about NT$7k a night and I have seen over NT$10k, at Tai Da I think. Still a bargain compared to the UK, but much more than Bangkok.
So your insurance paid out more than your actual costs? Which company and when did you get it? How do they calculate the benefit?
How come a tonsillectomy took four days? I ask not because I’m a nosey bastard, but rather to enquire if there were complications, and if so (and even without I suppose) your bill of NT$45k was not excessive. Did you notice how much the private rooms were?
I recently had out-patient surgery but I never got to see the bill in full (long story which I won’t go into) but it was done privately and the charge for theatre alone (about an hour) was NT$13k. I wonder if the bulk of an in-patient bill is in fact related to accommodation, or theatre “rental” and staff costs. May I ask what procedure was used? (Butcher’s knife, cauterising laser, radio frequency thingummybob, Coblation, voodoo…?) General anaesthetic, I presume?
Surely there must be a source of info on this rather than us having to swap medical experiences over the internet? I must check it out.
I’m interested because it sounds as if yours is local insurance, and I was told the benefits had changed recently and it was no longer the good deal it was four or five years ago (“especially for foreigners”, of course). Also I am only interested in the medical benefits, and do not want any tie-in to life insurance or timeshares in the Costa del Bravo. However, yours seems to have come up trumps, with the end-payment possibly covering even a private room if you had selected one. (Was it down south? Those rates sound very cheap for Taipei.)
Does your policy cover pre-existing and/or chronic ailments? Does it (best-case scenario) just cover anything that you might need done in a hospital out of medical necessity? If so, I would be very interested.
Me (30s) and the missus (20s) together are paying a thousand quid (NT$60k and rising daily as the NT dollar slowly becomes worthless) a year for out-patient care from Goodhealth, and it’s going to go up next year and every year for ever. How does that compare with your terms? What is the fastest land animal? Does your chewing gum lose its flavour on the bedpost overnight? Which team won the FA Cup Final in 1951? What was the name given to the agreement that ended the… (Sorry for all the questions. 
)
It was Newcastle.