Healthcare Reimbursement in Taiwan: Who Pays for What Depending on Your Situation

Taiwan does not appear in the list of social security agreements concluded by France, published by CLEISS. No coordination therefore exists between the French Assurance Maladie (the national health insurance fund) and the NHI: no posting certificate provided for by an agreement, no totalisation of periods, no cross-coverage. France Diplomatie (the French foreign ministry) reminds that the embassy does not pay medical costs and that, without insurance covering all costs and repatriation, access to care can be refused, even in a life-threatening emergency.

Four players can be involved: the NHI (the compulsory local scheme for residents holding an ARC), the retained French scheme (secondment), the CFE and an international health insurance. The notions of reimbursement basis and out-of-pocket cost help to compare offers. How the local scheme works is presented in the guide Taiwan’s healthcare system.

The local-contract employee is enrolled in the NHI from the date of hiring by the employer (NHIA, the National Health Insurance Administration). They pay a co-payment at each consultation, depending on the level of the facility and whether there is a referral letter, and a limited cost-share for medicines and hospitalisation. See the glossary entry on the local contract. Supplementary insurance or the CFE remains useful for repatriation and for care outside Taiwan.

The seconded employee sent by a French employer remains, in principle, attached to French Social Security during their assignment; as no agreement applies, this retention falls under French law on secondment outside an agreement. Duration, conditions and contributions should be confirmed with the Urssaf (the French social security contributions collection body) and CLEISS before departure. Costs are then reimbursed under French rules, on paid invoices. The holder of an ARC employed locally or attached to the NHI retains the enrolment obligations described by the NHIA; the situation of a seconded employee should therefore also be checked with the NHIA and their employer. See posted worker or expatriate and the glossary entry on the posted worker.

The self-employed person or digital nomad has no employer to enrol them. The Employment Gold Card holder who works on their own account or employs staff in Taiwan can enrol directly in the NHI with their dependants; without an employer or a status of this type, enrolment takes place after six consecutive months of residence, with the local administrative office. Between arrival and enrolment, international insurance or the CFE ensures continuity; see digital nomad insurance.

The student can request enrolment in the NHI through their institution, according to the NHIA. Before age 30, the CFE offers its youth offer. See student insurance abroad.

The spouse and children of a foreign professional enrol from the date of their ARC; those of an employee without this status enrol as dependants, after six consecutive months of residence. A newborn of foreign nationality born in Taiwan with a valid ARC is enrolled from birth. The CFE and international insurers offer family contracts; see expat family insurance.

The retiree is not covered by form S1, valid in the European Union: Taiwan is not a state of the Union. As an ARC holder, they enrol in the NHI after six consecutive months of residence. The CFE offers its retirees’ offer, reserved for holders of a pension from a French basic scheme and with no health questionnaire. See the guide health insurance for retirees abroad and the page retiring in Taiwan.

The CFE is a voluntary social protection body. In France, it reimburses according to Social Security principles, with third-party payment in public and private hospitals; abroad, reimbursement depends on the scale of the country of care, applied as a rate or a flat amount to actual expenses. When the local price exceeds the basis used, the difference remains payable by the member: the guide CFE reimbursements details this mechanism.

• Offers: the main offer (over 30, excluding retirees), the youth offer (under 30) and the retirees’ offer; the contribution is calculated on the simulator at cfe.fr according to age, family situation and country.
• Waiting period: immediate cover if membership takes place before departure or within three months of settling in; beyond that, three months’ waiting, then six months from age 45.
• Maternity: conception must take place after membership or attachment as a dependant.

On returning to France, without resuming work, a three-month period with stable residence in France applies before Social Security rights open; a CFE member without professional activity benefits free of charge from retention of rights for the first three months. See the guide reducing the waiting period and the page return to France.

International health insurance at the first euro reimburses actual costs within its limits, after any deductible, waiting periods and exclusions of the contract. It complements the NHI for repatriation and for care outside the contracted network. Contracts are compared on the annual limit, the coverage zone, evacuation and the handling of medical history.

The tourist stays up to 90 days without a visa. France Diplomatie recommends checking cover before the trip: travel insurance with repatriation, possibly supplemented by bank card assistance, whose limits should be read. A long stay with a visa is prepared with long-stay travel insurance. For the working holiday visa, see working holiday insurance.

• Consultation: with the NHI, NT$50 at a clinic; with a referral, NT$100 at a regional hospital and NT$170 at a medical centre; the CFE reimburses according to its country scale; actual costs for a first-euro contract.
• Hospitalisation: the NHI covers 70% to 95% depending on the length of stay and the type of condition, with the remaining cost capped at NT$48,000 per admission and NT$80,000 per year; French scheme for the seconded employee; CFE with third-party payment in France; international contract with direct settlement.
• Medicines: cost-share capped at NT$300 in medical centres and regional hospitals for outpatient medicines; CFE scale; limits of an international contract.
• Dental: dental care and traditional Chinese medicine are excluded from the NHI referral system; the extent of cover should be checked with the NHIA; the CFE and international contracts apply their scales and annual limits.
• Optical: glasses and lenses mainly fall under international contracts, with limits per period; to be read in the table of benefits.
• Maternity: NHI cover should be checked with the NHIA; the CFE requires conception after membership; international contracts generally apply a waiting period to maternity.

The reimbursement guide and the page expat health insurance give pointers; Expavy helps to weigh these options against your situation.