Taiwan's Healthcare System: How It Works, Access for Foreigners and Emergencies

The NHI is a universal health insurance scheme. It is run by the National Health Insurance Administration (NHIA), under the Ministry of Health and Welfare (MOHW). Insured persons are treated in contracted facilities, public or private, classified into four levels: clinics, district hospitals, regional hospitals and medical centres. The level of the facility determines the co-payment to be paid.

The NHIA states that resident foreigners come under the same contribution calculation rules and have the same rights to care as Taiwanese citizens. The contribution is adjusted according to the category of the insured person: employee, dependant, insured person without an employer. The contribution rate, the scales and the calendar can be consulted on the NHIA site, which updates them regularly.

Foreigners holding a residence permit (ARC, Alien Resident Certificate) must enrol in the NHI. The timing depends on status, according to the NHIA:

• Employee with a work permit: enrolment by the employer from the day of hiring.
• Foreign professional (Act for the Recruitment and Employment of Foreign Professionals), with their spouse and minor children: enrolment from the date the ARC is obtained. Employment Gold Card holders hired in Taiwan, employers or self-employed enrol directly with their dependants.
• Dependant without employment: enrolment by attachment to a parent, spouse or child, after six consecutive months of residence.
• Student: enrolment request made through the institution.
• No employer and no attachment: enrolment with the local administrative office of the place of residence, after six consecutive months of residence.
• Newborn of foreign nationality born in Taiwan with a valid ARC: enrolment from birth.

The six-month period is calculated over six consecutive months after entry or, in the case of a single departure of under 30 days, over six months of actual stay once those days are deducted. In the event of an planned absence of more than six months, cover can be maintained by continuing to pay the contribution or be suspended, to be reinstated on return. The NHIA also reminds people to renew their ARC to preserve their rights. While waiting for enrolment, private insurance or the CFE (Caisse des Français de l’étranger, the voluntary social security fund for French nationals abroad) avoids any gap: see healthcare reimbursement in Taiwan.

The patient can consult the facility of their choice directly, but since 15 April 2017 a referral system modulates the co-payment. A consultation at a clinic costs NT$50. With a referral letter, the co-payment is NT$100 at a regional hospital and NT$170 at a medical centre. Without a letter, it is higher: according to an NHIA manual, the difference is NT$30 at a district hospital, NT$140 at a regional hospital and NT$250 at a medical centre (excluding dental care and traditional Chinese medicine). Consultations that follow a referral within the month (up to four), the first visit after surgery or a hospital stay, and a young mother’s first visit within the six weeks following her discharge are treated as referred visits.

The clinic is therefore the most economical route for a first opinion; the medical centre is justified for cases that require it, with a referral letter.

For emergencies, France Diplomatie gives 119 (fire brigade and medical rescue) and 110 (police); an English-speaking operator can sometimes answer. Since 1 July 2023, the emergency co-payment is a flat fee by facility level: NT$750 at a medical centre, NT$400 at a regional hospital and NT$150 at a district hospital or clinic. Households close to the poverty line and disabled people pay less: NT$550 at a medical centre, NT$300 at a regional hospital, NT$150 elsewhere (NHIA).

Medicines dispensed in outpatient consultations are subject to a cost-share capped at NT$300 in medical centres and regional hospitals. For hospitalisation, the NHI covers 70% to 95% of costs depending on the length of stay and the type of bed; the remaining cost to the patient is 5% to 30%, with a cap of NT$48,000 per admission and NT$80,000 per year (NHIA annual report). Medical centres and university hospitals in the large cities generally have reception services for international patients; the list of facilities can be consulted on the NHIA site.

France Diplomatie reminds that insurance covering all medical costs (surgery, hospitalisation) and medical repatriation is essential: otherwise, access to care can be refused, even in a life-threatening emergency, and the embassy does not pay these costs. The Taipei French Office (+886 2 3518 5151) provides guidance to nationals.

To travel with your treatments, France Diplomatie advises taking only the strictly necessary medicines, in their original packaging with the labels, accompanied by a prescription giving the names as international non-proprietary names (INN). Regulated products require the prescription and the declaration form (in English) presented at the dedicated customs counter, on arrival as on departure. You should also check that they are permitted in Taiwan, according to the “Practical information” page of the France Diplomatie site.

Medicines should never be bought in the street, because of counterfeits. For NHI insured persons, medicines prescribed in outpatient consultations give rise to the cost-share described above.

France Diplomatie recommends first checking the French vaccination schedule (diphtheria, tetanus, poliomyelitis, whooping cough, measles). Depending on the conditions and length of stay, other vaccines should be discussed with your family doctor or an international vaccination centre: hepatitis A, typhoid fever, hepatitis B for frequent or prolonged stays, rabies (young children, stays in rural areas), Japanese encephalitis, and, in the event of an epidemic or a prolonged stay in an affected area, chikungunya and dengue. Yellow fever is required of travellers coming from endemic areas.

• Dengue: flu-like syndrome, with no curative treatment; avoid anti-inflammatory drugs; protect against mosquito bites.
• Japanese encephalitis: incubation of 4 to 15 days; about 1 case in 250 is severe, with mortality of up to 30% according to France Diplomatie.
• Rabies: almost always fatal once symptoms appear; in the event of a bite or scratch, wash with soap and water and consult urgently, even if vaccination is up to date.
• Water and food: wash your hands thoroughly, cook food well, drink only safe water or water from a sealed bottle.

The Taiwan Centers for Disease Control (cdc.gov.tw, in English) publishes the evolution of diseases; the France Diplomatie Health page also reports occasional health alerts, for example for measles: check your vaccines before departure.

Three habits simplify the first months. First, ask the employer or the local administrative office for the exact date of NHI enrolment, since it determines the first co-payment. Next, keep the ARC up to date, as the NHIA reminds that renewing it preserves health insurance rights. Finally, keep the detailed invoice for each treatment received before enrolment, useful for reimbursement by the CFE, international insurance or, for a seconded employee, the French scheme. The NHI applies to enrolled foreigners the same calculation rules and the same rights to care as to citizens, which makes it possible to be treated in all contracted facilities.

France has no social security agreement with Taiwan (CLEISS list of agreements; CLEISS is the French Centre for European and International Social Security Liaison): the carte Vitale is not used on the spot. The local employee is enrolled in the NHI from hiring; for other statuses, international health insurance or the CFE covers the period before enrolment and complements the NHI, for example for medical repatriation. See also the page expat health insurance and the page health insurance in Taiwan. The settling-in arrangements are on the page living in Taiwan.