National Health Insurance Refund Application Form
ADVERTISEMENT
1
2Instructions for NHI Prepaid Medical Expense Reimbursement Application Form
1. Please note:
(1) The insured person should fill out the form completely; the
group insurance unit
should submit the application to the accepting unit.
(2) The
group insurance unit
is requested to make copies of the application form for its needs, or may request forms from a Bureau of National
Health Insurance (BNHI) branch.
(3) Persons at least 20 years of age who are mentally and physically competent must submit an application for themselves, and may not designate a
payer. A legal agent must apply on behalf of persons less than 20 years of age and attach personal identification documents. A legal heir may
apply if the original person has died; the heir must attach personal identification documents and a statement.
(4) If the
group insurance unit
prepays medical expenses, the insured person is requested to make a written statement designating the
group
insurance unit
as the payment recipient.
(5) If the case involves a major injury or illness, one photocopy of a document verifying the major injury or illness must be attached.
(6) Please fill out the payment address carefully so as to facilitate issuance of the refund.
(7) Starting from April 1, 2006 (hospital discharged date), when an insured applies for a refund for prepaid medical expenses for at least five days
of hospitalization in China, and a BNHI branch considers that the case requires verification, before the application can be accepted, a concerned
party must have the required medical verification documents (including original medical expense receipts, itemized expense lists, diagnostic
statements, and other verifying documents) first notarized at a notary office in China, and must apply bearing the original notarization certificate
to the Straits Exchange Foundation (phone: 02-2713-4726; ) for certification, and must complete certification documents.
2. Necessary conditions: An insured may apply for the refund of insured medical expenses in any of the following situations:
(1) If
the
insured has
not joined the NHI program
in accordance with the regulations of the National Health Insurance Act (herein referred to as
"this Act"), and has been punished with a fine and temporary suspension of insurance payments in accordance with Article 69-1 of this Act, the
insured prepays for medical care expenses at an insured medical service organization during the period of suspension of insurance benefits, and
has already paid all fines and insurance
premiums
in full.
(2) If the insured has been provisionally refused insurance payments in accordance with Article 30, Paragraph 3 of this Act, the insured prepays for
medical care expenses at
a contracted health provider
during the period of provisional refusal of insurance benefits, and has already paid all
insurance
premiums
and overdue payment in full.
(3) If the insured has failed to pay co-payments in accordance with Articles 33 and 35 of this Act, and has been provisionally refused insurance
premiums, the insured prepays for medical care expenses at
a contracted health provider
during the period of suspension of insurance premiums,
and has already paid all fines and insurance
premiums
in full.
(4) The insured has failed to submit any
certificate on exemption of co-payment
to
a contracted health provider
within seven
working
days
after
the
day
being treated
in accordance with Article 6 of this Act.
(5) One of the following situations applies and the case meets the requirements of Article 2 of the National Health Insurance Emergency Injury or
Illness Prepaid Medical Expense Refund Regulations (herein referred to as the "Refund Regulations"):
I. Within an area where NHI is in force, the insured is unable to go
receiving
care at a
contracted health provider
due to an emergency injury
or illness, and must seek care at a nearby
non-contracted health
provider.
II. Within an area where NHI is in force, the insured is unable to go for delivery care at
a contracted health provider
due to emergency
circumstances, and must go to a
non-contracted health
provider, or asks an approved physician or midwife to assist the delivery.
III. Within an area where NHI is not in force (including foreign countries and China), the insured suffers an unexpectedly injury, illness, or
emergency delivery, and must go to a local medical organization for care or delivery.
(6) In accordance with Article 35, Paragraph 2 of this Act and Article 64, Paragraph
3
of this Act's enforcement rules, the insured's
co-payments of
hospitalization
for the year exceed
10% of
the average per capita income during the most recent year.
3. Accepting units:
(1) In cases meeting the conditions of Subparagraphs 1~4 of Paragraph 2 above, please submit an application to the BNHI branch with jurisdiction
over the place of the hospital or clinic of treatment.
(2) In cases meeting the conditions of Subparagraph 5 of Paragraph 2 above, please submit an application to the BNHI branch with jurisdiction
over the place of the
group insurance
unit.
(3) In cases meeting the conditions of Subparagraph 6 of Paragraph 2 above, please submit an application to BNHI branch with jurisdiction over
the place of the first hospital or clinic of treatment.
4. Standards of the refund: The insurer shall process refunds in accordance with NHI Medical Expense Review and Payment Regulations and the
National Health Insurance Emergency Injury or Illness Prepaid Medical Expense Refund Regulations.
5. Ways of refunds: After approval of the expenses, the BNHI branch shall mail a check to the insured or remit the payment to the account of the
insured or insured's legal agent by
bank
transferation.
Addresses and Service Phone Numbers of Bureau of National Health Insurance Branches
Branch
Address
Area of jurisdiction
Phone
No.15-1, Gongyuan Rd., Jhongjheng District, Taipei
City
Taipei branch
Taipei, Ilan, Keelung, Kinmen, Matsu (02) 2523-2388
No.15-1, Gongyuan Rd., Zhongzheng District, Taipei
City
Northern Region branch
525 Jhongshan E. Rd. Section 2, Chungli, Taoyuan County
Taoyuan, Hsinchu, Miaoli
(03) 438-1111
st
Central Region branch
66 Shicheng N. 1
Rd., Taichung
Taichung, Changhua, Nantou
(04) 2258-3988
Southern Region branch
96 Gongyuan Rd., Tainan
Yunlin, Chiayi, Tainan
(06) 224-5678
nd
Kao-Ping Branch
157 Jioru 2
Rd., Sanmin District, Kaohsiung
Kaohsiung, Pingtung, Penghu
(07) 323-3123
Eastern Region branch
36 Syuanyuan Rd., Hualien City
Hualien, Taitung
(03) 833-2111
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business