Taiwan Raises Hospitalization Copayment Limits for 2024

The cap on out-of-pocket expenses for hospitalizations under Taiwan’s National Health Insurance (NHI) will increase on January 1, 2024. According to a draft regulation from the Ministry of Health and Welfare, the limit for a single visit will rise by NT$6,000 to NT$57,000, while the annual cap will increase by NT$8,000 to NT$94,000. This adjustment is anticipated to affect approximately 11,000 patients, resulting in an additional NT$60.93 million (approximately US$2.02 million) in copayments.

The new figures mark a significant increase compared to last year, when the cap for single visits and annual accumulations rose by only NT$1,000 and NT$2,000, respectively. Chen Chen-hui, Acting Director of the Department of Social Insurance, explained that the current rise was based on the same formula used in previous calculations, which takes into account increasing per capita national income. This data is sourced from the Directorate-General of Budget, Accounting and Statistics (DGBAS).

Patients suffering from catastrophic illnesses or those from low-income households who receive subsidies from other agencies will be exempt from these changes. The revised caps apply to insured patients hospitalized for a maximum of 30 days in acute care wards or 180 days in chronic care wards. They will only cover the medical expenses payable under Article 47 of the National Health Insurance Act.

The draft regulation is set to undergo a 60-day notice period before it takes effect at the start of the new year. Based on the DGBAS data, the one-time hospital stay cap represents 6 percent of the average income, while the annual cap equates to 10 percent.

This increase aims to align patient contributions with the growth in national income, reflecting the ongoing adjustments within Taiwan’s healthcare funding system. The changes have sparked discussions about the sustainability of healthcare costs in the context of Taiwan’s aging population and rising medical expenses.