Taiwan NHI Benefits Explained: What's Covered, Copayment Cheat Sheet, and What's Not
Taiwan's National Health Insurance covers an enormous range of care — outpatient visits, hospitalization, dental, Chinese medicine, even home care. But not everything is covered, and knowing the copayment table saves real money. This is the benefits overview; for enrollment rules, see our NHI enrollment guide.
What's Covered
- Outpatient care (門診): clinic and hospital visits across all specialties.
- Hospitalization (住院): ward care, surgery, nursing — with copayments that rise the longer you stay (acute wards: 10% for the first 30 days, 20% for days 31–60, 30% beyond; per-episode and annual caps apply — check current amounts with NHI).
- Emergency care (急診): covered, with the flat copayments by hospital tier.
- Dental (牙醫): exams, cleanings (once every 6 months for ages 13+), fillings, root canals, extractions. Implants, orthodontics, and cosmetic work are self-pay.
- Chinese medicine (中醫): acupuncture, herbal prescriptions, tui na within NHI's scope — flat NT$50 copayment at any tier.
- Tests and imaging: as ordered by a doctor (see our tests guide).
- Prescription drugs: covered with the drug copayment rules.
- Rehabilitation, home care, hospice, and preventive services: within NHI's defined scope.
Copayment Cheat Sheet (2026)
Outpatient basic copayment (西醫門診):
| Tier | With referral | Without referral |
|---|---|---|
| Medical center | NT$170 | NT$420 |
| Regional hospital | NT$100 | NT$240 |
| District hospital | NT$50 | NT$80 |
| Clinic | NT$50 | NT$50 |
Dental and Chinese medicine: flat NT$50 everywhere.
Emergency: NT$750 / NT$400 / NT$150 by tier (NT$550/300/150 for low-income or disability card holders).
Drugs: at clinics/district hospitals, drug costs ≤NT$100 are free, above NT$101 you pay 20% capped at NT$200; at regional hospitals/medical centers, 20% capped at NT$300. Chronic-disease refill prescriptions follow the same rules per refill.
Tests: 10% with referral (caps NT$200/150), 20% without (caps NT$400/300).
Registration fees (掛號費) are set by each hospital/clinic and are separate from copayments — budget roughly NT$100–250 on top.
What's NOT Covered
- Cosmetic procedures (美容醫學): double-eyelid surgery, Botox, laser skin treatments.
- Routine health checkups (一般健檢): self-pay except specific free preventive programs.
- Designated-physician fees (指定醫師費) and ward upgrades (病房差額): want a private room or a specific surgeon? You pay the difference.
- Dental implants, orthodontics, dentures (with narrow exceptions).
- Non-essential appliances: glasses, hearing aids, wheelchairs.
- Newer high-tech treatments not yet admitted to the NHI fee schedule.
Hospitals must disclose self-pay items and get your consent before providing them — if you're ever unsure whether something is covered, ask 批價櫃檯 first.
Foreign Residents: The Short Version
Most foreign residents with an Alien Resident Certificate (ARC) must enroll in NHI after 6 months of continuous residence (employed people enroll from day one through their employer). Premiums are income-based. Full enrollment details are in our separate NHI enrollment guide — this article focuses on what the benefits buy you once you're in.
Frequently asked questions
Q: Is there an annual cap on how much I can pay in copayments?
A: Yes — NHI sets per-episode and annual copayment ceilings (separate for outpatient and inpatient), and amounts exceeding the ceiling can be refunded on application. The exact figures are adjusted periodically; check the NHI website or ask the hospital's billing counter for the current numbers.
Q: Can I pay copayments by card?
A: Most hospitals accept credit cards and mobile payments at billing counters; small clinics are often cash-only. Ask at registration if it matters.
Q: What do I need for a hospital stay?
A: NHI card, ID, personal toiletries, and any current medications. Hospitals provide meals; family members often take turns staying with the patient (陪病), which is the cultural norm.
Sources
- https://www.nhi.gov.tw/ch/cp-5163-9803c-2737-1.html
- https://www.nhi.gov.tw/ch/cp-1448-643b9-3255-1.html
- https://www.mohw.gov.tw/cp-16-74668-1.html