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Medical Subsidy Regulations for Children & Youth

  • PostDate:2011-06-29 00:00
 

Article 1  The regulations have been enacted pursuant to paragraph 2, Article 20 of the Children and Youth Welfare Act.

 

Article 2  The subsidy items stipulated in the regulations are as below:

1.     The self-born expense is stipulated in Article 33 and 35 of the National Health Insurance Act.

2.     The self-born insurance premium is stipulated in Article 27 of the National Health Insurance Act.

 

Article 3   National health insured children under 3 years of age and the recipients of the subsidy stipulated in the subparagraph 1 of the preceding article.

          If the recipients for the subsidy stipulated in the preceding paragraph reach 3 years of age during the hospitalization period, the subsidy shall be continued until the day of discharge from the hospital.

 

Article 4   The recipients for the subsidy stipulated in subparagraph 2, Article 2 shall be the children or youth in mid and low income families.

 

Article 5   Medical treatment of the recipients who receive the subsidy stipulated in subparagraph 1, Article 2 shall be proceeded according to regulations of the National Health Insurance Act.

 

Article 6   The subsidy recipients stipulated in subparagraph 1, Article 2 pay the subsidy in advance because unattributable reasons may apply according to regulations of the National Health Insurance Act to the Bureau of National Health Insurance, Department of Health, Executive Yuan (initialed as BNHI) for a refund.

 

Article 7   The effective period of the insurance premium subsidy stipulated in the subparagraph 2, Article 2 shall start from the preceding month for applications approved before the 15th of the preceding month. However, for those approved after the 15th of the preceding month, the effective period shall start from the next month.

          The stipulation for the commencement of the effective period stated in the above paragraph will become invalid when the qualification of the subsidy recipients is forfeited and the subsidy is suspended.

 

Article 8   The competent authority of municipality or county (city) governments shall send basic information electronically of the children and youth in mid and low-income families to the Health Insurance Bureau before the 5th of each month. This also applies to data changes. 

          If subsidy qualification is still valid after the household registration change, the effective date for the change shall be carried back to the move-in date listed by the household registration office.

          The regulations for the exchange of electronic information stated in paragraph 1 are to be defined by the Health Insurance Bureau.

 

Article 9   The insurance premium subsidy will not be permitted under any of the following conditions. If a recipient with the following conditions received a subsidy, the competent authority of municipality or county (city) governments shall ask for a subsidy refund from the recipient.

1.     Those who do not submit the required documents as stipulated in the regulations.

2.     Those who have received a government insurance premium subsidy pursuant to other regulations for the same incident.

3.     Those who use fake certificates or improper behavior to apply for or acquire the subsidy.

4.     Those who are not eligible for the subsidy according to the stipulated regulations.

However, the abovementioned points are not applicable to applicants who are not accountable for the incidents and where applications have been rectified according to the regulations.

 

Article 10  The subsidized insurance premium for children and youth in mid and low-income families shall be per the regulations, and insurers shall check and collate insurance information electronically transmitted by the competent authority of municipality and county (city) governments, and delete the amount from the insurance premium table submitted by the insured unit. This process will be used by the insured unit as evidence for exemption of premium.

 

Article 11  The subsidy stipulated in the regulations is to be appropriated to the Health Insurance Bureau in advance at end of January and July respectively every year by the central government competent authority. In addition, the Health Insurance Bureau is to close the account book at each year-end with a detailed list and final statement.

 

Article 12  Funds required for the regulations will be listed in the annual budget by the central government competent authority.

 

Article 13  The competent authority of municipality, county (city) governments and the Health Insurance Bureau shall assist children and juveniles in participating in National Health Insurance.

 

Article 14  The subsidy recipients approved by the competent authority of municipality and county (city) governments, prior to the regulation amendments executed on July 1, 2011, may still receive subsidies until December 31, 2011, unless recipients have conditions stipulated in Article 9.

 

Article 15  The regulations amendments are to be executed on July 1, 2011.