Taiwan
Medical Device Reimbursement system
Overview:
Taiwan’s National Health Insurance (NHI) program was established
in 1995.
Previously, three different insurance systems were in effect,
offering nearly a dozen different insurance programs.
NHI is a mandatory insurance system:
- All Taiwanese citizens required to join program.
- Foreigners with Taiwan resident permits and their dependents
are also eligible for enrollment.
- Premiums are based on employee’s income and paid on a monthly
basis to Bureau of National Health Insurance (BNHI).
Reimbursement Approval Systems
BNHI has two reimbursement approval systems:
- Fee-for-service system
- Case-payment system under Global Budget Scheme
In the future, BNHI may adopt a case-payment system for all
in-patient services and discontinue fee-for-service system
entirely.
Fee-for-service System
Insured are responsible for a co-payment to medical service
provider.
Provider makes a claim to BNHI for reimbursement of the
remainder of the medical expenses.
BNHI reviews total number of points of services reported by the
medical facility, calculates the amount due for each point, and
pays in full.
Korea
Medical Device Reimbursement system
Overview:
National Health Insurance (NHI) Act oversees all public health
insurance.
Covers all citizens earning an income in Korea; citizens must
contribute a percentage of their monthly salary.
Ministry of Health and Welfare (MOHW) responsible for NHI.
There are two health insurance agencies under the MOHW:
- National Health Insurance Corporation (NHIC)
- Health Insurance Review Agency (HIRA)
These agencies are responsible for reviewing
reimbursement coverage/non-coverage and pricing
applications.
There are three options available when determining reimbursement
of a medical device:
- Reimbursement Approval.
Government approves reimbursement of device and decides on price.
NHI pays 80%; patients co-pay remaining 20%.
- Full-Patient Charge.
Government determines upper price limit. Often chosen when MOHW
recognizes the necessity of the device, but has no funds available
for reimbursement
- Non-Reimbursement.
Allows device to be priced freely; patients will be charged full
cost.
If you have any questions regarding reimbursements, please send
an e-mail to postmasterSG@kci-medical.com