If you require immediate medical care abroad due to unexpected emergency illness, acute injury, or emergency childbirth, you may apply to the National Health Insurance Administration (健保署) for reimbursement of self-paid medical expenses within 6 months from the date of outpatient/emergency treatment or hospital discharge (counted from the date of care or discharge, not from your return to Taiwan) under Articles 55 and 56 of the National Health Insurance Act; however, reimbursement is subject to quarterly statutory caps based on the domestic average costs of the preceding quarter. For example, for treatment between July and September 2026 (ROC year 115), the statutory caps are NT$1,162 per outpatient visit, NT$3,866 per emergency visit, and NT$7,239 per inpatient day, with expenses exceeding these caps not reimbursed. Planned overseas medical treatments and non-emergency clinic visits are strictly excluded.
Reminder: Reimbursement ceilings are adjusted quarterly. Figures for Q1 and Q2 2026 cited in this article are taken from published dispute rulings by the Ministry of Health and Welfare (衛生福利部), and Q3 figures from the official NHI Administration announcement; the NHI website encountered HTTP 403 browser verification blocks during verification, so Q4 caps (October–December 2026) are subject to official NHI phone or web queries. Regulatory basis rests on the Regulations Governing Reimbursement of Self-Paid Medical Expenses under National Health Insurance (amended December 4, 2017 / ROC year 106).
Eligible Conditions: 12 Categories of Emergency Illness/Injury
Article 55, item 2 of the National Health Insurance Act provides that reimbursement applies only when suffering from special injuries/illnesses announced by the insurer, unexpected acute conditions, or emergency childbirth requiring immediate local treatment outside Taiwan. Article 3 of the Reimbursement Regulations outlines 12 emergency categories:
- Acute diarrhea, vomiting, or severe dehydration.
- Acute abdominal pain, chest pain, headache, back pain (lower back, lumbar pain), joint pain, or toothache requiring urgent intervention to ascertain etiology.
- Hematemesis, bloody stool, epistaxis (nosebleeds), hemoptysis, hemolysis, hematuria, vaginal bleeding, or acute traumatic hemorrhaging.
- Acute poisoning or acute allergic reactions.
- Sudden body temperature instability.
- Dyspnea, wheezing, cyanosis of lips or extremities.
- Loss of consciousness, coma, convulsions, or motor impairment of extremities.
- Foreign bodies lodged in eyes, ears, respiratory tract, gastrointestinal tract, or genitourinary tract, or internal obstruction due to pathological lesions.
- Psychiatric patients endangering personal or public safety, or psychiatric symptoms requiring emergency intervention.
- Acute trauma resulting from major accidents.
- Unstable vital signs or other conditions potentially endangering life.
- Statutory communicable diseases or reportable communicable diseases requiring immediate management.
Whether a condition qualifies as an unexpected emergency is determined through expert review by the NHI Administration. When receiving determination notices, verify that outpatient, emergency, or inpatient categories are classified correctly; Article 51, item 10 of the National Health Insurance Act also stipulates that transportation, registration fees, and medical certificate fees are not covered.
Reimbursement Caps: 2026 Quarterly Figures
| Treatment Period | Outpatient (Per Visit) | Emergency (Per Visit) | Inpatient (Daily) | Official Notice |
|---|
| 115 / 2026 Jan–Mar (1–3) | NT$1,133 | NT$3,825 | NT$6,887 | NHI Admin Notice Jian-Bao-Yi No. 1140666066 (Jan 20, 2026) |
| 115 / 2026 Apr–Jun (4–6) | NT$1,121 | NT$3,844 | NT$6,686 | NHI Admin Notice Jian-Bao-Yi No. 1150661484 (Apr 21, 2026) |
| 115 / 2026 Jul–Sep (7–9) | NT$1,162 | NT$3,866 | NT$7,239 | NHI Admin Notice (PDF document downloaded 2026-11-02) |
| 115 / 2026 Oct–Dec (10–12) | Check notice | Check notice | Check notice | Subject to official announcement by NHI Administration |
Under Article 6 of the Reimbursement Regulations, caps are calculated based on the previous quarter's domestic average payment per outpatient/emergency visit and inpatient day at contracted institutions. If actual medical expenses converted to NTD are below the statutory cap, reimbursement is paid based on actual expenditure; if expenses exceed the cap, reimbursement is capped at the maximum statutory ceiling. Under Article 7, foreign currencies are converted using the daily average sell exchange rate of the Bank of Taiwan at the close of the month preceding the payment notice.
Required Evidentiary Documents
Under the schedule to Article 5 of the Reimbursement Regulations, submit the following original documents (within 6 months):
| Document Name | Detailed Requirement |
|---|
| Application Form | Completed National Health Insurance Reimbursement Application Form with applicant signature and bank account details |
| Medical Expense Receipt and Fee Breakdown | Original receipt and detailed expense breakdown; must specify medical items, tests, and medication charges |
| Diagnosis Certificate or Medical Proof | Official diagnosis certificate or proof issued by attending physician describing emergency condition, clinical course, and treatment |
| Hospital Discharge Summary | Mandatory for inpatient claims; must detail admission/discharge dates, diagnosis, and surgical records |
| Proof of Travel/Border Clearance | Photocopy of passport photo page and entry/exit stamps. If lacking stamps, apply for an entry/exit certificate from Immigration Agency (domestic fee NT$100), as described in e-Gate immigration registration |
| Power of Attorney | Required if filed by an agent, attaching agent's identity proof |
| Chinese Translation | Documents in foreign languages other than English must attach a Chinese translation |
| Mainland China Notarization | Inpatient treatment in Mainland China for 5 days or more requires receipts and diagnosis certificates notarized locally and verified by SEF |
Under Article 5, paragraph 2, if supplementary documents are required, applicants must submit them within 2 months of receiving notification. The NHI Administration must finalize adjudication within 3 months of accepting an application (Article 8).
Where to Apply: Taipei Division for Taipei and New Taipei Residents
| Handling Division | Address | Telephone |
|---|
| Taipei Division, NHI Administration | 100008 No. 15-1, Gongyuan Rd., Zhongzheng Dist., Taipei City | (02)2191-2006, (02)2523-2388, (02)2723-6664 |
Applications can be mailed or delivered in person to the regional division where your insured unit is located. Overseas seafarers must apply within 6 months of entering Taiwan (Article 56).
Preparations Before Traveling Abroad
Editorial guidance: NHI overseas reimbursement provides basic safety net coverage and cannot match high medical fees in countries like the United States or Japan; purchasing private commercial overseas travel medical insurance with emergency assistance is strongly advised. Keep your physical NHI card or receipt accessible, as explained in replacing a lost NHI card. For domestic medical expense copayments, refer to NHI copayment rules.
Frequently Asked Questions
How much can Taiwan NHI reimburse at most for medical care abroad?
Reimbursement is capped at the average domestic quarterly payment: in July–September 2026 (7–9), outpatient caps are NT$1,162 per visit, emergency NT$3,866 per visit, and inpatient NT$7,239 per day; April–June (4–6) caps were NT$1,121/3,844/6,686; January–March (1–3) caps were NT$1,133/3,825/6,887. Check NHI notices for October–December (10–12).
What is the application deadline?
Within 6 months from the date of outpatient/emergency care, or within 6 months from the date of discharge for inpatient hospitalizations; seafarers working at sea have 6 months from the date of returning to Taiwan (Article 56).
Can I claim reimbursement for chronic illness medication or routine health checks abroad?
No. Reimbursement applies strictly to special conditions, unexpected acute illnesses/injuries, or emergency childbirth requiring immediate local treatment; planned or elective care is ineligible.
Are Japanese medical receipts required to be translated into Chinese?
Yes. Medical expense receipts, itemized bills, diagnosis certificates, and discharge summaries in foreign languages other than English must be accompanied by Chinese translations.
How long does it take to receive reimbursement funds?
The NHI Administration must complete review and issue notifications within 3 months of receipt; time spent awaiting supplementary documents or overseas hospital records does not count toward this 3-month statutory window.
Last updated: 2026-11-03
This article was compiled by SOSfix editors from public information for general reference only; for specific individual cases, contact the Taipei Division of the National Health Insurance Administration, Ministry of Health and Welfare (衛生福利部).
Sources
- National laws and regulations database: National Health Insurance Act (amended June 28, 2023 / ROC 112, verified 2026-11-02) (in Chinese): Article 55 item 2 overseas emergency care reimbursement, Article 56 6-month statutory deadline.
- National laws and regulations database: Regulations Governing Reimbursement of Self-Paid Medical Expenses under National Health Insurance (amended December 4, 2017 / ROC 106, verified 2026-11-02) (in Chinese): Article 3 twelve emergency categories, Article 5 2-month document supplement deadline, Article 6 quarterly average caps, Article 7 exchange rate conversion, Article 8 3-month adjudication period.
- National laws and regulations database: Schedule to Article 5 of Reimbursement Regulations: Evidentiary documents required for claiming self-paid medical expenses (downloaded 2026-11-02) (in Chinese): application form, original receipts, diagnosis certificates, discharge summaries, travel records, translation requirements.
- Ministry of Health and Welfare: Ruling Wei-Bu-Zheng No. 1153401798 (June 18, 2026 / ROC 115, downloaded 2026-11-02) (in Chinese): citing NHI notice of January 20, 2026 Q1 caps of NT$1,133/3,825/6,887; case of Hong Kong hospitalization initially rejected as non-emergency then approved on appeal.
- Ministry of Health and Welfare: Ruling Wei-Bu-Zheng No. 1153403352 (September 16, 2026 / ROC 115, downloaded 2026-11-02) (in Chinese): citing NHI notice of April 21, 2026 Q2 caps of NT$1,121/3,844/6,686; Japan emergency care reclassified from outpatient to emergency at NT$3,844, excluding document fees and consumption tax.
- National Health Insurance Administration, Ministry of Health and Welfare: Reimbursement caps for self-paid medical expenses outside Taiwan for July, August, September 2026 (downloaded 2026-11-02) (in Chinese): outpatient NT$1,162, emergency NT$3,866, inpatient daily NT$7,239.
- Ministry of Health and Welfare: Emergency medical treatment abroad during Lunar New Year: applying for NHI reimbursement (published February 12, 2024 / ROC 113, verified 2026-11-02) (in Chinese): mailing or delivering applications to regional divisions, advice on commercial travel insurance.
- Ministry of Health and Welfare: Table 1 required application documents and Table 2 contact addresses and hotlines of NHI regional divisions (February 2024 / ROC 113, downloaded 2026-11-02) (in Chinese): automated gate notation on passport photo page, 5-day hospitalization notarization for Mainland China, Taipei Division address and contact info.
