Regulations Governing the Production and Issuance of the National Health Insurance Card and Data Storage and Access
2023-01-04
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Article 1
The Regulations Governing the Production and Issuance of the National Health Insurance Card and Data Storage and Access (hereinafter referred to as the “Regulations”) are duly enacted according to Paragraph 2 of Article 16 of the National Health Insurance Act (hereinafter referred to as the “Act”).
Article 2
National Health Insurance cards (hereinafter referred to as “NHI Card(s)”) are for use by beneficiaries of the National Health Insurance (hereinafter referred to as the “Insurance”) to receive medical treatment from contracted medical care institutions and to apply for services provided by the Insurer or online services provided through collaboration between the Insurer and other government institutions (or agencies). However, NHI Cards shall not be used to store information for non-medical use purposes and content irrelevant to medical treatment received by Insurance beneficiaries.
Article 3
A beneficiary shall apply to the Insurer for the issuance of an NHI Card from the date the beneficiary meets the subscription requirements set forth by the Act and completes the declaration of insurance subscription.
A beneficiary who has damaged or lost his or her NHI Card or wishes to change his or her photos or identification information thereon shall apply to the Insurer for reinssuance or replacement of his or her NHI Card.
The Insurer may entrust a private institution or government institution (agency) to receive the application data on behalf of the Insurer.
After the Insurer issues an NHI Card prescribed in Paragraphs 1 and 2, a beneficiary may apply to the Insurer, through the mobile health insurance identity verification mechanism, for the virtual version of the said NHI Card (a virtual NHI Card), which may be used for medical care under certain conditions determined by the Insurer.
The Insurer shall publish the information on how to apply for an NHI Card referred to in Paragraphs 1 and 2 or a virtual NHI Card referred to in the preceding paragraph on the Insurer’s global website and may also use other appropriate means to make such information widely known to the public.
The provisions of the Regulations relating to an NHI Card apply mutatis mutandis to a virtual NHI Card.
A beneficiary who has damaged or lost his or her NHI Card or wishes to change his or her photos or identification information thereon shall apply to the Insurer for reinssuance or replacement of his or her NHI Card.
The Insurer may entrust a private institution or government institution (agency) to receive the application data on behalf of the Insurer.
After the Insurer issues an NHI Card prescribed in Paragraphs 1 and 2, a beneficiary may apply to the Insurer, through the mobile health insurance identity verification mechanism, for the virtual version of the said NHI Card (a virtual NHI Card), which may be used for medical care under certain conditions determined by the Insurer.
The Insurer shall publish the information on how to apply for an NHI Card referred to in Paragraphs 1 and 2 or a virtual NHI Card referred to in the preceding paragraph on the Insurer’s global website and may also use other appropriate means to make such information widely known to the public.
The provisions of the Regulations relating to an NHI Card apply mutatis mutandis to a virtual NHI Card.
Article 4
When a beneficiary applies for the production, replacement, or reissuance of an NHI Card, the beneficiary must submit identification documents and a recent photo clearly showing his or her facial features alongside their application. This information is required for verification purposes and shall be submitted to the Insurer or the processing institutions that handle applications on behalf of the Insurer. However, the photo submission requirement may be exempted if any of the following circumstances are met:
1. A beneficiary agrees to use his or her photo submitted to and on file with the Insurer within two years and sufficient to identify the beneficiary by his or her facial appearance;
2. A beneficiary agrees to the interagency document retrieval of his or her photo on file with other agencies and sufficient to identify the beneficiary by his or her facial appearance; or
3. With the Insurer’s permission, a photo-less NHI Card may be applied if a beneficiary is a newborn baby or is under special conditions, making it hard for the applicant to provide his or her photo.
An applicant filing an online application mentioned in the preceding paragraph shall use the personal certificate or organization certificate issued by competent authorities or carriers that have the identity verification function to log into the web portal for the NHI Card application.
The identification documentation set forth in Paragraph 1 refers to any of the following documents:
1. National identification card: A household registration certificate may replace the national identification card in the case of a person under 14 years old;
2. Passport issued by the Republic of China;
3. Driver’s license of automobile (motorcycle) issued by the Republic of China;
4. Alien resident certificate in compliance with the Enforcement Rules of the National Health Insurance Act; or
5. Other documentation issued by government institutions (or agencies) with information, such as photos, name, birth date, and ID number, sufficient for identity verification purposes.
Where a beneficiary is sheltered, arranged, or assisted by government institutions (or agencies), the responsible government institutions (or agencies) may apply for an NHI Card on behalf of the beneficiary by issuing official documents to competent authorities.
1. A beneficiary agrees to use his or her photo submitted to and on file with the Insurer within two years and sufficient to identify the beneficiary by his or her facial appearance;
2. A beneficiary agrees to the interagency document retrieval of his or her photo on file with other agencies and sufficient to identify the beneficiary by his or her facial appearance; or
3. With the Insurer’s permission, a photo-less NHI Card may be applied if a beneficiary is a newborn baby or is under special conditions, making it hard for the applicant to provide his or her photo.
An applicant filing an online application mentioned in the preceding paragraph shall use the personal certificate or organization certificate issued by competent authorities or carriers that have the identity verification function to log into the web portal for the NHI Card application.
The identification documentation set forth in Paragraph 1 refers to any of the following documents:
1. National identification card: A household registration certificate may replace the national identification card in the case of a person under 14 years old;
2. Passport issued by the Republic of China;
3. Driver’s license of automobile (motorcycle) issued by the Republic of China;
4. Alien resident certificate in compliance with the Enforcement Rules of the National Health Insurance Act; or
5. Other documentation issued by government institutions (or agencies) with information, such as photos, name, birth date, and ID number, sufficient for identity verification purposes.
Where a beneficiary is sheltered, arranged, or assisted by government institutions (or agencies), the responsible government institutions (or agencies) may apply for an NHI Card on behalf of the beneficiary by issuing official documents to competent authorities.
Article 4-1
The Insurer shall digitally save the photo submitted by a beneficiary in archives. Any updates of archives shall be made by writing over the old files and keeping the latest updates on file.
The photo held by the Insurer in archives, as referred to in the preceding paragraph, shall only be used for the reissuance or replacement of an NHI Card upon a beneficiary’s application.
The photo held by the Insurer in archives, as referred to in the preceding paragraph, shall only be used for the reissuance or replacement of an NHI Card upon a beneficiary’s application.
Article 5
Where a beneficiary applies to the Insurer for the NHI Card, he or she shall pay a fee according to the requirement. Nonetheless, the above fee shall be exempted if any of the following circumstances occurs:
1. The beneficiary applies for his or her first NHI Card; or
2. The basic information stored in the NHI Card cannot be accessed because there is an error in its production by the Insurer, the card and the chip are bent, cracked due to scratch or undue pressure or deformed, or detachment, change of color or wear and tear of the chip occurs, which is not caused by human conduct.
There is no charge for a beneficiary’s application to the Insurer for a virtual NHI Card.
1. The beneficiary applies for his or her first NHI Card; or
2. The basic information stored in the NHI Card cannot be accessed because there is an error in its production by the Insurer, the card and the chip are bent, cracked due to scratch or undue pressure or deformed, or detachment, change of color or wear and tear of the chip occurs, which is not caused by human conduct.
There is no charge for a beneficiary’s application to the Insurer for a virtual NHI Card.
Article 6
Data that may be stored from the NHI Card includes the basic information, the Insurance data, medical service data, and health administration data, with the data column for each storage area listed in Appendix 1.
- Appendix 1 Data which may be stored and retrieved from the NHI Card.PDF
Article 7
A beneficiary may set up a password on his or her NHI Card to restrict access to his or her personal Insurance data, data on medical services, and data on health administration.
Article 8
The Insurer shall install NHI Card readers in all of its regional branch offices, liaison offices, and all township (town, city, district) administrations for beneficiaries to inquire and update data as well as settings that are stored in their NHI Cards or change their passwords on their NHI Cards.
Where a beneficiary forgets the password mentioned in the preceding paragraph, he or she may request the Insurer to reset it but must provide proof of identity for verification. The Insurer shall proceed with the application after verifying the beneficiary’s identity.
Where a beneficiary forgets the password mentioned in the preceding paragraph, he or she may request the Insurer to reset it but must provide proof of identity for verification. The Insurer shall proceed with the application after verifying the beneficiary’s identity.
Article 9
Contracted medical care institutions shall record the medical visit information in the beneficiary's NHI Card after providing medical services to the beneficiary or upon verification of the NHI Card. When beneficiaries receive medical care using a virtual card, the information shall be uploaded to the Insurer. Notwithstanding, the above may not apply in the case stipulated in Note 3 of Appendix 1.
- Appendix 1 Data which may be stored and retrieved from the NHI Card.PDF
Article 10
After a contracted medical care institution enters the data of medical records into an NHI Card or uses a virtual NHI Card in accordance with the preceding Article, the contracted medical care institution shall upload the beneficiary’s medical records to the Insurer on the Virtual Private Network within 24 hours for future reference. Notwithstanding, the above may not apply in the event of force majeure or special circumstance approved by the Insurer.
The medical records which are required to be uploaded to the Insurer are set forth in Appendix 2.
For the data of medical records required to be entered into an NHI Card or be uploaded to the Insurer as prescribed by the preceding Article or Paragraph 1, the Insurer may, after considering the storage capacity of an NHI Card or the time required for the production of medical records, request a contracted medical care institution to upload the data of medical records to the Insurer within a designated period and exempt the said contracted medical care institution from entering the data of medical records into an NHI Card or uploading the data of medical records within 24 hours for future reference.
The medical records which are required to be uploaded to the Insurer are set forth in Appendix 2.
For the data of medical records required to be entered into an NHI Card or be uploaded to the Insurer as prescribed by the preceding Article or Paragraph 1, the Insurer may, after considering the storage capacity of an NHI Card or the time required for the production of medical records, request a contracted medical care institution to upload the data of medical records to the Insurer within a designated period and exempt the said contracted medical care institution from entering the data of medical records into an NHI Card or uploading the data of medical records within 24 hours for future reference.
- Appendix 2 Medical records which shall be uploaded to the Insurer by the contracted medical care institutions.PDF
Article 11
When providing medical services for beneficiaries, contracted medical care institutions shall access medical records already stored in or uploaded through NHI Cards or beneficiaries’ medical visit results and medical treatment expenses information provided by contracted medical care institutes based on medical needs. However, this requirement does not apply when beneficiaries have set password restrictions to limit data access.
Article 12
In the event that a beneficiary’s benefits are temporarily suspended or not payable under the Act, the Insurer may place restrictions on the NHI Card of such beneficiary, restricting such beneficiary from using his or her NHI Card to obtain medical treatment.
After the cause of the restrictions prescribed in the preceding paragraph has ceased to exist, a beneficiary may update the data stored in his or her NHI Card in accordance with Article 13 and use his or her NHI Card to obtain medical treatment.
After the cause of the restrictions prescribed in the preceding paragraph has ceased to exist, a beneficiary may update the data stored in his or her NHI Card in accordance with Article 13 and use his or her NHI Card to obtain medical treatment.
Article 13
Where any of the following circumstances occur, a beneficiary may update his or her NHI Card data by using card reader equipment installed by the Insurer or update the data with the assistance of a contracted medical care institution when obtaining medical treatment:
1. Complete enrollment in insurance coverage or reinstate insurance coverage;
2. The beneficiary acquires or loses the status of a low-income household member, veteran, household representative of survivors of veterans;
3. Upon notification by the Insurer to obtain, revoke, or terminate a certificate of major illness;
4. The registration and change of organ donation or hospice palliative care;
5. The cause of the restrictions referred to in the preceding Article ceases to exist;
6. The Insurer revokes the annotations for medical supervision; or
7. Any other medical need that is recorded.
1. Complete enrollment in insurance coverage or reinstate insurance coverage;
2. The beneficiary acquires or loses the status of a low-income household member, veteran, household representative of survivors of veterans;
3. Upon notification by the Insurer to obtain, revoke, or terminate a certificate of major illness;
4. The registration and change of organ donation or hospice palliative care;
5. The cause of the restrictions referred to in the preceding Article ceases to exist;
6. The Insurer revokes the annotations for medical supervision; or
7. Any other medical need that is recorded.
Article 14
When a beneficiary obtains a replacement new card, the original NHI Card shall be canceled and may no longer be used.
Article 15
The Insurer may only use the data entered and uploaded by the contracted medical care institutions for the following purposes:
1. Management and audit of medical visits of beneficiaries or diagnosis and treatment behaviors of physicians;
2. Real-time supervision for beneficiaries who are high users of medical services;
3. Management of drug use by beneficiaries;
4. Coordination with disease prevention and health-related policies; and
5. Improving the data integrity of medical treatment information and the quality of medical services.
1. Management and audit of medical visits of beneficiaries or diagnosis and treatment behaviors of physicians;
2. Real-time supervision for beneficiaries who are high users of medical services;
3. Management of drug use by beneficiaries;
4. Coordination with disease prevention and health-related policies; and
5. Improving the data integrity of medical treatment information and the quality of medical services.
Article 16
The Insurer shall take the following measures in respect of data that is uploaded by the contracted medical care institutions:
1. Put into place strict information security mechanisms and formulate standard operation procedures for the information system that stores and utilizes such data, and carry out the implementation in strict compliance;
2. Construct monitoring and management mechanisms that ensure transmission quality, security, and efficiency of connections of the Virtual Private Network; and
3. Install a proper mechanism to protect the originally uploaded data and internally processed data from being accessed by unauthorized personnel. Staff shall be properly authorized before accessing the data.
1. Put into place strict information security mechanisms and formulate standard operation procedures for the information system that stores and utilizes such data, and carry out the implementation in strict compliance;
2. Construct monitoring and management mechanisms that ensure transmission quality, security, and efficiency of connections of the Virtual Private Network; and
3. Install a proper mechanism to protect the originally uploaded data and internally processed data from being accessed by unauthorized personnel. Staff shall be properly authorized before accessing the data.
Article 17
The Regulations shall enter into force on January 1, 2013.
The Amendment to the regulations shall enter into force on the date of promulgation.
The Amendment to the regulations shall enter into force on the date of promulgation.