When you seek treatment at a NHI-contracted clinic or hospital for an occupational injury or disease, as long as you have labor insurance in addition to National Health Insurance, not only are you exempt from co-payments, half of your expenses for a hospital stay of up to 30 days are covered by labor insurance.
| Definition of Occupational Injury or Disease |
- Injuries sustained while on the job.
- Occupational diseases shown on the labor insurance occupational diseases list or occupational diseases in different professions, workplaces or jobs later added to the labor insurance occupational diseases list.
- Injuries sustained in an accident while traveling to or from work, but the time of the accident must be verified as being consistent with going to or getting off work and the patient must be cleared of having violated major traffic regulations.
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| Documents Needed to Get Care |
- Application letter for occupational disease (either a labor insurance occupational disease outpatient treatment request form or labor insurance occupational disease hospitalization application form).
- NHI Card.
How to get the forms?
- Application letter for occupational disease can be downloaded at the Bureau of Labor Insurance website. It is also available at their branch offices. After the organization through which the patient is insured affixes its seal, it can be used for medical purposes. See the Bureau of Labor Insurance website for details at http://www.bli.gov.tw.
- The same "labor insurance occupational injury/disease treatment form" can only be used in the same clinic or hospital to treat the same injury/disease. A single form can be used six times.
- Those seeking outpatient care without the "Labor insurance occupational injury/disease medical treatment form" can still be exempted from co-payments if the physician, whose qualifications are verified by the Ministry of Health and Welfare or is employed at a medical center, diagnoses their condition as an occupational injury or disease.
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| What Happens If You Forgot to Bring the"Labor Insurance's Medical Treatment Form for Occupational Disease" when Seeing a Doctor and Paid the Co-payment Out-of-pocket? |
- If you present your "application letter for occupational disease" to the clinic or hospital where you were treated within 10 days of the outpatient visit or prior to being discharged, your co-payment will be refunded.
- Patients who paid their co-payments out of pocket but failed to submit the labor insurance occupational disaster medical treatment form within 10 days from the day they were treated or before being discharged from the hospital have another way they can have the payment reimbursed. They can submit the following documents by mail to the Bureau of Labor Insurance within six months from the date when they were treated (or discharged, or within five years if special reasons exist):
(1)"Labor insurance medical expense reimbursement form"
(2)"Labor insurance occupational injury/disease outpatient or hospitalization form" (As mentioned above, the form is not needed if the refund application form has the seal of the insured unit).
(3)The original copy of the medical expense receipt and expense details: In case the original copy of the receipt and expense details are lost or used for other purposes, the medical institution that originally supplied the said information should provide a duplicate copy with same text as the original and stamp it with their official seal.
(4)A certificate of diagnosis or other certifying documentation.
Note:
A "labor insurance medical expense reimbursement form" can be secured from the Bureau of Labor Insurance or its branch offices. It can also be downloaded at the Bureau of Labor Insurance website.
- Bureau of Labor Insurance website: http: //www.bli.gov.tw/
- Bureau of Labor Insurance Address: No.4, Section 1, Roosevelt Road, Taipei City 10013. Telephone: (02)2396-1266.
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