Regulations Governing the Production and Issuance of the National Health Insurance IC Card and Data Storage
2023-01-04
手機睡眠
語音選擇
Article 1
These 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 IC cards (hereinafter referred to as “NHI IC Card(s)”) are for use by beneficiaries of the National Health Insurance (hereinafter referred to as the “NHI”) 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 IC Cards shall not be used to store information for non-medical use purposes and content irrelevant to medical treatment received by NHI beneficiaries.
Article 3
A beneficiary shall file an application for production and issuance of NHI IC Card to the insurer 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 IC Card, or wishes to change his or her photos or identification information thereon shall apply to the insurer for change or replacement of his or her NHI IC 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 IC 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 IC 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 IC Card apply mutatis mutandis to a virtual NHI Card.
A beneficiary who has damaged or lost his or her NHI IC Card, or wishes to change his or her photos or identification information thereon shall apply to the insurer for change or replacement of his or her NHI IC 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 IC 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 IC 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 IC Card apply mutatis mutandis to a virtual NHI Card.
Article 4
When a beneficiary applies for the production and issuance, change or replacement of an NHI IC Card, he shall submit identification documentation and a photo sufficient to identify the beneficiary by his facial appearance along with his application to the insurer or processing institutions collecting applications on behalf of the insurer for verification purposes. However, the photo submission requirement may be exempted if any of the following circumstances is met:
1. A beneficiary agrees to use his photo submitted to and on file with the insurer within two years, and sufficient to identify the beneficiary by his facial appearance;
2. A beneficiary agrees to the interagency document retrieval of his photo on file with other agencies and sufficient to identify the beneficiary by his facial appearance; or
3. With the insurer’s permission, a photo-less NHI IC Card may be applied if a beneficiary is a newborn baby or is under special conditions rendering him hard to provide his photo.
An applicant filing an application mentioned in the preceding paragraph online should use the personal certificate or organization certificate issued by competent authorities or carriers which have the identity verification function to log into the web portal for NHI IC Card application.
The identification documentation set forth in Paragraph 1 refers to any of the following documents:
1.National identification card; household registration certificate may replace the national identification card in the case of a person under the age of 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 of 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 IC Card on behalf of the beneficiary through issuing official documents to competent authorities.
1. A beneficiary agrees to use his photo submitted to and on file with the insurer within two years, and sufficient to identify the beneficiary by his facial appearance;
2. A beneficiary agrees to the interagency document retrieval of his photo on file with other agencies and sufficient to identify the beneficiary by his facial appearance; or
3. With the insurer’s permission, a photo-less NHI IC Card may be applied if a beneficiary is a newborn baby or is under special conditions rendering him hard to provide his photo.
An applicant filing an application mentioned in the preceding paragraph online should use the personal certificate or organization certificate issued by competent authorities or carriers which have the identity verification function to log into the web portal for NHI IC Card application.
The identification documentation set forth in Paragraph 1 refers to any of the following documents:
1.National identification card; household registration certificate may replace the national identification card in the case of a person under the age of 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 of 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 IC Card on behalf of the beneficiary through 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 change or replacement of an NHI IC 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 change or replacement of an NHI IC card upon a beneficiary’s application.
Article 5
Where a beneficiary applies to the insurer for the NHI IC Card, he or she shall pay a fee according to the requirement. Nonetheless, the above fee should be exempted if any of the following circumstances occurs:
1.The beneficiary applies for his or her first NHI IC Card; or
2.The basic information stored in the NHI IC 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 IC Card; or
2.The basic information stored in the NHI IC 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 which may be stored from the NHI IC Card includes the basic information, the NHI data, medical service data and health administration data with the data column of each storage area listed in Table 1.
- Table 1 Data which may be stored and retrieved from the NHI IC Card.pdf
Article 7
A beneficiary may set up a password on his or her NHI IC Card to restrict the access to his or her personal NHI data, data of medical services and data of health administration.
Article 8
The insurer shall install NHI IC 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 which are stored in their NHI IC Cards or change their passwords on their NHI IC Cards.
Where a beneficiary forgets his or her own password mentioned in the preceding paragraph, he or she may apply to the insurer for re-setting the password, but shall provide proof of identity for verification purposes. The insurer shall proceed the application after verifying the beneficiary’s identity.
Where a beneficiary forgets his or her own password mentioned in the preceding paragraph, he or she may apply to the insurer for re-setting the password, but shall provide proof of identity for verification purposes. The insurer shall proceed the application after verifying the beneficiary’s identity.
Article 9
After the contracted medical care institution provides medical services for a beneficiary or verifies the NHI IC Card of such beneficiary, it shall enter the data of medical records of the current medical visit into the NHI IC Card of the beneficiary; when using a virtual NHI Card for medical care, a beneficiary shall upload the data of his or her medical records to the insurer. Notwithstanding, the above may not apply in the case stipulated in Note 3 of Table 1.
- Table 1 Data which may be stored and retrieved from the NHI IC Card.pdf
Article 10
After a contracted medical care institution enters the data of medical records into an NHI IC 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 Table 2.
For the data of medical records required to be entered into an NHI IC 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 IC 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 of time and exempt the said contracted medical care institution from entering the data of medical records into an NHI IC 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 Table 2.
For the data of medical records required to be entered into an NHI IC 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 IC 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 of time and exempt the said contracted medical care institution from entering the data of medical records into an NHI IC Card or uploading the data of medical records within 24 hours for future reference.
- Table 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 IC Cards, or beneficiaries’ medical visit results and medical treatment expenses information provided by contracted medical care institutes, based on medical needs. Notwithstanding, the medical care institutions may not access the aforementioned records if a beneficiary sets up a password to restrict the access to data.
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 IC Card of such beneficiary, restricting such beneficiary from using his or her NHI IC 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 IC Card in accordance with Article 13 and use his or her NHI IC 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 IC Card in accordance with Article 13 and use his or her NHI IC Card to obtain medical treatment.
Article 13
Where any of the following circumstances occurs, a beneficiary may update his or her NHI IC 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.The completion of subscription or resumption (of subscription) to the National Health Care Insurance;
2.The beneficiary acquires or loses the status of a low-income household member, veteran, household representative of survivors of veterans;
3.The proof of major illness and injury of the beneficiary is acquired, revoked or cancelled upon the notice of the insurer;
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 visit advice; or
7.Any other medical need which is recorded.
1.The completion of subscription or resumption (of subscription) to the National Health Care Insurance;
2.The beneficiary acquires or loses the status of a low-income household member, veteran, household representative of survivors of veterans;
3.The proof of major illness and injury of the beneficiary is acquired, revoked or cancelled upon the notice of the insurer;
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 visit advice; or
7.Any other medical need which is recorded.
Article 14
After a beneficiary receives a replacement NHI IC Card, the beneficiary’s original NHI IC Card is automatically revoked, and the beneficiary may no longer use the beneficiary’s original NHI IC Card.
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 advice 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 advice 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 which is uploaded by the contracted medical care institutions:
1. Put into place strict information security mechanism and formulate standard operation procedure for the information system which stores and utilizes such data, and carry out the implementation in strict compliance;
2. Construct monitoring and management mechanism which ensures transmission quality, security and efficiency of connections of the Virtual Private Network; and
3. Install proper mechanism to protect the originally uploaded data and internally processed data from being accessed by unauthorized personnel. A staff should be properly authorized before accessing the data.
1. Put into place strict information security mechanism and formulate standard operation procedure for the information system which stores and utilizes such data, and carry out the implementation in strict compliance;
2. Construct monitoring and management mechanism which ensures transmission quality, security and efficiency of connections of the Virtual Private Network; and
3. Install proper mechanism to protect the originally uploaded data and internally processed data from being accessed by unauthorized personnel. A staff should be properly authorized before accessing the data.
Article 17
These regulations shall come into force on January 1, 2013.
The Amendment to the regulations shall come into force on the date of promulgation.
The Amendment to the regulations shall come into force on the date of promulgation.