Apr 02

Special Circumstances
Loss of Insurance Eligibility
People are not allowed to participate in the health insurance program and those already
enrolled must withdraw from the program under the following circumstances:
1. They are serving a prison sentence or being detained for more than two months for
rehabilitation or correctional education. Those held in protective custody are exceptions .
2. They are missing for six months or more. If an individual is missing because of a disaster,
coverage can be withdrawn from the day the disaster occurred.
3. They lost Republic of China citizenship, moved overseas, or have an expired Alien
Resident Certificate.

Going Abroad for More than Six Months:
If you plan to go abroad for more than six months, you can either maintain your health
insurance or suspend your coverage.
1. Continuing coverage:
No application needs to be submitted. As long as the insured continue paying their
premiums while they are out of the country, they will be covered for emergency
procedures or child delivery abroad but must apply for reimbursement for self-advanced
medical expenses(to find out how,please see page56).

2. Suspending coverage:
Those who decide to suspend their insurance coverage must submit an “Insurance
Suspension Application Form” before going abroad. While outside the country, they do
not have to pay premiums but will also not be covered for medical care.
Suspending your coverage means you do not have to pay premiums while abroad, but
upon returning to Taiwan, you must remember to restore your coverage from the day of
your return. Restoring coverage will fulfill your obligation to enroll in the health insurance
program and re-establish your health care. If you have suspended coverage but left the
country for fewer than six months, you must void the suspension and pay back premiums
retroactively for the period from when coverage was halted to the time you return to the
country.
Those who suspend coverage during their time abroad can only suspend their insurance
starting the day of the application rather than making it retroactive to the day they left the
country. This group of people cannot apply retroactively to suspend their coverage after
returning home or request a reimbursement of premiums paid while they lived abroad.
We suggest, therefore, that you complete any appropriate insurance procedures before
going overseas. Once you suspend coverage, you cannot restore coverage or request
reimbursement of medical expenses while abroad. Only after returning to Taiwan and
restoring coverage can you regain your right to health care.
If you have applied to suspend your coverage before heading overseas but retain residency
in Taiwan, when you return home you are legally required to restore coverage from the
day you return, regardless of how long you stayed. If you later decide to go abroad again
and want to suspend coverage, remember that you must again apply to withdraw from
the program before heading overseas. That way, you will avoid being held responsible for
paying premiums while you are away.

A special reminder:
If you decide to suspend coverage, you must fi le an application to do so. Those who fail
to apply to have their insurance suspended must remain enrolled in the program and pay
premiums even if they stay overseas for more than six months.
Also, if you reside abroad for more than two years without returning, your household
registration will automatically terminate and you will no longer be able to participate in the
health insurance program. When you re-establish residency in Taiwan at a later date, you
can apply for the enrollment again.

Suspending and Restoring Coverage
To suspend coverage, the insured should have their insurance registration organizations
(generally their employers) fill out an “insurance suspension reporting form” and submit
it, along with travel documents such as visas and plane tickets, to the Universal Health Care regional divisions serving the area where your employer is registered.
If formerly insured return home — meaning the reason for suspending coverage no
longer exists — they must restore coverage from the day they re-enter the country. They
should have their insurance registration organizations filled out an “insurance resumption
application form” and submit it within three days of their return along with a copy of the
insured’s household registration and an entry and exit certificate (or a complete copy of
their passport) to the Universal Health Care regional divisions serving the area where
your employer is registered.

Re-registering when Coverage Is Interrupted
If your insurance coverage is interrupted as a result of a change in jobs, insurance
category, or address, you will be required to pay health care expenses out of your own
pocket. The Bureau of Universal Health Care therefore suggests that you update your
registration in the program as quickly as possible. Here’s how:
1.If your coverage has been cut off and you are an employee of a company or an
organization, you should re-register in the health insurance program through your
employer.
2.If your coverage has been cut off and you are a member of a union, farmers’, or
fishermen’s association, you should re-register in the health insurance program through
your union or association.
3.If your coverage has been cut off and you are unemployed but can be legally registered
as a dependent of an employed relative, you should enroll in the health insurance
program though the insurance registration organization of your spouse or blood relative
as a dependent.
4.If your coverage has been cut off and you are unemployed and cannot be treated as
a dependent of a spouse or direct blood relative, please enroll in the health insurance
program through your village, township, city or area administrative office.

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