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Subsidy plan of the prenatal examination for pregnant women as Taiwanese new immigrants who have not received prenatal health insurance

I. Background Description
Except for those eligible to participate in national health insurance from the date of employment, they must hold their residence certificate for at least six months before they can participate in health insurance after new immigrants come to Taiwan. View that the purpose of the prenatal examination is to protect the health of pregnant women and fetuses and prevent possible problems during pregnancy and labor to provide timely detection and proper prevention or treatment. Therefore, the prenatal examination is one of the significant measures for pregnancy health care, which is beneficial for the safety of the mother and child during pregnancy, childbirth, and the postpartum period. To protect the reproductive health of new immigrant women before insurance, they can receive regular prenatal examinations during pregnancy to protect their mother and child's health. Since 2011, the National Health Insurance Administration has budgeted for providing prenatal care services for pregnant women with spouses who are nationals of the Republic of China who have not yet received health insurance and enjoy the same prenatal care subsidy services as nationals. And increase the number of production inspections and projects on July 1, 2021. Increase the prenatal examination to 14 times, and add pregnancy diabetes screening, anemia test, and two ultrasonic checks. To comply with the Ministry of Health and Welfare's Order No. 1111460140 of March 8, 2022, which revised and issued the "Precautions for Medical Service Institutions to Handle Preventive Health Services," this subsidy plan has been amended, effective from July 1, 2022.

III. Subsidy objects, items, and criteria 1. Objects and items: The cost of prenatal examination for pregnant women who are new immigrants of the Republic of China and whose spouse is not covered by health insurance. 2. Subsidy criteria: The subsidy criteria will be in accordance with the subsidy standards for prenatal preventive healthcare services for pregnant women stipulated by the National Health Insurance Administration of the Ministry of Health and Welfare (hereinafter referred to as the Health Insurance Administration) and the "Precautions for Medical Service Institutions to Handle Preventive Health Services."

IV. Prenatal examination subsidy application process 1. Pregnant women whose spouse is a national (here referred to as the case): prepare the original household certificate or household registration transcript of the current household registered residence registration and the original residence permit. And go to the public health center of your county, city, and township area to apply.

2. Personnel from the public health center of the county, city, and township area shall: (1) Verify the identity documents attached to the case. (2) After confirming that there are no errors, photocopy and retain the basic information of the case and register it in the "Maternal and Child Health Management Integration System" established by the Health Insurance Administration. The personnel will print 15 copies of the prenatal examination case record sheet (including the stub for the health center) by the system (as shown in Attachment 1). After affixing the staff seal of the health center in the personnel issuance column, they shall issue 14 copies of the documents to the case as medical vouchers. The health center shall keep a photocopy of the counterfoil and individual identification documents for future reference.

3. Documents required for prenatal examination of the case: The case shall bring the prenatal examination case record sheet for use in conjunction with the prenatal check and the pregnant woman's health handbook to the hospital for prenatal examination. Each prenatal checkup uses one case record sheet. Lost sheets will not be reissued, except for special reasons.


4. Medical institutions and midwifery clinics shall provide services and declare fees as follows: (1) The institutions providing services shall meet the qualification requirements outlined in the "Precautions for Medical Service Institutions to Handle Preventive Health Services" of the Health Insurance Administration and comply with its relevant regulations. (2) The hospital should confirm whether the national health insurance has included the case. If the case holds a health insurance card, the institution shall not reapply for the Health Insurance Administration's prenatal examination service fee. The Administration will pursue the payment of this fee for those who have repeatedly declared it. (3) Collect the "prenatal examination case record sheet" (Attachment 1) for each case. The results of other prenatal preventive health services include the Health Insurance Administration's record of routine blood and urine tests for pregnant women's prenatal preventive health services (Attachment 2), the Health Insurance Administration's first prenatal ultrasound examination result form (Attachment 3), the Health Insurance Administration's second prenatal ultrasound examination result form (Attachment 4), and the Health Insurance Administration's third prenatal ultrasound examination result form (Attachment 5) The results of the first and second antenatal health examination, health care, education, guidance and checkup record form (Attachment 6), the results of pregnancy diabetes screening/anemia examination record form (Attachment 7) and the results of antenatal Group B Streptococcus examination record form (Attachment 8) of the Health Insurance Administration. If the hospitals and clinics need a hard copy, they can directly download it from the Health Insurance Administration official website >Health Promotion Regulations>Preventive Health Services. (4) Before providing prenatal prevention and health services for pregnant women, hospitals and clinics should check the "Maternal and Child Health Management Integration System" of the Health Insurance Administration to see if other hospitals and clinics have already provided prenatal prevention and health services. (5) Upload and save production inspection-related materials: ① Provide prenatal examination at the hospital to the "Maternal and Child Health Management Integrated System" of the Health Insurance Administration and type in prenatal examination subsidy application information. And upload a record form of pregnant women who have not received health insurance for prenatal examinations and record the results of various prenatal prevention and health services for pregnant women. ② The hospitals and clinics shall, within 14 days from the day following the day of providing various prenatal prevention and health services for pregnant women (sampling or actual examination date), register and upload the examination results of the item in detail according to the provisions of the prevention and health service to the "Maternal and Child Health Management Integration System" of the Health Insurance Administration. If the relevant information is not logged in and uploaded within the specified period, the Health Insurance Administration will not be responsible for payment. When medical service institutions have objections, they may file an appeal with the Health Insurance Administration within 60 days of receiving a letter of approval notice from the Health Insurance Administration. The attached documents include the "Application List for pregnant women as Taiwanese new immigrants who have not received prenatal health insurance" (Attachment 9) and the relevant medical records that record the provision of this prenatal examination service project. Also, submit a screen recording of the relevant medical records of the inspection service project and the upload time of the inspection service project results on the results of the inspection service project. ③ Please keep a copy of the prenatal examination case record sheet (Attachment 1), the results of various prenatal prevention and health services (Attachments 2-8), and relevant information in the attachment paper in the medical record. According to Article 2 of the Regulations on the Production and Management of Electronic Medical Records in Medical Institutions, medical service institutions may exempt medical records produced and stored in electronic format from being stored in hard copy. However, medical service institutions should fully present the content of electronic documents that can print or take out at any time for inspection by the management authority according to Article 5 of the Regulations on the Production and Management of Electronic Medical Records in Medical Institutions. ④ Please submit the medical subsidy application list and receipt (Attachment 10) to the "Maternal and Child Health Management Integration System" for pregnant women as Taiwanese new immigrants who have not received prenatal health insurance in the month following the month of providing various services, and send to the Health Insurance Administration of verification. Those who have not declared the subsidy before the next month are limited to reporting the expenses to the Health Insurance Administration within six months from the next month of service. Those who fail to declare within the time limit cannot receive the payment. (6) Hospitals and clinics that provide prenatal examinations shall not collect prenatal examination subsidies from cases in advance. The Health Insurance Administration shall directly approve and pay them to the requesting institution.
5. Review and allocation of fees by the Health Insurance Administration: (1) After receiving the medical subsidy application list and receipt (Attachment 10) sent by the Health Insurance Administration Review Institute, as well as the "prenatal examination subsidy information" on the system, the prenatal examination case record sheet (Attachment 1), and the results of various prenatal preventive health services for pregnant women, the subsidy will be allocated to each hospital and clinic based on the actual application amount. (2) The Health Insurance Administration may conduct random inspections and counseling.

V. The service funding source: Tobacco Hazards Prevention and Health Care Fund of the Health Insurance Administration.

  • Data update: 2023-05-24
  • Publish Date: 2023-05-01
  • Source: Civil Affairs Bureau
  • Hit Count: 277
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