National Health Insurance Act Article 43
A beneficiary is required to pay 20 percent of the expenses of either ambulatory or emergency care and 5 percent of home nursing care expenses; 30 percent, 40 percent, and 50 percent of the expenses if they visit outpatient departments of district hospitals, regional hospitals, and medical centers respectively directly without referral.The insured in areas with inadequate medical resources will be exempted from paying self-bearing expenses.When deemed necessary by the Competent Authority, the expenses to be borne by the individual as stipulated in the first paragraph may be collected as a fixed amount based on the average outpatient costs of clinics and hospitals of all levels from the previous year and the ratio specified in the first paragraph. This amount shall be announced annually.The implementation of the referral procedure and regulations in Paragraph 1, as well as the conditions for areas with inadequate medical resources in Paragraph 2, shall be regulated by the Competent Authority.
中文原文 全民健康保險法第43條
保險對象應自行負擔門診或急診費用之百分之二十，居家照護醫療費用之百分之五。
但不經轉診，於地區醫院、區域醫院、醫學中心門診就醫者，應分別負擔其百分之三十、百分之四十及百分之五十。
前項應自行負擔之費用，於醫療資源缺乏地區，得予減免。
第一項應自行負擔之費用，主管機關於必要時，得依診所及各級醫院前一年平均門診費用及第一項所定比率，以定額方式收取，並每年公告其金額。
第一項之轉診實施辦法及第二項醫療資源缺乏地區之條件，由主管機關定之。
但不經轉診，於地區醫院、區域醫院、醫學中心門診就醫者，應分別負擔其百分之三十、百分之四十及百分之五十。
前項應自行負擔之費用，於醫療資源缺乏地區，得予減免。
第一項應自行負擔之費用，主管機關於必要時，得依診所及各級醫院前一年平均門診費用及第一項所定比率，以定額方式收取，並每年公告其金額。
第一項之轉診實施辦法及第二項醫療資源缺乏地區之條件，由主管機關定之。