Required Documents

※ Applications can be sent to the bureau by post or submit in person at the bureau.

I.  When applying for outpatient or inpatient treatment, the insured shall present the following documents to the National Health Insurance special hospital or clinic:
The "Occupational Injury and Disease Outpatient Form" or the "Occupational Injury and Disease Hospitalization Application Form" filled out by the insured unit. (If the insured unit fails to fill out the form according to the regulations, the insured may claim from the bureau and local offices, and it will be issued after verification.)
National health insurance card and national identity card or other documents that are sufficient to prove identity. (If you have a photo on your health insurance card, you don't need to show your identity document)

II.  If the insured uses his or her medical insurance status to seek diagnosis or treatment from National Health Insurance special hospitals or clinics due to occupational injury or illness, but fails to submit an occupational injury and disease outpatient form or hospitalized application within 10 days from the date of diagnosis or treatment, he or she may fill out the following application form to apply for medical reimbursement within 6 months (5 years for special reasons) from the date of outpatient treatment or discharge from the hospital. (The insured may file an application on his own within one year after the surrender of the insurance, in compliance with the provisions of Article 27 of the Labor Occupational Accident Insurance and Protection Act. The insured may also file an application on his own by providing an explanation if the insured unit is closed, dissolved, revoked, abolished, declared bankrupt or other reasons and is unable to issue stamps.)

III.  Application form and payment receipt for Advance Self-paid Medical Expenses Reimbursement for labor occupational accident insurance.
Medical certificate or supporting documents. (If the document is in foreign language, a Chinese translation version is required)

IV.  Medical expense receipts and payment details. (If lost or used for other purposes, a photocopy should be attached. The photocopy should be stamped and notarized by the medical institution where the original receipt is issued.)

V.  In the event of an accident 1) on the way to work 2) getting off work 3) on a business trip, the insured should fill out a form titled as “Statement of Injury Caused by an Accident On the Way to and from getting off Work (on Business Trip)”. Additionally, a copy of the front and back of the driver's license should be attached as well.

VI. Since May 1, 2022, for those who seek medical treatment due to occupational injuries and diseases, and choose to pay for the special materials and items specified in Article 45, Paragraph 1 of the National Health Insurance Act, they should attach a form titled as “National Health Insurance Special Contract and Management Regulations Consent to Pay for the Medical Bill Difference Form”.

VII.  If the insured suffers an occupational injury or illness abroad, he or she shall present a proof of entry/exit or a certificate issued by the service agency.

VIII. In case of applying for reimbursement of self-paid medical expenses for hospitalization in PRC China for more than 5 days (included), the medical certification documents (original medical expenses receipt, details of expenses, diagnosis certificate or certification documents, etc.) must be notarized by a notary office in PRC China, and then hold the original copy of the notarized certificate to be verified by the Straits Exchange Foundation.

Notes:

1. If the insured goes to the same National Health Insurance special hospital or clinic for diagnosis and treatment for the same occupational injury or disease, one copy of the Occupational Injury and Disease Outpatient Form with the top and bottom pages can be used up to 6 times. If the insured choose to go to another national health insurance hospital or clinic for diagnosis or treatment, the insured unit should fill out the form separately. On the other hand, if the insured needs hospitalization, the application form for occupational injury and illness hospitalization with the upper and lower pages can only be used once for every single hospitalization need.

2. If the insured suffers an occupational injury/disease accident during the insurance policy period, and needs to be outpatient or hospitalized within 1 year after the insurance expires, the Occupational Injury and Disease Outpatient Clinic and Hospitalization Application Form can still be used.

3. If professional trade unions, fishermen associations, seamen general trade unions, captains guilds, or the insured are in arrears of insurance payments and forfeit penalties, the insured unit shall not fill out and issue the insured's occupational injury and disease medical treatment form before the payment is completed according to Article 23 of the Labor Occupational Accident Insurance and Protection Act. However, if the insured has already paid the insurance to the insured unit, the form can be filled out.
If the insured unit is in arrears of insurance payments and forfeit penalties, and the insured is obliged to pay, or acts as the representative or person in charge of the insured unit, he or she shall not fill out the insured's occupational injury and disease medical treatment form according to Article 23 of the Labor Occupational Accident Insurance and Protection Act.
If the insured unit fills out the medical form, but does not comply with the insurance payment regulations or provide false information or is handed to a user other than the insured, the insured unit shall cover all the medical expenses except the insurance under the national health insurance law and regulations.
 

本資料僅供參考，須依照主管機關公告辦理。
The above information is for reference only, the process must be guided by the competent authority.