全 民 健 康 保 險 年 報
National Health Insurance In Taiwan
2013-2014
ANNUAL REPORT
健保財源
全民健保係財務自給自足、自負盈虧
的社會保險，以隨收隨付（
pay-as-you-go
financing
）
維持短期財務平衡，不以累積盈
餘為目的，只須依法維持
1
個月安全準備。
目前保險財務收入主要來自於被保險人、
雇主及政府共同分擔的保險費，少部分為外
部財源挹注，包括保險費滯納金、公益彩券
分配收入、菸品健康福利捐等補充性財源。
為維持全民健保財務的平衡，依全民健
康保險法規定，保險人至少每
5
年應精算一
次保險費率。在維持全民健保財務獨立自主
的精神下，精算報告呈現未來
25
年的保險財
務收支預估，供主管機關籌劃長期全民健保
財務之參考。
Sources of Financing
Designed to be financially self-sufficient and responsible
for its deficits, the NHI system relies primarily on the “pay-as-
you-go” financing principle to balance its accounts in the short-
term. By law, the NHIAcannot be run as a for-profit enterprise
and is required tomaintain a contingency reserve fund equal to
at least onemonth of medical expenditures.
The system is primarily funded by the premiums paid
collectively by the insured, employers, and the government.
Other revenues come from outside sources, such as fines on
overdue premiums, public welfare lottery contributions, and
the health surcharge on cigarettes.
The National Health Insurance Act, the legal foundation
of the health insurance system, stipulates that premium rates
should be reviewed and re-calculated every five years to
ensure the system's financial sustainability and soundness.
During these periodic reviews, the NHIA estimates revenues
and expenditures 25 years into the future, and the results are
given to policy planners as a reference for future adjustments
in premium rates and long-termhealth policy.