全 民 健 康 保 險 年 報
National Health Insurance In Taiwan
2013-2014
ANNUAL REPORT
圖 4 全民健保醫療費用總額預算研擬程序及方向
年度醫療給付費
用總額，由主管機
關於年度開始
6
個
月前擬訂其範圍，
經諮詢健保會後，
報行政院核定
健保會於年度開
始
3
個月前，在行
政院核定總額範圍
內，協議訂定醫療
給付總額及其分
配方式
保 險 人 於 健 保
會協議訂定醫療給
付總額後
1
個月，
將保險費率提請
審議
費率
公告
實施
健保會應於年度
開始
1
個月前依協
議訂定之醫療給付
總額，完成該年度
應計之收支平衡
費率之審議
年度開始 6 個月前 年度開始 3 個月前
不能於期限內協議訂定
時，由主管機關決定。
不能於期限內完成審議
時，由主管機關逕行報
行政院核定後公告。
年度開始 2 個月前 年度開始 1 個月前 年底
Chart 4 Procedure for Establishing Global Budget
Sixmonths before
fiscal year begins
Threemonths before
fiscal year begins
If the global budget cannot
be set by the deadline,
health authorities make
the final decision.
If review cannot be
completed by the deadline,
health authorities send the
premium rate proposal to the
ExecutiveYuan for approval
and implementation.
Twomonths before
fiscal year begins
Onemonth before
fiscal year begins
Year-end
Health authorities
figure out general
parameters for the
overall global budget six
months before fiscal year
begins. After consulting
with the NHI Supervisory
Commi t t e e , h e a l t h
authorities send the
proposed global budget
parameters to the
Executive Yuan for
approval.
Once Executive Yuan
approves the global
budget parameters,
the NHI Supervisory
Committee discusses and
sets the final global budget
and how it will be
allocated three months
before fiscal year
begins.
Within one
month after the NHI
Supervisory Committee
completes its review, the
NHIAmust set the health
insurance premium
rate and submit it for
review.
PremiumRate
Announced for
implementation
The NHI Supervisory
Comm i t t e e mu s t
complete full review
of premium rate needed
to balance revenues and
expenditures under global
budget system at least
one month before
fiscal year begins.