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Taiwan’s Healthcare Landscape

The Ministry of Health and Welfare

In the Spring of 2023, a group of friends living in Taiwan with disabilities, but with diverse backgrounds and a shared interest, came together to form a fellowship. Their journey hasn’t been easy, but they’ve found support in surprising places. We’ll delve into their stories shortly. But before we begin, let’s explore the landscape of healthcare services available to people with disabilities in Taiwan.

 

A Look Beyond National Health Insurance

Taiwan is renowned for its excellent healthcare system. While the National Health Insurance (NHI) program offers universal coverage for doctor visits, prescriptions, and basic medical needs, expats in Taiwan may face limitations when it comes to social welfare services.
The Ministry of Health and Welfare governs two main categories:
National Health Insurance (NHI): a comprehensive healthcare coverage for all residents of Taiwan, regardless of nationality, as long as they contribute the monthly premium. NHI covers doctor visits, prescriptions, therapies, and emergency care.

Social Welfare Services: Exclusively for Taiwanese citizens. However, since September 25th, 2023, a limited number of expats holding Permanent Alien Resident Cards (APRCs) from four specific countries can access them under the Mackay Project*. Social welfare services encompass a wider range of support, including:

  • Home visits
  • Subsidies for medical assistive devices
  • Subsidies for wheelchair taxis
  • Respite care for caregivers
  • Discounted fares for patients and caregivers on public transportation
  • Disability parking permits
  • Discounted hospital fees

Challenges for Expats: While NHI offers robust healthcare coverage, expats with APRCs currently lack access to most social welfare services. This can pose a significant challenge for those requiring additional support.

An Expat’s Struggle with Parkinson’s Disease in Taiwan

Michael, a resident of Taiwan since 1989, has lived here longer than in his passport country. Diagnosed with Parkinson’s Disease in 2019, his worsening condition created a critical need for assistive devices and home healthcare. Medical consultations and medication were available through the NHI system, but Michael was ineligible for other healthcare services due to his nationality. His wife contacted the Social Welfare hotline, 1966, pleading for assistance, which ultimately led to a referral to the Occupational Therapist Association. A therapist conducted a home visit, recommending assistive devices for purchase and instructions on their use. However, this support came at acost. Michael, left without access to standard care recommendations offered to Taiwanese citizens, shouldered the expense of a follow-up home evaluation and private speech therapy a year later. Obtaining a Certificate of Disability remains a crucial step in unlocking broader healthcare assistance for Michael. This case highlights the challenges faced by foreign residents in Taiwan navigating the healthcare system, particularly when needing social welfare services beyond basic medical care.
Meagunn and her husband, American professionals who relocated to Taiwan, faced a life-altering challenge when their daughter Anwynn was born with multiple disabilities. Meagunn left her full-time job to care for their daughter. The family initially encountered limitations due to their nationality. Even basic disability assistance was unavailable. After a five-year residency process, Anwynn finally obtained an APRCin December 2023. This newfound status allowed her to apply for a Certificate of Disability under recent regulation changes. While obtaining the certificate offered a glimmer of hope, it proved to be a bittersweet victory. Anwynn’s most pressing needs – essential medical equipment, specialized care facilities, and access to appropriate education and training – remained unmet. These crucial services, unfortunately, are not currently included in the disability benefits available to expats in Taiwan.

Disability Certificate in Taiwan

The Disability Certificate, issued by the Ministry of Health and Welfare (MOHW), plays a crucial role in accessing social welfare services for people with disabilities in Taiwan. Resembling a driver’s license, the Disability Certificate details an individual’s disability level (mild, moderate, severe, or extreme severe). This categorization determines eligibility for various social welfare programs. The Disability Certificate is essential for accessing disability support in Taiwan. However, expats face limitations in leveraging its full benefits due to current regulations. Benefits (Limited for Expats): Waiver of National Health Insurance (NHI) monthly fee and hospital fee discounts. These vary by city and may include subsidies for assistive devices, transportation discounts, and specialized care services. However, access to these is often restricted for expats.

Change of Policy

The spring of 2023 marked a turning point for a group of expats with disabilities in Taiwan. When facing limitations in accessing social welfare services, expats with disabilities found an ally in Legislator Wang Ting-yu (王定宇) from Tainan City (DPP). Despite the group lacking voting rights, Mr. Wang’s office championed their cause. Instead of approaching the Ministry of Health (MOHW), a public hearing was held with the National Development Council (NDC). This government body, under the Executive Yuan, focuses on attracting foreign talent to Taiwan. Highlighting the disconnect between attracting talent and neglecting their needs resonated with the NDC.

Crossroads: A Guiding Force

The fellowship wouldn’t have materialized without the tireless efforts of Crossroads 台灣全球連結發展協會. Led by founder and secretary-general David Chang, a skilled negotiator and coordinator. Crossroads played a pivotal role in uniting the group and presenting their case.

Disability Inclusion Campaign: Fighting for Equality
The Disability Inclusion Campaign (DIC) emerged with a clear mission: to dismantle the unequal treatment of expats with disabilities in Taiwan. Their message was clear: attracting foreign talent necessitates a social safety net that includes residents, not just citizens.
The DIC navigated challenges – petitions, media interviews, and ongoing communication with the MOHW. A breakthrough came on September 25th, 2023, when the MOHW announced a policy change. However, the win came with caveats. The Certificate of Disability was only opened to four nationalities – American, Canadian, Japanese, and British – based on reciprocity with those countries.

The Fight Continues

The battle is far from over. While access to the Certificate represents progress, “benefit packages” for expats still face limitations. Despite remaining roadblocks, the DIC’s unwavering advocacy has paved the way for a more inclusive future.
*Mackay Project: Designed by the Ministry of Health and Welfare to benefit expats who have made significant contributions to the society and country. Once approved by the ministry, your APRC will have a special note to indicate your status.

If you are a permanent resident in Taiwan and in need of assistance, please reach out to Crossroads.

HOW TO APPLY FOR CERTIFICATE OF DISABILITY

WHERE TO APPLY

區公所District Office for the district on your APRC address. For example: the Taipei City, Shi Lin District Office

WHO TO SPEAK TO

General Service Counter. Ask for Disability Certificate assistance.

WHAT TO BRING

  1. Photograph of the patient: 3 copies of a one-inch mugshot. If the patient is not able to take a proper picture, a close-up photo taken by a smartphone is allowed. A pillow background or oxygen tube attached to the face is allowed. It must be a recent photo.
  2. Certificate issued by a hospital with the description of symptoms: focus on the disabilities of the patient. It must be dated within the last 3 months.
  3. Patient’s APRC.
  4. The patient’s personal chop. It is very practical to have it made as it will come in handy in many situations in Taiwan.
  5. If the patient can not present at the service counter, the surrogate person’s ID or ARC and personal chop are also required.
Disability Certificate
Disability Certificate

STEP 1 IN THE PROCESS

Application Form for Evaluation in Chinese to be filled at the counter (hopefully the lady behind the counter will help you). Congratulations, you’re in.
Time: it may take up to 10 working days
NOTE: it is confirmed that even ARC holders are granted equal rights as Taiwanese citizens. Therefore, it is acceptable to request a home visit evaluation if one is bedridden and with multiple disabilities.

WHAT TO EXPECT NEXT

  • A: If the patient is capable of going out of the home, you will be required to visit a designated hospital and a designated doctor to give a full evaluation of your disabilities. or
  • B: a designated doctor will visit the patient if they are unable to make it to the hospital for an evaluation. There is a list of disabilities to qualify for a home visit evaluation. There will be a phone call to arrange the date and time.
  • After the evaluation, a report will be sent to the ministry for review.
  • Time: it may take up to 10 working days at this stage
  • Then, the Ministry will approve (or deny) the application for a disability certificate. The City Social Welfare Department will contact the applicant with detailed benefits.
  • Time: it may take up to 15 working days.

HOW LONG DOES THE WHOLE PROCESS TAKE

In general, the longest time to expect from the day you send in the application to the day you receive the certificate is 35 working days. For expats, it may take up to 55 working days.

Katy Boyden works full-time at an international school as an art technician. Her focus now is caring for her husband with PD. In her spare time, she manages the FB group: Parkinson’s and Me in Taiwan.

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