If an inmate’s household registration is suspended for he has been out of the country for more than two years, how does the suspension affect the inmate?

Pursuant to Article 8 of the National Health Insurance Act, a person who does not have a registered domicile in Taiwan is not eligible to enroll in National Health Insurance (NHI). Inmates without NHI can see a public health physician or pay to see other doctors.

How do inmates with household registration suspended restore their registration so they can enroll in National Health Insurance (NHI)?

1. If the inmate entered Taiwan with Republic of China (Taiwan) passport:
   1. Provide a photocopy of the basic-data page of passport (photograph included) and a photocopy of the page that carries the latest entry stamp; and
   2. Fill out a consent form entrusting the household administration authority to restore his household registration while he is in prison.
2. If the inmate entered Taiwan without Republic of China (Taiwan) passport:
   1. Inmate’s family prepares a power of attorney signed by the inmate, a certificate of imprisonment, a 2-inch color photo of inmate, a photocopy of inmate’s ID card, and NT$400 to apply to any service station of the National Immigration Agency for a copy of entry permit, and then mail the permit to the inmate;
   2. Inmate fills out a consent form entrusting the household administration authority to restore his household registration while he is in prison; and
   3. Inmate prepares the aforesaid documents and writes a report to the correctional facility to apply for approval. Then the correctional facility will write a letter to the local household administration office, asking them to restore inmate’s household registration and handle the NHI enrollment matters according to rules.

What kind of medical care is available to inmates after they enter a correctional facility?

Correctional facilities provide the following medical care to inmates:

1. Preventive health services: Carry out regular physical checkup, and track on inmates who have chronic illnesses or special diseases, and educate inmates on health promotion and disease prevention.
2. Treatment services: For inmates who may be ill, doctors will make diagnosis and provide treatment to make sure they receive proper medical care.
3. Infectious diseases prevention: Newly admitted inmates will receive blood test (to examine whether they have Acquired Immune Deficiency Syndrome or syphilis) and expanded chest X-ray to achieve the purpose of early diagnosis and early intervention. In addition, every correctional facility regularly holds expanded health screenings every year.

Are inmates with chronic illness able to receive treatment during incarceration?

1. Currently most inmates have been included in National Health Insurance (NHI) and hospitals have clinics set up in correctional facilities. Inmates who do not have NHI can see a public health physician by requesting their ward superintendent to make an appointment for them.
2. Inmates who have chronic illness and need to take medications on a long-term basis can apply to see a doctor and get their medications inside the correctional facility. However, to facilitate uninterrupted treatment, inmates can apply for certificates of diagnosis, summary of medical record and prescription record from previous hospitals for the reference of the correctional facility.
3. Relatives of inmates can rest assured that if an inmate is unable to receive proper treatment inside the correctional facility, the doctor will recommend the arrangement of out-of-prison treatment or transfer to in-facility medical ward. If an inmate is critically ill, the facility will also consider granting outside medical care on bail.

What happens when an inmate needs to take medications during detention or incarceration period?

1. Since the implementation of the second-generation national health insurance program, hospitals have been setting up clinics in correctional facilities. If inmates get ill and need to take medications, they will be able to see a doctor inside the facility and take medications as instructed by the doctor.
2. Inmates can bring medications with them upon arrival at the correctional facility. However those medications must be placed in an intact medicine bag or come with the prescription for identification purpose. The medicine bag should indicate patient name, name, unit content and quantity of medication, use instruction and dosage, name and address of medical institution or pharmacy, name of pharmacist and date of preparation or delivery. Correctional facilities will check the information and return the medicine bag to inmates afterwards. Inmates who need insulin shots must prepare certificate of diagnosis, prescription, needle and the drug.
3. If a medicine prescribed by a correctional facility doctor is not available at the facility, inmates can fill out an application form for approval to let their relatives send the medicine. The medicine sent by inmate’s relatives must be placed in intact and unopened outer bag and comes with fully labeled medicine bag, certificate of diagnosis or prescription, and the medicine is to be used by the inmate only.
4. How to send medicine: The relatives of inmates can send medicine by post, or deliver it in person at the time and place designated by the facility, or by other ways permitted by the facility. However inmate’s relatives must first apply for approval by submitting prescription and relevant supporting documents according to the established procedure before sending the medicine.
5. If a medicine does not conform to the aforementioned requirements, or does not come with a permit number of Taiwan Food and Drug Administration, or has unclear label or torn package, the correctional facility will reject the delivery.
6. How rejected medicines are handled:
   1. Inmates can mail the medicines to an address designated by them at their own cost or ask their relatives to pick it up at the facility.
   2. If inmates do not take any action, the facility may destroy the medicine or dispose it by other appropriate means.

Do inmates in correctional facilities have NHI coverage? Do they need to pay for the insurance?

National health insurance status of inmates at correctional facilities:

1. Inmates classified under Category 4, Item 3 (the Ministry of Justice will subsidize the premiums): For prisoners serving sentence, individuals receiving rehab (detoxification) treatment,  juvenile receiving reformatory education and individuals subjected to compulsory rehab (detoxification) treatment pursuant to Article 91-1 of the Criminal Code who have been at a correctional facility for more than two months, their NHI premiums will be paid fully by the central corrections authority.
2. Inmates not classified under Category 4, Item 3 (need to pay NHI premiums on their own):Defendants, rehab inmates under observation, juvenile inmates held at juvenile detention houses, civil detainees and prisoners whose sentence is less than two months.
3. Inmates who are not eligible to enroll in NHI: Domestic inmates who do not meet the provisions of Article 8 and foreign inmates who do not meet the provisions of Article 9 of the National Health Insurance Act. However foreign inmates who have obtained resident permits and have resided in Taiwan for 6 months or longer (based on the data of National Immigration Agency) are eligible to enroll in NHI.

Do inmates with national health insurance (NHI) need to pay when they see doctors? What are the expenses?

1. Inmates need to pay the following expenses when they see a doctor:
   1. Registration fee: Registration fee of clinic inside correctional facilities range from 0 to NT$100, depending on the fees set by the hospital.
   2. Co-payment: Co-payment of clinics inside correctional facilities will be charged at the level of primary health institutions in accordance with Paragraph 1, Article 7 of the Regulations Governing Medical Services for Insured of the National Health Insurance Held at Correctional Facilities. In addition, pursuant to Article 48 of the National Health Insurance Act, co-payments are exempted for NHI insureds who have major illness or injury, undergo child delivery or receive medical care in mountainous regions or outlying islands.
   3. Hospitalization expenses: Co-payment for hospitalization range from 10% - 30% of the expenses. The longer the length of hospital stay, the higher the ratio.
2. If inmates cannot afford to pay registration fee or co-payment, correctional facilities will deduct the amount from inmates’ safekeeping account or labor income, demand payment from the inmate or inform inmates’ relatives to pay the bills. If an inmate has not paid up the bills when he is released or discharged, the cooperative hospital (clinic) will take over the collection.

For inmates who owe premiums on national health insurance (NHI) before entering a correctional facility, will the Ministry of Justice pay the premiums on their behalf?

1. For inmates who are serving a sentence, are subjected to rehabilitative measure or protective measure for a duration of longer than two months (inmates classified under Category 4, Item 3), their NHI premiums will be fully subsidized by the central corrections authority (Ministry of Justice). However, the Ministry of Justice will not pay for premiums owed by inmates before they enter a correctional facility, regardless whether the inmate is classified under Category 4, Item 3 or other categories.
2. If inmates classified under Category 4, Item 3 have their national health insurance suspended due to premium payments in arrears, the National Health Insurance Administration will have their coverage reinstated after they enter a correctional facility so their healthcare benefits will not be affected.

How do inmates without national health insurance (NHI) seek medical treatment? Who will pay for their expenses?

1. Inmates who serve a sentence of less than two months and are eligible to enroll in NHI should maintain their insurance and pay premiums to avoid coverage disruption. Inmates who have enrolled in NHI but have not picked up the NHI card or whose NHI card is missing or damaged are advised to get their card before entering the correctional facility in order to uphold their interests.
2. For inmates who are not eligible to enroll in NHI according to the National Health Insurance Act and become ill while being held in the correctional facility, the facility will engage a doctor to provide treatment or the cooperative hospital will provide free services. However if an inmate must be escorted to an outside hospital for treatment, the inmate shall pay for the expenses incurred. Inmates who are qualified to apply for subsidy due to financial difficulty may apply for medical subsidy.
3. For inmates who are eligible to enroll in NHI but are in the process of making an application and do not have a NHI card yet, or currently are not covered or have coverage suspended due to premium payments in arrears, they may receive medical treatment as an NHI insured first. Subsequently the regional division of National Health Insurance Administration and the correctional facility will help the inmate to enroll in NHI or arrange installment payments for premiums owed.

What happens if an inmate cannot afford to see a doctor?

According to the National Health Insurance Act, inmates should pay registration fees and some expenses of outpatient services, emergency or inpatient care. Inmates who have financial difficulty and cannot afford to pay their portion of the medical expenses to medical institutions may resort to the following remedies:

1. Inmates who meet the NHI criteria for “financial difficulty” may prepare relevant documentation to apply for an interest-free NHI relief fund loan; or
2. Apply to the correctional facility for arranging treatment at a medical institution or by a doctor:
   1. Application period: Within three months before or after receiving treatment.
   2. Required documents: A certificate of financial status issued by the chief of village within one year and certificate of low or middle income household.
   3. If an inmate’s financial status has not improved six months after he has been determined to have financial difficulty, the inmate must reapply.
   4. For inmates who are determined to meet the financial difficulty criteria and unable to pay for their medical expenses, if their safekeeping account or labor income may be used to pay for the expenses within six month after their treatment session is over, correctional facilities may deduct the expenses from their safekeeping account or labor income.
   5. In case of any of the following circumstances, correctional facilities may recover from inmates the expenses incurred in the medical services rendered by a medical institution or doctor engaged by the facilities for inmates:
      1. The inmate provides false information.
      2. The inmate conceals or refuses to provide information requested by the facility.
      3. The inmate obtains supporting documents by fraud or other illicit means.

What should an inmate do when he receives a notice from the correctional facility to pay medical expenses?

1. Currently all correctional facilities have clinics that accept National Health Insurance (NHI). However inmates with NHI still need to pay registration fee and co-payment when they see a doctor inside the facility. Inmates without NHI will have to pay for their medical expenses unless they are seen by a public health physician. Thus when inmates receive a notice to pay, they should make payment before the specified deadline.
2. Inmate’s relatives may send inmates money to pay for their medical expenses. Refer to “6. Sending Money, Food and Supplies to Inmates” about ways to send money or items to inmates.

Under what conditions can inmates receive medical treatment outside correctional facilities? Will their relatives be notified?

1. When an inmate is ill and determined by a doctor inside the correctional facility (based on the inmate’s condition, the availability of medical personnel and equipment, etc.) that the inmate will not be able to receive proper care inside the facility, the doctor can write a referral sheet or the inmate can submit a self-pay medical service report. The inmate can then seek outside medical care under escort after obtaining approval.
2. When inmates seeking outside medical care are hospitalized or have certain health conditions, the correctional facility will notify their relatives to pay a visit (for inmates who are held incommunicado, the consent of the court or prosecutors’ office that handles their case is required). When such inmates need to receive invasive examinations or operations, their relatives should visit the hospital as instructed to sign a consent form.
3. When making hospital visits, relatives of inmates must show their ID card and visit at the specified time.

Can inmates designate the time and the hospital when they have been approved to seek outside medical care under escort?

1. According to the National Health Insurance Act and the Regulations Governing Medical Services for Insured of the National Health Insurance Held at Correctional Facilities, when and where inmates may seek outside medical care under escort will be determined by the correctional facility based on the medical needs of inmates and security management needs, for which inmates cannot designate on their own. Thus when an inmate has the need to seek outside medical care, be it inpatient or outpatient services, the time and the hospital will be determined by the correctional facility.
2. When an inmate needs to be hospitalized outside the correctional facility, the inmate should be arranged to stay in the guarded ward. If the hospital does not have a guarded ward, the inmate should be arranged to stay in a NHI room, and the hospital may not charge the inmate additional costs for room upgrade.

What are the criteria and application procedure for prisoners to seek out-of-prison medical treatment on bail?

1. Criteria for seeking out-of-prison medical treatment on bail:
   1. When an injured or ill prisoner is sent to an outside hospital or in-house patient ward for treatment under escort but is still unable to receive proper care, the prison may report the case (including doctor’s recommendations) to the supervisory agency seeking approval to allow the prisoner to receive out-of-prison medical treatment on bail. In case of emergency, the prison can approve out-of-prison treatment on bail first and then report the case to the Agency of Corrections for reference.
   2. The provisions on general out-of-prison medical treatment on bail in the preceding paragraph apply to female prisoners who are pregnant for more than five months or have given birth less than two months earlier.
2. There are two procedures for out-of-prison medical treatment on bail – general and emergency:
   1. General procedure: The correctional facility prepares related supporting documents, such as certificate of diagnosis and report to the Agency of Corrections for approval. If the application is approved, the correctional facility will notify the relatives of prisoner to carry out the bail formality at prosecutors office.
   2. Emergency procedure – The correctional facility prepares supporting documents, such as certificate of diagnosis and critical condition notice, for approval by the head of the facility, and sends a letter to the prosecutors office, requesting the office to take action by its vested authority, and then notifies relatives of the prisoner to carry out the bail formality at prosecutors office. After all steps are completed, the correctional facility will file a report to the Agency of Corrections for reference.
3. The criteria, operating procedure and review process for prisoners to receive out-of-prison medical treatment on bail:
   1. For prisoners whose health condition meets the provisions of Article 63 of the Prison Act and meets a situation under any subparagraph of Paragraph 1, Article 3 of the Regulations Governing Review Standards and Management of Prisoners Receiving Out-of-Prison Medical Treatment on Bail, the prison may request the approval of the Agency of Corrections for prisoners to receive out-of-prison medical treatment on bail:
      1. The prisoner is contracted with a disease with high fatality rate that his life may be endangered if incarceration continues.
      2. The prisoner suffers from senility or there are objective facts indicating that he has severe physical or mental disability and cannot take care of himself in prison and will not receive proper medical care in prison.
      3. The prisoner is gravely ill that he must be hospitalized and treated outside the prison on a long-term basis.
      4. The prisoner has severe physical disabilities that he must undergo rehabilitation therapy outside the prison on a long-term basis.
      5. The prisoner’s health condition is complex and hard to manage that he faces the risk of death at any time.
      6. The prisoner has a notifiable disease and it is difficult for him to receive treatment in isolation in prison.
   2. Operating procedure and review:
      1. Before a correctional facility reports out-of-prison medical treatment on bail for an prisoner, it must escort the prisoner to a medical institution for treatment or hospitalization and obtains relevant supporting documents (e.g. certificate of diagnosis, summary of medical record), and take reference of doctor’s recommendations and evaluate the following conditions:
         1. Severity of health condition;
         2. Treatment plan;
         3. Prisoner’s self-care ability; and
         4. Family’s ability to care for the prisoner or placement planning of the social welfare organization.
      2. When necessary, the prison can engage other professional agencies (institutions), groups or individuals to assist in the aforementioned evaluation.
      3. When a prisoner requests out-of-prison medical treatment on bail, the prison should let medical staff determine whether prisoner’s health condition meets any of the conditions under the subparagraphs of Paragraph 1, Article 3 of the Regulations Governing Review Standards and Management of Prisoners Receiving Out-of-Prison Medical Treatment on Bail. Before reporting the case to the Agency of Corrections, the prison must escort the prisoner to a medical institution for treatment or hospitalization and obtains relevant supporting documents, such as certificate of diagnosis and summary of medical record, and consider doctor’s evaluation of the prisoner’s health condition, treatment plan, and prisoner’s self-care ability, and notify the prisoner of the review results.
   3. After determining whether prisoner’s health condition meets the criteria for out-of-prison medical treatment on bail under Article 63 of the Prison Act, the prison shall submit an “Out-of-Prison Medical Treatment on Bail Report”, which details the prisoner’s health condition, treatment plan, self-care ability, family’s ability to care for the prisoner or placement planning of the social welfare organization, to the Agency of Corrections for deliberation and approval. In the event of an emergency, the prison may approve out-of-prison medical treatment on bail before reporting the case to the Agency of Corrections.
4. If a defendant under detention is gravely ill that he or she is unable to receive proper treatment inside the correctional facility, the facility will prepare certificate of diagnosis or other documents to the court or the prosecutor for a decision. Thus the provisions of out-of-prison medical treatment on bail do not apply to defendants.

How should prisoners behave themselves when they receive out-of-prison medical treatment on bail?

1. Prisoners who receive out-of-prison medical treatment on bail shall observe the following rules:
   1. May not act in a way that violates laws or regulations.
   2. Receive treatment according to doctor’s instructions.
   3. May not leave or change the medical institution or facility for receiving out-of-prison treatment without justification. If such change is necessary for treatment or care purposes,the prisoner may submit relevant supporting documents to the prison where he or she was incarcerated to apply for change of medical institution or facility. However if the situation is urgent, the prisoner may make the change first and apply to the prison for approval within 5 days.
   4. Actively keep in touch with the prison and must not be out of reach without justification.
   5. When a prison officer visits, make a report on his or her health, treatment or care received, and living conditions and provide the officer with supporting documents, such as hospital’s certificate of diagnosis.
   6. Unless it is necessary for maintaining daily life, do not engage in activities that are inconsistent with or apparently irrelevant to the purpose of treatment.
   7. Do not harm, intimate, harass, stalk, bother, or otherwise act unlawfully against victims, complainants, informants, witnesses and other interested parties.
   8. Observe other matters deemed necessary by the prison.
2. Prison’s actions when a prisoner on bail for medical treatment violates any of the aforementioned rules:
   1. When a prisoner on bail for medical treatment violates any of the aforementioned rules, the prison should first order the prisoner in writing to take corrective actions within a given period of time. Should the prisoner fail to do so, the prison may request the Agency of Corrections to rescind the approval for receiving out-of-prison medical treatment on bail.
   2. However if the prisoner’s violation is of serious nature or if it is determined by medical staff that the prisoner’s illness is cured or has improved, or if the prisoner fails to report to the prosecutors office on the date designated by the prison, the prison may proceed to request the Agency of Corrections to rescind the approval for receiving out-of-prison medical treatment on bail.
3. The period of out-of-prison medical treatment on bail will not be counted as time served. Prisoners on bail who are not yet recovered shall submit a certificate of diagnosis every month and the prison may grant an extension in light of prisoner’s health condition.
4. While a prisoner is on bail for medical treatment, if it is assessed and determined by medical staff that the prisoner’s illness is cured or has improved, the prisoner shall report to the prosecutors office on the date designated by the prison and then go back to prison to serve his or her remaining sentence.

If a prisoner dies while out on bail for medical treatment, what should his or her relatives do?

1. Present the prisoner’s death certificate and relevant supporting documents to the prosecutors office of jurisdiction to claim the bail money back.
2. Present the prisoner’s death certificate to the correctional facility that used to hold the prisoner to carry out death verification procedure and de-registration formality