Cataract Surgery Insurance Applications in Taiwan

Cataract health insurance application?

Hello Dr.
Ke: My father (48 years old) went to the hospital for an eye examination three weeks ago, and the doctor diagnosed him with severe cataracts that require surgery.
The doctor submitted an application for us, but we have not received any response yet.
Since it is a severe case of cataracts, why has it taken so long to hear back from the hospital? How long does it typically take for health insurance applications to be processed? If there is no insurance coverage, what is the approximate cost of cataract surgery? Thank you for your response! ^_^

A Miao, 10~19 year old female. Ask Date: 2005/03/12

Dr. Ke Meilan reply Ophthalmology

Hello, may I ask your father's name? We usually do not receive notifications if the application does not pass the review.
Please come to the outpatient clinic again, and we can apply once more.
The general application takes about three weeks.
If there is no National Health Insurance subsidy, the cost is approximately 23,000.
Thank you, Dr.
Ke Mei-Lan, Ophthalmology Department.

Reply Date: 2005/03/12

More Info

Dear Patient,
Thank you for reaching out regarding your father's cataract surgery and the associated insurance application process in Taiwan. Understanding the intricacies of healthcare and insurance can be quite challenging, especially when it comes to surgical procedures like cataract surgery.

Cataracts are a common condition, particularly in older adults, and they can significantly impair vision if left untreated. In Taiwan, cataract surgery is typically covered by the National Health Insurance (NHI) system, provided that certain criteria are met. The process usually begins with a thorough examination by an ophthalmologist, who will assess the severity of the cataract and determine if surgery is necessary. If the doctor deems the cataract to be severe enough to warrant surgery, they will submit an application to the NHI for approval.

The delay in receiving a response regarding your father's application could be attributed to several factors. Firstly, the hospital may be experiencing a backlog of applications, which is not uncommon in busy healthcare systems. Additionally, the approval process can take time as the NHI reviews the application to ensure that it meets the necessary medical criteria for coverage. Typically, you should expect to hear back within a few weeks, but this can vary depending on the hospital and the volume of applications they are processing.

If the application is approved, the surgery will be scheduled, and the costs will be covered under the NHI. However, if the application is denied, you will need to consider the out-of-pocket expenses for the surgery. The cost of cataract surgery without insurance can vary widely depending on the hospital and the specific procedure performed. On average, the cost can range from NT$30,000 to NT$100,000 (approximately USD 1,000 to USD 3,300) per eye, depending on whether a standard or premium intraocular lens is used.

In the event that your father's application is still pending, I recommend following up with the hospital's administrative office or the ophthalmology department. They can provide you with updates on the status of the application and any additional information you may need. It’s also a good idea to keep a record of all communications regarding the application, including dates and names of the personnel you speak with.

In summary, while the waiting period for the NHI application can be frustrating, it is a standard part of the process. If approved, your father's surgery will be covered, significantly reducing the financial burden. If denied, understanding the costs involved will help you make informed decisions moving forward. Please do not hesitate to reach out to the hospital for updates, and I wish your father a successful surgery and a smooth recovery.

Best regards,
Doctor Q&A Teams

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