National Yunlin University of Science and Technology (YUNTECH)

 
◆針對初次來臺而前四個月，未加入全民健保之新生 Medical Treatment Procedures
   ●參加此保險之外籍生，在保險有效期間四個月內因傷病保險事故須要使用此保險，請先確認您的醫療項目，並非特殊疾病及醫療行為不給付項目（請參考備註），使用流程如下：
     1.至雲科大僑外組領取門診就診單，至簽約醫療院所就診，門診費用須先行自付，再向醫院索取門診費用相關收據正本，及請看診醫師在門診就診單簽章及填寫症狀。
     2.請務必至簽約醫院看診（可參考附表→表1、表2），否則不適用本保險給付，建議可就近到位於斗六市區的臺大醫院就診，但簽約醫院並不包含臺大醫院，請留意。
     3.看完診後，請務必檢附下列文件至本處，我們會協助您辦理理賠。
      一、繳費收據正本
      二、門診就診單（需有看診醫師的簽名及填寫症狀）
      三、臺銀存摺封面影本（請寫上居留證號碼及護照號碼以供理賠金匯款）
      四、保險理賠申請書（可至本處索取此表格現場填寫或自行點此下載填寫）
      僑外組檢查文件齊全後核章，寄送給保險公司，待保險公司理賠部門確認文件齊全並為該保險理賠項目，約4週後核定理賠金額匯款至您的臺銀帳戶。
    If you wish to receive medical treatment, please check remarks to ensure if your medical treatment is not excluded from this insurance and follow the procedures:
      1.Pick up an Insurance Claim Form from ISA office and bring it on the visit to the hospital or clinic. Pay full amount of fee for the treatment, but be sure to get both a receipt and the Claim Form with doctor`s signature and symptom description.
      2.The insurance only covers the medical treatment occurred in the hospitals specified by the insurance company. Please do go to the listed hospitals (refer to the Listed Hospitals→List1  List2  List3  List4). We recommend YUNTECH students to go to NTUH Yun-lin Branch Hospital in Douliau as it is near campus and conveniently accessible. Please note that NTUH Yun-lin Branch Hospital is not on the list and not applicable.
      3.The documents you need to bring to ISA office as follows:
         a. the original receipts of payment,
         b. the claim form(with doctor`s signature and symptom description)
         c. copy of your post Taiwan Bank passbook cover (please write your ARC no. and passport no. on the copy),
         d. Compensation Application Form (download here or fill out this form at ISA office on spot)
        Bring all documents on point 3 to ISA office and we will help you deliver them to the insurance company. If your documents are complete and within the coverage policy, the insurance company will transfer the claims payment into your Taiwan Bank account about 4 weeks later.
      4. Map to NTUH Yun-lin Branch Hospital ↓
         

★請留意：門診給付相同症狀每日以一次為限，每日一次理賠上限為新台幣1,000元，且不包括下列費用：
（一）掛號費。
（二）部分負擔費用：
１、第一次至第五次，每次自付新臺幣50元。
２、第六次至第十次，每次自付新臺幣100元。
３、第十一次以上，每次自付新臺幣150元。
（三）每日看診總費用超過新台幣1,000元上限。
Please note:
1.For the same symptoms, the insurance company covers only one visit per day. The maximum coverage per visit is NT$1,000, but does NOT include the following:
  A.Hospital or clinic registration fee
  B.Deductible fee:
      a.first to fifth visit, NT $50 deductible per visit.
      b.sixth to tenth visit, NT $100 deductible per visit.
      c.eleventh and more visits, NT $150 deductible per visit.
  C.Total amount exceeding the maximum coverage NT. $1,000 per day.

★保險醫療給付項目如下：
（一）門診：
    １.診療、處置或手術。
    ２.藥劑、注射。
    ３.治療所必需之材料及檢驗、檢查。
（二）住院：
    １.診療、處置或手術。
    ２.藥劑、注射。
    ３.治療所必需之材料及檢驗、檢查。
    ４.護理、三等病床及膳食之供應。
保險給付範圍：限於台灣地區之醫療行為。投保前之傷病及保險公司規定之特殊疾病及醫療行為不給付。
Insurance Coverage
 A.Outpatient:
    a.Physicians and specialists consultations, medical treatment and surgery
    b.Prescribed medicines and injection
    c.Diagnostic laboratory tests and surgical appliances
 B.Hospitalization
    a.Physicians and specialists consultations, medical treatment and surgery
    b.Prescribed medicines and injection
    c.Diagnostic laboratory tests and surgical appliances
    d.Basic room and board including general nursing care
Policy Coverage:
Insurance covers accidents or sickness occurring in the Taiwan area. Accidents or sickness
requiring specialized medical care or occurring before the insurance policy was taken out will not
be covered.

＊備註：
投保外籍生因傷病事故必須就醫醫療時，皆可就診。但有下列情形者承保機構不負給付之責：
（一）自殺行為、酗酒、吸食違禁藥品或犯罪行為和戰爭變亂所致之傷害或疾病。
（二）不孕症、懷孕、流產或分娩及其所引致的併發症。
（三）健康檢查、視力矯正、預防注射、外科整型美容、洗牙、假牙、義肢、義眼或其他附屬之裝置。
（四）救護車、診斷證明書、指定醫師費、特別護士看護、陪伴費、非治療之用品費。
（五）紅斑性狼瘡（先天性）、血友病、多汗症、愛滋病、性病、先天性疾病、結紮手術、器官移植、投保前之傷病。
Remarks:
 1.This policy does NOT cover medical treatment incurred by the following situation or personal behavior:
    A.Suicidal behavior, alcohol abuse, drug abuse, overdose, any sickness or damage result from
illegal behavior and warfare.
    B.Complication incurred by vibriosis, pregnancy, miscarriage or labor.
    C.Health exams, optical correction, inoculation, elective cosmetic surgery, dental scaling, denture, prosthesis, ocular prosthesis.
    D.Ambulance, diagnosis statement, the fee for assigning doctors, special nursing, any costs not relevant to the treatment.
    E.Systemic lupus erythematosus, Hemophilia, Hyperhidrosis, AIDS-Acquired Immunodeficiency Syndrome, sexual y transmitted disease, congenital disorder, vasectomy, organ transplant, and any disease diagnosed before the insurance policy taken out.