Microsoft Health Insurance Association

Microsoft Health Insurance Association

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When you incur high medical care costs

The copayment for medical care costs you can be required to pay is capped. If your copayment calculated based on a certain standards exceeds this maximum, the excess amount will be paid as “High-Cost Medical Care Benefits”.
Since the Health Insurance Society automatically calculates these benefits together with its additional benefits (Patient Cost-Sharing Reimbursements and Additional Benefits), no special application is required.

Please fill in the application form clearly and correctly. If it is not legible, we will return the application form.

When you want to reduce in advance the amount of medical care costs you pay at the medical care institution

We recommend using a Myna health insurance card. By doing so and consenting to provide your cost-sharing maximum amount information, you will not need a Certificate of Application of Maximum Copayment Amount.

When applying using a paper application form:
When applying using an electronic application:
Object person: Insured persons or dependents whose copayment amounts for one month are expected to exceed their individual cost-sharing maximum amounts in the following cases:
  • Examinations and treatment received at a medical care institution or other facility that has not adopted the online eligibility verification system
  • When not using a Myna health insurance card
  • When not using a Myna health insurance card and you are 70 or older and in the same income category as active workers Ⅰ or Ⅱ
  • If you are in the low income category (certificate of application of maximum copayment/reduced standard copayment)
Submit documents to: Microsoft Health Insurance Association
Notes: The Maximum Copayment Certificate for Health Insurance can be used for both inpatient and outpatient expenses.
It will be issued and sent on after the first day of the first month of the expected period of hospitalization or hospital visit indicated in the application form.

When you face high copayments for medical care or long-term care

Required documents:
  • “Application for Payment of High Aggregate Cost for Long-Term Care Service”

[Documents to attach]
Copayment certificate for long-term care insurance

Object person: Insured persons paying copayments for both medical care and long-term care for all individuals in the same household, for whom the total copayment amount paid under both systems over a one-year period exceeds the maximum amount
Deadline: As soon as possible
Submit documents to: Microsoft Health Insurance Association
Notes: For calculation purposes, the one-year period above refers to the period August 1 to July 31 the following year.

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