健保保險給付法律規定，基本上屬於相對法律保留的範疇，除了法律明確的規定外，也得基於授權明確原則，由主管機關訂定法規命令，規範保險給付。本文建議修法的方向，以法律保留以及法律明確為基調，儘量限縮授權訂定法規命令的適用情形。尤其健保制度在於保障全體國民的健康權益，健保保險給付的法律規定應兼具提供充分資訊的功能。由於保險給付的範圍牽動著保險財務的範圍，尤其健保財務屬於即支即付型，除了法定的安全準備之外，保費收入完全用於支付保險給付，所以明確的保險給付也在於達到穩定的健保財務。健保制度所能負擔的保險給付是有一定的範圍。現行法律僅以經驗性法律概念規定「疾病、傷害、生育」，均由健保負擔，給付範圍遂由醫學專業或者保險對象主觀認定。因而有必要區分「標準保險給付」、「新保險給付」、「不保險給付」，分別明確規範。

　　　　　The payment of national health insurance act fundamentally is the periphery of the Law act Principle. This insurance act should be designed in clear provisions and how to implement national health insurance effectively. This research provides the directions of that supervisory board of the National health may consider. Firstly, the act should base on the framework of law provisions and law precision in order to reduce the possibility of explanation of law by health units. Such provisions and precision can provide full information for insured citizens and strengthen the system of national health insurance. Secondly, regarding the periphery of payment relates of finance of insurance. The revenues of national health insurance should be totally paid for insurance of payment, except for secured reserves. Therefore, prevailing law to implement the act based upon experience to pay illness, injury or maternity is arguable. We suggest that the Board may consider to identify the standard payment of insurance, new insured payment, non-payment of insured insurance.