OBJECTIVE: The evidenced-based study tests the hypotheses (i) National Health Insurance Expenditure increases with closeness to death (ii) National Health Insurance Expenditure decreases with age. This study analysis age, sex and health expenditure differences before the day of death for one-year period during 1999 and 2000. METHODS: In Taiwan the National Health Insurance Program had covered 97% population. The claim data were obtained from Bureau of National Health Insurance (in 1999 and 2000), the vital registration data (in 2000) were from Department of Health in Taiwan. Use the vital registration ID number to merge the National Health Insurance Expenditure, then retrospect 1 day, 2-7 days, 8-14 days, 15-30 days, 31-60 days, 61-90 days, 91-180 days, 181-270 days, and 271-365 days before dying. RESULTS: The 22.1% dead people had no medical expenditure in the last year of life. The expenditure of last year of life accounts for 12.8% of all National Health Insurance Expenditure, 2.6% of it on ambulatory care, (1.1%for female, 1.5%for male), and 10.3% of it on inpatient care (3.9%for female, 6.39%for male), respectively. The expenditure 91-180 days before death accounts for18.1% (highest) total expenditure of the last year of life, the lowest is 1 day before death accounts for 2.3%. The total expenditure for the age groups 0-64, 65-84, and 85+ accounts for 36.5%, 54.2% and 9.3%, respectively. The total expenditure ascending with age from 27 years-old (0.11%) to76 years-old (3.3%) then decreasing with each age. But the last year expenditure proportion to all year expenditure is ascending from 27 years-old with age. The average expenditure is $8,307 US dollars per decedents, 26.1 times for average expenditure for each person.