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National Health Services for Expats in Hong Kong

Submitted: July 2013

Hong Kong is a low tax, low spend country. In 2009/2010, Hong Kong’s public health spending amounted to 2.6% of GDP, and 50% of total health spending was private.

Hong Kong’s national health policy is based on a co-payment structure and social citizenship. Consequently, taxpayer support towards your healthcare costs is conditional on your immigration status. Expatriates should always check their residence status and how it interacts with Hong Kong’s national health system. If you are not an “eligible person”, you are unlikely to get much health-related financial support from the Government.

Public hospitals and outpatient clinics are designed to provide basic healthcare mainly. See Doctors and Hospitals for Expats in Hong Kong. This helps ensure service quality in emergencies. See Health Emergencies for Expats in Hong Kong. If your problem is deemed non-urgent, do not underestimate potential waiting times.

A private medical insurance policy may supplement or even replace taxpayer-funded health services. See Health Insurance for Expats in Hong Kong

Eligible persons

You are an eligible person if:

  • You hold a Hong Kong Identity Card (HKID)
  • You are less than 11 years old with Hong Kong resident status, or
  • You have been approved by the Chief Executive of the Hospital Authority (HA).

Otherwise, you are a non-eligible person.

Benefits for eligible persons

Eligible persons may enjoy access to subsidised healthcare at public hospitals and outpatient clinics. See Doctors and Hospitals for Expats in Hong Kong Typically, an eligible person is charged 5 to 20% of the fee charged to a non-eligible person for a similar service.

Non-eligible persons

If you are non-eligible, the healthcare system is designed to encourage you to go private in order to put less strain on public facilities.

Non-eligible persons may still attend public hospitals and/or clinics, but they will be charged market prices unless it is public policy to charge even higher prices (see below). A deposit may also be required. For more information on deposits, click here.

Public vs. Private patients at public establishments

Private healthcare is also available in public hospitals or clinics, albeit availability is not guaranteed. This is because the Government strives to limit the expansion of private healthcare in public hospitals to ensure the continuity of public services.

Although this is not automatic, it is worth noting that non-eligible in-patients may be charged higher fees in public wards than as a private patient. This pricing policy is designed to encourage expatriates to seek private treatment (in a public or a private hospital) in order to relieve the pressure on certain overstretched public services. This is particularly true of prenatal care. See Doctors and Hospitals for Expats in Hong Kong

Fee waiver mechanism

As a general rule, Hong Kong’s fundamental policy is to ensure that nobody is denied access to basic healthcare for financial reasons. This must be understood in light of Hong Kong’s welfare policy, which is based on social assistance to those who need it most only.

Under the fee waiver mechanism, patients with financial difficulties may apply to the HA for a full or partial fee reduction. The application is subject to means-testing as follows:

Income limit (HK$)

1

5,475

30,000

2

12,000

60,000

3

17,325

90,000

4

22,875

120,000

5

29,775

150,000

6 and above

30,075

150,000

The assets limit is raised by HK$120,000 for each dependant aged 65 or over. The application may also be considered if the assets limit is exceeded but the income doesn’t exceed two thirds of the income limit.

However, applications are considered on a case-by-case basis, and non-financial factors may also be taken into account. These include:

  • The patient’s medical condition
  • If the patient belongs to a socially vulnerable group (e.g. lone parent, disabled, etc.)
  • If the fee waiver could provide an incentive and help solve family problems
  • If the patient has large legitimate expenses, and
  • Other justifiable social factors.

Benefit fraud is a serious criminal offence in Hong Kong, and it is punishable by 10 years of imprisonment.

Cost/benefit analysis for expats

Foreign expats living in Hong Kong may be at a disadvantage if they are ineligible to subsidised treatment at public facilities. However, this must be weighed against Hong Kong’s comparatively low tax burden.

 

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