Is Affordable Healthcare in Hong Kong Only a Dream for Expat Families?

By Thams Nicol, 29 September, 2015

Hong Kong is a popular destination for expatriates from around the world, lured to the financial hub for a variety of reasons. Some are looking for a job. Others perhaps just want a healthy dose of adventure.

Like many industrialized nations, the city has a public healthcare system to take care of its citizens. But what happens if an expatriate in Hong Kong gets sick? The answer can be expensive if they don't have proper health insurance.

Hong Kong has only 1,104 km2 land mass but has a population of 7,112,688. Among the population are a huge number of expats and their families that are currently living in the city. The number of expats is said to rise as long as the economy is vibrant. At present, the economy is strong and this is evidenced by major employment opportunities that continue to attract expats from the US and the UK. In 2012 alone, work visas issued to British expats have risen 45% and for American expats, 96%.

Living in Hong Kong truly has its advantages for expats but there are some disadvantages that are also seen. For a family that has decided to relocate in Hong Kong, health care concerns may be one of the most important. And in the city, health care is getting to be more expensive for native Hongkongers, but the public health care system will continue to provide basic protection for citizens without health insurance.

The specialty outpatient departments of public hospitals always have a long queue. Photo from Apple Daily News. Non-commercial use.

Even though the natives are protected by the public hospital system, the queue for the treatment of specialty diseases is extremely long, up to a few years. Citizens urge the government to allocate more resources to the public health care system but its policy in the long-run is to privatize the public health sector. In its latest budget, instead of improving the public sector's service, the government decides to subsidize the elderly with chronic diseases to visit private clinics.

At present, the government allots 17% of its annual budget to health care however this amount is insufficient with the massive population growth and the rising cost of medical care that is expected for the next years to come. By 2020, it is estimated that Hong Kong’s cost of health care will double.

As for expats, they are not protected by the government public health care system. Health care for expat families is expected to become very expensive. Even with the huge number of work opportunities in the city it could be hard to live in Hong Kong. Although most services and utilities are cheaper compared to other countries in the world, rent is very expensive. An expat that relocates with his family will need to appropriate a large portion of his salary for housing rental and food, as well as children's education. What is left is usually allotted for health care and other emergency expenditures.

For expats who have chronic diseases, they will face a very tough situation in Hong Kong. One expat named mmr is asking for help for her diabetes in an expat forum as she takes a teaching job in Hong Kong:

What I would have to do to get all what I need? How much I would have to pay for it? It is because I am not going to earn a lot of money, so even I am thinking to ask my doctor here…”

If the expats are not well insured, they will find themselves helpless if they have serious illnesses such as cancer. Justinfo asks in the expat forum about affordable chemotherapy:

Since I couldn’t find this when we were looking and the cost hit us like a brick.Breast Cancer 3rd Generation Chemotherapy in Hong Kong quotation private with the latest drugs is around one million HK$!

Expats in Hong Kong have to choose between going to a private-run clinics and hospitals which are expensive or public facilities but paying the unsubsidized fee, which is still a bit cheaper than the private ones.

Eddy advised PDQ in Asia Expat forum regarding how to find decent healthcare service for a reproductive/women’s health case:

You can also send her to the Family planning run by the government next to Southorn Playground. I go there and its cheap compares to private doctors/hospital. You might have to wait a month to get an appointment to see a doctor but if it's just for health check, it's ok.

An anonymous expat also posted in the Expat forum regarding her experience in a hospital in HK while she delivered her baby:

The main drawback is the public ward, because you can't pay for a private or semi-private room without being back-charged for the whole of your treatment as a private patient, which makes it no cheaper than private hospitals. However it will be busier at some times than others - I was unlucky enough to give birth at a very busy time, and had noisy babies on either side of me…

Will health insurance help?

Health insurance companies are becoming more selective when it comes to their clients. They would rather prefer young policy holders with no signs of illness. The elderly and those at risk for major illnesses are footing an expensive monthly premium for some kind of coverage in case of an emergency. For instance,Bupa International has exclusive health insurance packages for expats which offers $250,000 annual maximum coverage as the most affordable. But with the high cost of surgery and treatment for chronic illnesses, this may not offer enough coverage at all. Expats may also need to pay higher premium just to get a better coverage.

Expats working in Hong Kong may enjoy some health care benefits from their employers but this is not available in all companies. The chance of getting a fully covered health care may only be available for executives and major stock holders of a company or firm. Expats are starting to take matters into their own hands by looking for insurance that will offer a decent coverage but in a more affordable premium.

Kam Sun work as a freelance SEO in Hong Kong and a blood donor @RS mentioned in an expat forum about how insurance companies may be able to help:

I know of a few companies that offer good medical insurance, including cover for chronic conditions. It can be expensive but you may not need to take the plan with the highest benefits. There are other options to reduce the premiums.