Commonly Asked Questions on Medical and Dental Benefits

Q1

What is the Medical and Dental Benefits Eligibility Checking System (ECS)?

A1

The ECS is a computer-based system which enables the medical and dental facilities of Department of Health and Hospital Authority (HA) (designated facilities) to have online access to the data stored in the system for verification of eligibility status of civil service eligible persons when they seek treatment. Upon implementation of the ECS, civil service eligible persons covered by the ECS are no longer required to present a treatment application form when they attend the designated facilities. They only need to advise counter staff of designated facilities that they are eligible for civil service medical and dental benefits and produce valid proof of identity for their inspection. The latter will check their eligibility through the ECS.

The ECS has been fully rolled out for serving and retired civil servants, their eligible dependants and other persons eligible for civil service medical and dental benefits with effect from 30 June 2008.

As accuracy of the ECS data is essential for the provision of medical and dental benefits for civil service eligible persons, the latter should inform the departmental management or the Treasury (for retired civil servants) promptly of any changes in personal particulars of themselves and their dependants (e.g. their marital status, the education status and physical or mental infirmity status of their dependent children at the age of 19 or 20) for updating the ECS database.

Q2

How do I know if I am a civil service eligible person covered by the ECS?

A2

Civil Service Bureau Circular No. 4/2008 provides details of the coverage of the ECS. In case of doubt, civil service eligible persons should consult their departmental management and Treasury (for retired civil servants) as appropriate.

Q1

Do I need to pay the charge for treatment at the Accident and Emergency (A&E) Departments in Hospital Authority (HA) hospitals?

A1

Civil service eligible persons are eligible for medical treatment free of charge at the A&E Departments in HA hospitals. The free medical treatment will be provided subject to verification of eligibility through the ECS or presentation of a valid G.F. 181 (for civil servants and their eligible dependants), or Try. 447 (for retired civil servants and their eligible dependants).

If their eligibility cannot be confirmed through the ECS and no G.F. 181  or Try. 447 can be produced on spot, they should advise the Registration Counter, obtain a payment advice and return a valid G.F. 181 or Try. 447 as appropriate together with the payment advice to the Accounts Office of the relevant hospital by post or the Main Shroff of the relevant hospital in person as soon as possible following the attendance. Civil service eligible persons are reminded that if they pay the charge for treatment at the A&E Departments in HA hospitals, such payment will be taken as their agreement to forfeit their entitlement to free treatment on that occasion and the Government and HA will not arrange for reimbursement of the payment afterwards.

In returning a G.F. 181 or Try. 447 to HA, civil service eligible persons should ask their departmental management (for serving civil servants) or the Treasury (for retired civl servants) to certify their eligibility on the date of attendance in the form if that date is not covered within the validity period of the G.F. 181 or Try. 447.

Q2

Some new fees and charges have been introduced at public hospitals and clinics. Do persons who are eligible for civil service medical benefits need to pay for these new charges?

A2

The drug fee and first attendance fee for specialist out-patient service as well as the admission fee for the first day of in-patient (general beds) service do not apply to persons eligible for civil service medical and dental benefits.

The fees payable at the Chinese Medicine Clinics cum Training and Research Centres apply to persons eligible for civil service medical and dental benefits and such fees will not be reimbursed by the Government. 

Civil Service Chinese Medicine Clinics provide free general consultation and acupuncture services for treatment purpose to civil service eligible persons.

Q1

The A&E departments in HA hospitals accept valid G.F. 181 or Try. 447 subsequently if eligibility cannot be confirmed through the ECS or the necessary proof cannot be provided at the time of attendance. Will the same arrangement apply to other HA departments or clinics?

A1

Civil service eligible persons must not assume that they may obtain free medical and dental treatment if they cannot produce the requisite valid proof. In general, hospital and clinic staff are not under any obligation to provide free treatment to individuals who claim to be civil service eligible persons but their eligibility cannot be confirmed through the ECS or they cannot produce any valid proof at the time of attendance. The arrangement at the A&E departments of HA hospitals (See Q1 under "Charges for Public Health Care Services") are in recognition of the emergency nature of the attendance in which the requisite valid proof may not be readily available.

Q2

My child is under the age of 11 and is eligible for civil service medical and dental benefits. What kind of identity document should I bring along when accompanying him/her for free medical and dental treatment?

A2

Eligible dependent children under the age of 11 are required to produce their Hong Kong Identity Cards or Hong Kong Birth Certificates (if they do not hold Hong Kong Identity Cards) when they seek treatment at designated facilities.

Q3

My spouse and children do not normally live in Hong Kong nor do they have Hong Kong Identity Cards or Hong Kong Birth Certificates. Can they seek free medical treatment in Hong Kong?

A3

For dependants who are not normally resident in Hong Kong and who do not hold Hong Kong Identity Cards or Hong Kong Birth Certificates (for dependent children under the age of 11), free medical treatment will be provided subject to verification of eligibility through the ECS or presentation of a valid treatment application form, production of proof of identity (such as valid travel documents containing personal particulars (bearing the same date of birth and Official English name as kept in Treasury's Central Payroll Related Database (CPRD) or other departmental records) and photograph, including passports, One-way Permits issued by the People's Republic of China, Exit-entry Permits issued by the People's Republic of China, etc.) and proof of legitimacy of presence in Hong Kong (for example, visa endorsement on travel document subject to the limit of stay not having expired). Dependants who are allowed to enter into a recognizance under the Immigration Ordinance (Cap. 115) are not regarded as satisfying this condition and are therefore not eligible for civil service medical and dental benefits.

Q1

Do the HA specialist clinics only accept referrals by government doctors and not those by private doctors?

A1

In accepting referrals, the specialist clinics under the HA do not differentiate between referrals from private doctors and those from public doctors.

Q2

Why do I need to pay the charge for treatment at the private clinics in the HA hospitals?

A2

Civil service eligible persons are entitled to free consultation and treatment at the HA hospitals and clinics, except for payment of hospital maintenance fees in hospitals. They, like members of the public, are treated by a team of doctors and will not be assigned specific doctors. However, there are certain hospitals where arrangements are available for patients to choose to see individual doctors as their "private patients". As private patients, they will have to pay for consultation, medicines, etc. Since these are not civil service benefits, civil service eligible persons need to pay the charge for treatment at these private clinics.

Q1

Is there any limit on the amount of medical expenses to be reimbursed to an applicant?

A1

The Government will reimburse the medical expenses incurred on drugs / equipment / services to the applicants as long as the criteria set out in Civil Service Bureau (CSB) Circular No. 2/2013 are fully met.

On reimbursement of expenses on medical equipment, the existing policy is that unless the attending HA doctor has certified that a specific or a more sophisticated model of the equipment is required, only the costs of the basic model will be reimbursable. For Continuous Positive Airway Pressure machines, please refer to the detailed note setting out the reimbursement arrangements, including the maximum rate for a basic model.

Q2

Civil service eligible persons will not be reimbursed the medical expenses incurred if they procure services from outside that are available in HA. Is there any list of such services provided by HA?

A2

An exhaustive list on the services available in HA is not available. In case of doubt, you are advised to contact the Medical Reimbursement Section, Finance and Supplies Division of the Department of Health (DH) for advice before procuring the items outside. Some examples on diagnostic services that are available in HA are given below –

• Computed Tomography (CT) scan
• Magnetic Resonance Imaging (MRI) scan
• Ultrasound examination
• Positron emission tomography (PET)^Note

Please note that enhanced diagnostic services are available at Block G Imaging Centre at Queen Elizabeth Hospital for the exclusive use of civil service eligible persons. Civil service eligible persons who already have a scheduled appointment for general CT/MRI/mammogram/ultrasound services at their attending HA hospitals and do not need to be hospitalised for receiving the required services may contact the Block G Imaging Centre to check whether an earlier appointment could be scheduled for receiving the service at the Imaging Centre. Civil service eligible persons are reminded that they should continue to book the required services at their attending HA hospitals first.

Please also note that imaging services provided by local universities or Tung Wah Group of Hospitals Computed Tomography Imaging Centre, etc. are not reimbursable.

Note:

Q3

I have been prescribed drugs / equipment / services (e.g. cataract surgery, CT scan, and MRI scan, etc.) by a registered private medical practitioner. Could I claim for reimbursement of the drugs / equipment / services procured?

A3

The reimbursement arrangement does not apply if civil service eligible persons seek medical treatment from private facilities or procure medicines from private dispensaries on their own accord, even in cases of emergency. If a private medical practitioner provides a referral letter for the civil service eligible person and the patient’s case is taken over by HA, the treatment / services thereafter prescribed by the attending HA doctor will be reimbursable subject to the criteria and procedures set out in CSB Circular No. 2/2013.

Q4

The attending HA doctor may indicate that private treatment / diagnostic services are available. In that case, could I claim for reimbursement of medical expenses for procuring the private medical service?

A4

HA provides comprehensive medical services to its patients and only few medical treatment / diagnostic service will not be available in HA. You may contact the Medical Reimbursement Section, Finance and Supplies Division of DH for advice before procuring the items outside.

Under the existing reimbursement policy, if a civil service eligible person procures medical service which is available in HA from outside, even in cases of emergency or based on information provided by the attending HA doctor, the medical expenses so incurred will not be reimbursed. DH will not process any such claims, even if the attending HA doctor provides the certification on the application FORM B.

Q5

The attending HA doctor prescribed drugs for me to be obtained in HA’s pharmacy. Could I purchase those items in community pharmacies and then seek reimbursement of the medical expenses incurred?

A5

Civil service eligible persons will not be reimbursed the medical expenses on the purchase of drugs from outside if the drugs are available from the pharmacy at the attending HA facility.

Q6

Could I seek reimbursement for hospital maintenance fees?

A6

Civil service eligible persons will not be reimbursed hospital maintenance fees payable to HA hospitals. According to Civil Service Regulation (CSR) 920, officers and their dependants are charged for maintenance in hospitals under the auspices of HA. The daily hospital maintenance fees charged, which are set out at Annex 6.1 of CSRs, are lower than the charges for the public.

Q7

I attended a certain HA clinic before and was prescribed a drug that I found effective for my (chronic) condition and I was able to claim for reimbursement. Could I request the same drug to be prescribed to me (for the same condition) if I attended a different/new HA clinic and seek reimbursement for the drug?

A7

Drug prescriptions are provided by the HA attending doctor based on his/her clinical judgment of the patient’s clinical conditions at the time. As patient’s clinical conditions may change over time, whether the same drug would be prescribed to the same patient would depend on the HA attending doctor’s clinical judgment of the patient’s conditions at the time. In any case, certification on the claimant’s reimbursement form should be a clinical decision. As long as the drug was prescribed on medical ground, a civil service eligible person may claim for reimbursement, subject to the criteria and procedures set out in CSB Circular No. 2/2013.

Q8

Could I seek reimbursement for medical expenses paid by health care voucher issued under the “Elderly Health Care Voucher Scheme” and/or consumption voucher issued under the “Consumption Voucher Scheme”?

A8

Civil service eligible persons will not be reimbursed the medical expenses, wholly or partly, paid by health care voucher issued under the “Elderly Health Care Voucher Scheme” and/or consumption voucher issued under the “Consumption Voucher Scheme”.

Q1

Can I visit another dental clinic for dental appointment? How can I obtain information about the waiting time of dental clinics?

A1

If you wish to switch to another clinic for recall appointments, please ring up individual clinics first to ascertain the current waiting time for recall appointments (you may refer to the timetable of dental clinics for telephone numbers of all dental clinics).  After identifying a "designated" dental clinic, you may inform the counter staff of the original attending clinic in person or by phone, who will arrange to transfer your records to the "designated" clinic.  The counter staff will contact you in due course for arranging the appointment at the "designated" clinic.

After the routine check-up, further dental appointments will be given to clients who require follow-up treatment.  A list showing the approximate waiting time for follow-up appointments is displayed at all dental clinics for clients' information.

Q2

How to get a dental emergency treatment?

A2

There is no need for advance booking. To ensure that appropriate treatment can be rendered within the same session, report to your own clinic at around 8:45 a.m. or 2:00 p.m. Be prepared to wait as treatment can only be given in between the scheduled appointments.

Q1

Can non-civil service contract staff join the Voluntary Medical Insurance Scheme for Civil Servants?

A1

In view of the requests from some departments, the Standing Committee on Medical and Dental Facilities for Civil Servants has agreed that the carriers of the Scheme should be allowed to extend their plans to cover non-civil service staff and their eligible dependants. The Scheme has now been renamed "Voluntary Medical Insurance Scheme for Civil Servants and Non-Civil Service Staff".

Q1

I have participated in the "Colorectal Cancer Screening Programme" of DH and paid medical expenses on top of government subsidy. Could I claim reimbursement for the relevant expenses?

A1

The "Colorectal Cancer Screening Programme" (the Programme) launched by DH is a government-subsidised health screening. The screening pathway comprises two stages. Eligible persons will first make an appointment with a primary care doctor participating in the Programme and then enroll into the Programme to undergo a Faecal Immunochemical Test (FIT). If the FIT result is positive, the Government will subsidise the participant to receive colonoscopy by referral. For details of the Programme, please refer to the DH's "Prevent Colorectal Cancer" webpage (http://www.colonscreen.gov.hk).

As the FIT is a preventive screening, if civil service eligible persons participating in the Programme pay medical expenses on top of the government subsidy due to the FIT, they will not be reimbursed by the Government for the expenses.

For the colonoscopy referred under the Programme, participants can opt for referral to the colonoscopy specialists enrolled in the Programme, to other private doctors, or to HA. As the examination can be conducted in HA, if civil service eligible persons participating in the Programme opt to receive the service from private doctors and incur any medical expenses, or opt to receive the service from the colonoscopy specialists enrolled in the Programme and pay medical expenses on top of the government subsidy, they will not be reimbursed by the Government for the expenses.

Q1

I have participated in the "Pilot Scheme for Supporting Patients of the Hospital Authority in the Guangdong-Hong Kong-Macao Greater Bay Area ".  Do I have to pay Renminbi (RMB) 100 to the University of Hong Kong – Shenzhen Hospital (HKU-SZH) as consultation fee per visit?

A1

The Government launched the "Pilot Scheme for Supporting Patients of the Hospital Authority in the Guangdong-Hong Kong-Macao Greater Bay Area " (the Pilot Scheme) on 10 May 2023 to facilitate eligible Hong Kong citizens residing in the Greater Bay Area to address their medical need for their chronic diseases and receive subsidised medical consultations at the HKU-SZH.  The Pilot Scheme has been extended to operate up to 31 March 2025.  Patients with chronic disease having appointments with the designated Special Outpatient Clinics and General Outpatient Clinics of HA would be eligible to receive subsidised consultation sessions at designated Outpatient Medical Centers of HKU-SZH. 

Under the Pilot Scheme, civil service eligible persons are entitled to be waived the RMB 100 consultation fee per vist, and the rest of the medical fees are subsidised under the Pilot Scheme.  Each eligible patient will have subsidy amount of RMB 2,000 during the extension period of the Pilot Scheme for use up to 31 March 2025.  Fees beyond the subsidy amount should be paid by the patients to HKU-SZH directly.

Details of the extension of the Pilot Scheme will be uploaded to the website of the HKU-SZH later for public reference.