|
Commonly Asked Questions on Medical and Dental Benefits
Medical and Dental Benefits Eligibility Checking System
| 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.
|
Charges for Public Health Care Services
|
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 revised GF 181 (in pink) (for civil servants and their eligible dependants), or revised Try. 447 (in brown) (for retired civil servants and their eligible dependants).
If their eligibility cannot be confirmed through the ECS and no revised GF 181 or revised Try. 447 can be produced on spot, they should advise the Registration Counter, obtain a payment advice and return a valid revised GF 181 or revised 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 revised GF 181 or revised 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 revised GF 181 or revised 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 in HA hospitals apply to persons eligible for civil service medical and dental benefits and such fees will not be reimbursed by the Government.
|
Proof of Identity at Clinics and Hospitals
| Q1 |
The A&E departments in HA hospitals accept valid revised GF 181 or revised 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.
|
Services Provided by the HA
| 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.
|
| Q3 |
If the civil service eligible persons attend HA hospitals / clinics, can they claim reimbursement from the Government?
|
| A3 |
Under existing policy, reimbursement may be made for drugs, equipment and services which form an essential part of the medical treatment as prescribed by the attending HA doctors on medical grounds but are either not available in HA or are chargeable by the HA. For the purpose of reimbursement of medical expenses incurred by civil service eligible persons, the attending HA doctors may provide the required certification if the drugs / equipment / services are:-
-
prescribed on medical grounds (excluding lifestyle items that are not required out of the medical necessity of the patient but as a matter of personal convenience or preference, or items not related to treatment of ailment); and
- without alternative treatment of equivalent efficacy available in HA free of charge; or if such is available, patients do not respond well clinically to the alternative treatment.
This reimbursement arrangement does not apply to the following situations:
-
the purchase of drugs / equipment / services (except self-financed drugs under the Hospital Authority Drug Formulary which are prescribed according to the criteria set out in the above paragraph) from outside if the items are available in HA (whether chargeable or not);
-
the 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; or
-
the civil service eligible persons consult an individual HA doctor or a member of the teaching staff of a university, and obtain drugs / equipment / services as his/her private patients.
|
| Q4 |
At present, certain special medical items need to be purchased privately by patients. For civil service eligble persons, they need to seek reimbursement from the Department of Health (DH) afterwards. Can the HA hospitals provide the items to civil service eligible persons direct so that they don't need to seek reimbursement subsequently?
|
| A4 |
At present, a direct payment arrangement is in place between the Government and HA for percutaneous transluminal coronary angioplasty (PTCA) cases, intraocular lens procedures, non-PTCA consumables for interventional cardiology and positron emission tomography (PET) service. Under this arrangement, HA purchases the required items on behalf of the patients. Civil service eligible persons may complete the application form for HA to settle the payment with DH direct. In such case, the civil service eligible persons concerned are not required to make advance payment to HA before the procedures.
|
Dental Treatment
| Q1 |
The waiting time for dental appointment at the dental clinic I visit is very long. Can I visit another dental clinic with a shorter waiting time? How can I obtain information about which dental clinics have shorter waiting time?
|
| A1 |
The waiting time for recall appointment (i.e. routine check-up) for most dental clinics is kept within 12 months. If you wish to switch to another clinic for recall appointments, you may first ring up individual clinics to ascertain the current waiting time for recall appointments (you may refer to the clinic 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 arrangement of appointment at the "designated" clinic.
After the rountine check-up, further dental appointments will be given to clients who require follow-up treatment. A list showing the approximate waiting time for such dental 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.
|
Voluntary Medical Insurance Scheme
| 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".
|
|
