Civil Service Medical and Dental Benefits
The Government, as the employer of civil servants, has a contractual obligation to provide civil service medical and dental benefits.
In general, civil service eligible person (CSEPs) are entitled to medical and dental treatment and services that are provided by the Department of Health (DH) or the Hospital Authority (HA) free of charge, save for the charges applicable to hospital maintenance, dentures and dental appliances as provided for in the Civil Service Regulations (CSRs).
CSEPs may also apply to DH for reimbursement/ direct payment of medical expenses if the attending HA/DH doctors certify that the drugs, equipment and services concerned are prescribed as medical necessity, and are chargeable by HA or not available in HA/DH.
As set out in the CSRs, the following persons are eligible for medical and dental benefits:
- monthly paid officers and their families Note ;
- daily rated staff who are injured in the course of their duty (for medical treatment only);
- retired Government officers living in Hong Kong and in receipt of a pension or an annual allowance and their families Note living in Hong Kong;
- families Note of officers killed on duty and living in Hong Kong; and
- families Note living in Hong Kong and in receipt of a pension under the Widows' and Orphans Pension Scheme or Surviving Spouses' and Children's Pensions Scheme following the death of officers while in service or after retirement.
The Medical and Dental Benefits Eligibility Checking system (ECS) has been fully rolled out since 30 June 2008. CSEPs who are covered by the ECS only need to advise counter staff of the designated facilities that they are eligible for civil service medical and dental benefits, and produce valid proof of identity (e.g. Hong Kong Identity Card, Hong Kong Birth Certificate) for inspection when they seek treatment at the designated facilities. The counter staff will verify their eligibility through the ECS.
CSEPs who are not covered by the ECS will need to present a valid G.F. 181 (for civil servants and their eligible dependants) or Try. 447 (for retired civil servants and their eligible dependants) and produce valid proof of identity to counter staff when they seek treatment at the designated facilities.
Eligible persons will be provided with civil service medical benefits only if their eligibility is confirmed through the ECS or G.F.181/Try. 447 as appropriate. Hospital/clinic staff are not under any obligation to provide civil service medical benefits to individuals whose eligibility cannot be confirmed. (Special arrangements are provided for accident and emergency (A&E) services in HA hospitals. Eligible persons may request deferred payment at the A&E Department. They should advise the Registration Counter, obtain a payment advice and return a GF 181 together with the payment advice to the Accounts Office by post or to the Main Shroff in person as soon as possible). If eligible persons whose eligibility cannot be confirmed pay the requisite fees, refund is generally not allowed even if their eligibility is confirmed afterwards or they produce a G.F. 181 subsequently.
It is the officers' responsibility to report promptly to departmental management their own and their eligible dependants' personal particulars on first appointment and upon changes in such particulars as and when they arise, in order that departmental management can arrange timely updating in the departmental records and / or Treasury's Central Payroll Related Database (or electronic template). In particular, officers are reminded to update information on full-time education or vocational training of their dependent children at the age of 19 or 20 as the ECS will automatically exclude all dependent children once they reach the age of 19. If an officer fails to report changes in personal particular, thus resulting in the provision of civil service medical benefits (including reimbursement / direct payment of medical expenses) to ineligible persons, the officer concerned will be held liable for payment of unpaid charges and recovery of over-paid benefits. Disciplinary action and / or legal proceedings may also be instigated.
HA provides outpatient medical services to CSEPs alongside members of the public through its network of general out-patient clinics (GOPCs) and specialist out-patient clinics (SOPCs) throughout the territories. Inpatient services at concessionary rates and free A&E services are also provided by HA hospitals to CSEPs.
GOPCs in HA are providing general outpatient services to the general public including CSEPs.
CSEPs are entitled to free medical treatment at HA's GOPCs, subject to the availability of quota, verification of eligibility through the ECS or presentation of a valid G.F. 181 or Try. 447, and production of valid proof of identity by CSEPs. Discs are issued at GOPCs to indicate the order and time of consultation.
A number of priority discs are reserved for serving civil servants during normal day sessions, at the beginning of the morning and / or the afternoon session at most of the GOPCs (except Sundays and public holidays). Priority discs are also reserved in clinic sessions in the evening from Monday to Friday (except public holidays) in Tuen Mun Clinic (TMC) under a pilot scheme. The main purpose of giving civil servants priority treatment is to enable them to return to work, if considered fit, as early as possible in order to maintain normal workforce. Hence, no priority discs will be given to pensioners, or eligible dependants of civil servants or pensioners.
In general, the registration hours for the civil servants priority discs at the GOPCs are from 8:45 a.m. to 9:30 a.m. for the morning session and from 1:45 p.m. to 2:30 p.m. for the afternoon session, except for a few GOPCs in remote areas Note . Any unused priority discs after 9:30 a.m. and 2:30 p.m. respectively will be released to members of the public. This notwithstanding, civil servants who turn up at the GOPCs after 9:30 a.m. and 2:30 p.m. respectively will be attended to provided that the number of priority discs given to civil servants during the session has not exceeded the stipulated priority discs quota.
Advance booking of priority discs by telephone is also available for serving civil servants at selected clinics. This can be made only for the day on which appointments are made and does not apply to clinic sessions which operate outside normal working hours, i.e. in the evenings, on Sundays and on public holidays.
The number of priority discs varies amongst clinics. It may also vary on different days depending on the actual circumstances of the days. Civil servants can check with the registration counter or telephone the general enquiry number of GOPCs to check whether the relevant priority discs are still available. As a general reference, civil servants may refer to the table on a rough indication on the utilisation of priority discs in GOPCs. The table will be updated at regular intervals.
If all priority discs are given out on a day, civil servants may make telephone booking for a public disc in the same manner as members of the public and receive free treatment. In the case of emergency, CSEPs, like the public, may approach the nursing officer of a GOPC in person. The nursing officer may arrange for earlier medical attention according to the medical condition of the patient.
Pilot scheme for provision of priority discs in the evening session of TMC
Starting from 3 July 2018, TMC Note provides five priority discs for serving civil servants in its evening session each day from Monday to Friday (except public holidays). The consultation hours of the evening session of TMC are from 6:00 p.m. to 10:00 p.m. and the registration hours for the civil servant priority discs in the evening session are from 5:45 p.m. to 6:30 p.m. Any unused priority discs after 6:30 p.m. will be released to members of the public. Serving civil servants who turn up at TMC after 6:30 p.m. will, however, not be attended to under the pilot scheme even if the stipulated priority discs quota for serving civil servants of that evening session has not been exhausted.
SOPCs in HA are providing specialist outpatient services to the general public including CSEPs. All attendances at SOPCs should be made by appointments. A CSEP who has obtained a doctor's referral from a public or private clinic may make an appointment at HA’s SOPC. Subject to the verification of eligibility through the ECS or presentation of a valid G.F. 181 or Try. 447, and production of valid proof of identity by CSEPs, CSEPs are entitled to free medical service when they attend the scheduled appointment at HA’s SOPCs. However, private clinic services in HA are outside the scope of civil service medical and dental benefits. CSEPs opted for HA's private clinic services have to bear the related medical expenses by themselves.
Apart from the SOPCs providing services to CSEPs and the general public, the following dedicated services are available for the exclusive use of CSEPs.
L Block of QEH provides eight general specialty services including family medicine, gynaecology, medicine, neurosurgery, obstetrics, orthopaedics & traumatology, paediatrics, and surgery for the exclusive use of CSEPs. A CSEP who has obtained a doctor's referral from a public or private clinic may approach the L Block of QEH (Tel. No.: 3506 6123). CSEP patients first visiting L Block of QEH will be triaged having regard to their medical condition. For urgent and semi-urgent cases or where sub-specialty service is required, patients will be referred to the relevant specialty of the SOPCs (or sub-specialist outpatient clinics) of QEH for follow-up alongside the general public. For the remaining CSEP patients (i.e. those who have not been referred to other specialist clinics and the general specialty service required is available thereat), they would be given an appointment in the L Block of QEH.
A dedicated SOPC for the exclusive use of CSEPs, namely 9HSC at PWH, has commenced service with effect from 26 March 2012. It provides general SOP services in seven specialties including ear nose & throat, family medicine, gynaecology, medicine, orthopaedics & traumatology, paediatrics & adolescent medicine, and surgery. A CSEP who has made an appointment for first consultation at an HA SOPC (other than the Saturday SOP (SSOP) clinic at QMH) may approach 9HSC (Tel. No.: 3505 4154) to see if an earlier appointment in the relevant specialty is available at 9HSC. If an appointment date at 9HSC is accepted by a CSEP, the CSEP’s case will be managed by 9HSC until the date of the original SOP appointment. Related administrative details are set out in the detailed note, and a gist is available in the leaflet.
Extra SOP services sessions for the exclusive use of CSEPs are also available on Saturday morning at QMH with effect from 1 September 2012, providing general SOP services. At present, two specialties (i.e. medicine and surgery) are available. A CSEP who has made an appointment for first consultation at an HA SOPC (other than 9HSC in PWH) may approach the QMH SSOP Clinic (Tel. No.: 2872 0155) to see if an earlier appointment in the relevant specialty is available at the SSOP Clinic. If an appointment date at SSOP Clinic is accepted by a CSEP, the CSEP's case will be managed by QMH SSOP clinic until the date of the original SOP appointment. Related administrative details are set out in the detailed note, and a gist is avaialble in the leaflet.
The Block G Imaging Centre at QEH for the exclusive use of CSEPs commenced services on 3 January 2011. The Centre provides general Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and ultrasound scanning services for CSEPs in addition to the existing imaging services provided at HA hospitals. The Centre has also provided general mammographic service for the exclusive use of CSEPs with effect from 4 March 2019. CSEPs (CSEP outpatients of the designated Kowloon Central Cluster hospitals who require CT/MRI/ultrasound services will be automatically arranged to attend the Block G Imaging Centre for the required examination) who already have a scheduled appointment for general CT/ MRI/ ultrasound/ mammographic 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 (Tel. No.: 3506 5711) to check whether an earlier appointment could be scheduled for receiving the service at the Block G Imaging Centre. CSEPs may refer to note (1) for the detailed arrangement regarding general CT, MRI and ultrasound scanning services and note (2) for the detailed arrangement on general mammographic service. A gist is available in the leaflet. The waiting time of the respective diagnostic services provided in the Centre will also be updated regularly for CSEPs' information.
Inpatient services at concessionary rates are provided by HA hospitals to CSEPs. CSEPs may apply for private/special accommodation beds which will be subject to the availability of the class of beds requested and the clinical conditions of CSEP patients as advised by the attending HA doctors.
Arrangement for Wives of Civil Servants or Pensioners Not Normally Residents in Hong Kong to Receive Obstetric Services in Hong Kong
Starting from 1 February 2007, women from the Mainland of China who have been pregnant for seven months or more are required to produce the original of the Confirmation Certificate issued by either HA or private hospitals upon entry at immigration control points to prove that they have confirmed antenatal and delivery booking at a hospital in Hong Kong. Failing this, they might be denied entry and might be repatriated.
Eligible dependants (including wives) of civil servants or pensioners, even not residing in Hong Kong and do not hold Hong Kong Identity Cards, are eligible for civil service medical benefits in Hong Kong. In the light of the new measure mentioned above, wives of civil servants or pensioners, who are not holding Hong Kong Identity Cards and wish to obtain obstetric services from HA in the capacity of CSEPs, are reminded to -
- book HA obstetric services in advance at the HA hospital where they intend to deliver; and
- obtain the Confirmation Certificate from the HA hospital, which is required for entry into Hong Kong at late pregnancy.
These CSEPs will have the same access to HA obstetric services as local pregnant women, subject to verification of their CSEP status. The obstetric charges for non-Hong Kong residents do not apply to them. Upon admission to HA hospitals, they will be charged at prevailing hospital maintenance rates as set out in CSRs.
DH provides families clinic and dental clinic services to CSEPs as well as processing their applications for reimbursement of medical expenses.
DH operates 6 families clinics, 1 in Kowloon, 2 on Hong Kong Island and 3 in the New Territories. Families clinic will allocate same-day appointment, advanced appointment (within seven working days) and re-appointment to CSEPs as appropriate. They receive telephone bookings at 8:00 a.m. from Monday to Friday.
CSEPs can make appointments through the Automated Telephone Booking System (ATBS), in addition to calling at individual clinics direct. The ATBS operates round-the-clock at 3950 9600 and provides booking service in Cantonese, Putonghua and English. CSEPs can call at any time to choose a families clinic for making appointments for the next 24 hours or the next seven working days. CSEPs who have successfully made an appointment through the ATBS can make enquiries of or cancel the appointment through the system. Details of the appointment flow are set out in the flow chart.
DH operates 40 Government dental clinics to provide general dental services for CSEPs, including routine check-up, scaling and filling etc. For better treatment and use of resources, CSEPs should select one dental clinic for receiving the services concerned.
Individual dental clinics provide services during extended operating hours. CSEPs should contact their attending dental clinics for details and make prior appointment before visiting the specified dental clinic during the extended operating hours.
CSEPs using dental services for the first time should contact DH by phone (Tel. No.: 2892 2577) for making appointments. Recall appointments for routine check-ups will be arranged after the completion of treatment. Please attend the check-ups according to the date and time on the appointment card.
For those CSEPs who require follow-up treatment after routine check-ups, their waiting time for such dental appointments varies from time to time and from clinic to clinic. CSEPs could make reference to the waiting time for dental appointment for follow-up treatment displayed at the dental clinics, and he/ she should contact the individual dental clinic to obtain the exact date of appointment available. For CSEPs who wish to switch to another dental clinic, they could approach their attending dental clinic for the details and follow-up arrangement.
Notwithstanding the comprehensive scope of services provided by HA, there may be occasions where the required drugs/ equipment/ services which form an essential part of the medical treatment as prescribed by the attending HA doctor on medical grounds are either chargeable by HA, or not available in HA. Under such circumstances, a CSEP may procure them from HA, or from outside (only when the required drugs/ equipment/ services are not available in HA), and then apply to DH for reimbursement of medical expenses or direct payment in respect of specified items.
A summary of the coverage of the reimbursement programme and the relevant application form is provided below:
Note: Must be prescribed on medical grounds
|Through direct payment
from DH to HA
For reimbursement of expenses on medical equipment, the prevailing 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 cost of the basic model will be reimbursable. Specifically, 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.
The reimbursement programme is also applicable in cases where an attending DH doctor prescribes drugs which form an essential part of the medical treatment to the CSEP on medical grounds and the drugs are not available in the pharmacy of the attending DH clinic. For such cases, a CSEP concerned may apply to DH for reimbursement of medical expenses incurred on the drugs. The application FORM B is also applicable for this purpose.
The application FORM A should be used for applying for direct payment arrangement for drugs which are available at the pharmacy of the attending HA facility, prescribed on medical grounds and chargeable by HA (except lifestyle drugs).
The CSEP should present the drug prescription obtained from the attending HA doctor to the pharmacy at the attending HA facility to obtain an invoice. For hospital in-patients, invoice(s) will be provided by ward staff. The duly completed FORM A together with the invoice issued by the pharmacy should be submitted by the CSEP to the shroff office of the attending HA facility. Upon checking the patient's eligibility for civil service medical benefits, the shroff will issue a receipt to the CSEP for presenting to the ward/ pharmacy in order to obtain the prescribed drugs. The CSEP will not be required to make any payment out-of-pocket. It should be noted that the CSEP will no longer be provided with an invoice for retention.
For each episode of hospitalisation in the same hospital, a CSEP in-patient is only required to submit one application. For CSEPs using outpatient services, including patients who have been discharged from hospital, a fresh application should be submitted for each round of prescription. The CSEP attending the medical consultation is advised to bring along a FORM A, duly completed and signed by the applicant (i.e. civil servant or pensioner), for use if necessary.
The stock of drugs varies from facility to facility under HA. If the prescribed drug(s) shown in the attending HA doctor's prescription is/are available from the pharmacy of the attending HA facility, CSEPs must obtain the drugs from that pharmacy. In such cases, DH will not arrange reimbursement to any CSEP who buys the prescribed drug from an outside pharmacy.
Please refer to the flow chart for the steps for applying for direct payment from DH for drugs provided by the pharmacy at the attending HA facility. Separately, please note the salient points for application for direct payment using FORM A.
Application for Reimbursement / Direct Payment of Medical Expenses (except drugs provided by the HA)
The application FORM B should be used for applying for-
- (i) direct payment of medical expenses for specified equipment/services provided by HA;
- (ii) reimbursement of medical expenses for other chargeable equipment/services provided by/through HA; and
- (iii) reimbursement of medical expenses for drugs/equipment/services not available at HA.
i. Direct payment of medical expenses from DH for specified equipment/ services provided by HA
Provided that the equipment / services are prescribed on medical grounds, CSEPs are also not required to pay out-of-pocket for the following equipment / services provided by HA which are covered under the direct payment arrangement:
- percutaneous transluminal coronary angioplasty (PTCA) cases;
- intraocular lens procedures;
- non-PTCA consumables for interventional cardiology; and
- positron emission tomography (PET) service.
Unless otherwise advised by the attending HA facility concerned, the completed FORM B should be submitted to the shroff office of the attending HA facility before the equipment/service is provided.
ii. Reimbursement of medical expenses for other chargeable equipment/services provided by/through HA, and
iii. Reimbursement of medical expenses for drugs/equipment/services not available at HA
For reimbursement of medical expenses for other chargeable equipment/services provided by/through HA and for drugs/equipment/services not available at HA, applicants should complete and submit the original application FORM B and supporting documents to the Medical Reimbursement Section, Finance and Supplies Division of DH (Unit 1107-1108, 11/F, 248 Queen’s Road East, Wan Chai, Hong Kong) (including original itemised bill/receipt(s), photocopy of the drug prescription issued by the HA attending doctor and any other relevant documents) within three months of procurement of the item(s).
Please refer to the flow chart for the steps for applying for direct payment or reimbursement using FORM B. Separately, please note the salient points for application for reimbursement/ direct payment of medical expenses using FORM B.
Items that are not reimbursable
CSEPs should note that no reimbursement will be provided in the following situations -
- the drugs / equipment / services are not prescribed on medical grounds (e.g. lifestyle drugs);
- the drugs procured from outside are available at the pharmacy of the attending HA facility (regardless of whether the drugs are chargeable by HA), even in cases of emergency;
- the equipment / services procured from outside are available in HA (regardless of whether the equipment / services are chargeable by HA), even in cases of emergency and irrespective of whether the attending doctor has provided medical certification;
- drugs / equipment / services are procured from private facilities on the CSEP's own accord, even in cases of emergency; and/or
- medical consultation, drugs, equipment and/or services pursuant to a consultation with an individual HA doctor or a member of the teaching staff of a university in the CSEP's capacity as the attending doctor's private patient, even in cases of emergency.
CSEPs may download the following forms for use:
Civil servants may approach the administrative unit of their bureau/department for copies of the forms. Pensioners who require forms may contact the Pensions Section of CSB by phone (at 2810 3850) or by email (firstname.lastname@example.org). Separately, a limited quantity of the application forms is available at the shroff of major HA hospitals.
For enquiries concerning processing of applications and related payment and accounting arrangements, please contact the Medical Reimbursement Section, Finance and Supplies Division of DH (at 3107 3415 or 3107 3417; or by email at email@example.com).
Reimbursement of Co-payment under HA's Pilot Public-Private Partnership Scheme in Cataract Surgeries
HA has launched a pilot public-private partnership scheme in cataract surgeries. Patients with the longest waiting time on HA central waiting list and suitable for local anaesthesia cataract surgeries will be invited to participate in the scheme on a voluntary basis. Under the scheme, patients may choose to have the cataract surgery performed by a private ophthalmologist. CSEPs will also be invited by HA to participate in the scheme as other public patients, in accordance with the selection criteria. If they agree to participate in the pilot scheme, they will be subject to co-payment of not more than $8,000 to the private ophthalmologist, while the latter will receive the fixed subsidy of $5,000 from HA. CSEPs may apply to DH for reimbursement of co-payment. Details of the pilot scheme (including the list of private ophthalmologists participating in this scheme) are available at the HA website. CSEPs may refer to the detailed note setting out the arrangement for reimbursement of co-payment under the scheme.
HA has launched a Colon Assessment Public-Private Partnership Programme. Patients who are currently on the waiting list for colonoscopy in HA hospitals, classified as stable cases, and fit for home bowel preparation and colonoscopy under an ambulatory setting will be invited by HA to enrol to the programme on a voluntary basis. Patients do not need to apply by themselves. Under the programme, patients may choose to have the clinical assessment, colonoscopy and post-procedural explanation and management performed by a private specialist participating in the programme. CSEPs will also be invited by HA to participate in the programme as other public patients, in accordance with the selection criteria. If they agree to participate in the programme, they will be subject to co-payment of not more than $2,000 to the private specialist, and the latter will receive a fixed subsidy from HA. CSEPs may apply to DH for reimbursement of co-payment. Details of the programme (including the list of private specialists participating in this programme) are available at the HA website. CSEPs may refer to the detailed note setting out the arrangement for reimbursement of co-payment under the programme.
Please click here for some commonly asked questions.
For serving civil servants, enquiries concerning civil service medical and dental benefits should be addressed to Departmental Secretaries. If Departmental Secretaries themselves are in doubt, they may contact Executive Officer (Conditions of Service)1 at 2810 3079 or Senior Executive Officer (Conditions of Service)1 at 2810 3082. For pensioners, they may contact the Pensions Section of CSB at 2810 3850 or the Pensions Enquiry Office of the Treasury at 2829 5113 or 2829 5114.
Voluntary Medical Insurance Scheme for Civil Servants and Non-Civil Servants Employed by the Government
In 1996, the Standing Committee on Medical and Dental Facilities for Civil Servants introduced a Voluntary Medical Insurance Scheme for Civil Servants. The Scheme serves as a supplement to the existing civil service medical and dental benefits for serving civil servants and their eligible dependants by providing an option for officers to take out medical insurance for themselves and their families. Participation in the Scheme is entirely voluntary and would not affect the eligibility of CSEPs for medical and dental benefits provided by the Government. Since October 2002, non-civil servants employed by the Government and their dependants may also participate in the Scheme. All officers and their eligible dependants who join the Scheme are required to pay the full premium.
The Working Group on Voluntary Medical Insurance Scheme for Civil Servants and Non-civil Servants Employed by the Government (VMIS), comprising representatives from the Staff Sides of the Disciplined Services Consultative Council, the Model Scale 1 Staff Consultative Council, the Police Force Council and the Senior Civil Service Council, has selected in 2022 the following eleven companies to be carriers of the Scheme for one year effective from 1 July 2022 (with schedule of surgical operations for reference). Please click here for a list of VMIS plans that are certified plans under Voluntary Health Insurance Scheme.
|Since||Name of Company||Hotline||Schedule of Surgical Operations (Schedule)
(for reference only, please contact individual insurance company for details)
|1996||BUPA (Asia) Ltd||2517 5922||Schedule (PDF Format)|
|1998||Blue Cross (Asia-Pacific) Insurance Ltd||3608 2966||Schedule (PDF Format)|
|2000||AIG Insurance Hong Kong Limited (formerly Chartis Insurance Hong Kong Ltd)||3666 7015||Not applicable|
|2009||Zurich Insurance Company Ltd||2903 9372|| Hyperlink to Zurich's dedicated
Assicurazioni Generali Societa per Azioni
form and brochure (PDF format)
|3187 6827||Not applicable|
|2015||Bank of China Group Insurance Company Ltd
form and brochure (PDF format)
|3187 5100||Schedule (PDF Format)|
|2018||China Taiping Insurance (HK) Company Ltd||3716 1616||Hyperlink to China Taiping’s dedicated website|
|2018||Cigna Worldwide General Insurance Company Ltd||8100 6162||Schedule (PDF Format)|
|2019||AIA International Ltd||3108 1718||Schedule (PDF Format)|
|2019||Asia Insurance Company Ltd||3606 9361||Schedule (PDF Format)|
|2021||2894 4684||Schedule (PDF Format)|