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Civil Servant Subsidy

Arrangements for Reimbursement / Direct Payment of Medical Expenses 

Reimbursement of Medical Expenses

Notwithstanding the comprehensive scope of services provided by the Hospital Authority (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 doctors on medical grounds are either not available in HA or are chargeable by HA. Under such circumstances, civil service eligible persons may apply to Director of Health (DH) for payment of such items.

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 :-

  1. 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
  2. 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.

On reimbursement of expenses on medical equipment, 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. 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.

Direct payment arrangement between the Government and HA

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, positron emission tomography (PET) service and cancer drugs provided by HA. Under this arrangement, civil service eligible persons may complete the application form for HA to settle the payment with DH direct. Civil service eligible persons concerned are not required to make advance payment to HA.

Instead of seeking reimbursement, civil service eligible persons may also apply to DH for the direct settlement of expenses with outside suppliers, provided that the requisite medical certification from the attending HA doctor and acceptance of such direct payment arrangement from the suppliers concerned have been obtained.  If an application is rejected by DH or the amount approved is less than the actual amount incurred, the civil service eligible person concerned should settle the outstanding sum with the outside supplier direct.

Items that are not reimbursable

Civil service eligible persons should note in particular that the reimbursement arrangement does NOT apply to the following situations -

  1. the purchase of drugs / equipment / services from outside if the items are available in HA (whether chargeable or not);
  2. 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
  3. 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.  

In respect of (a) above, the purchase of drugs not covered by HA's standard fees and charges is reimbursable so long as they are prescribed according to the criteria set out in the second paragraph above.

In respect of (c) above, the private service described above falls outside the scope of civil service medical benefits.  Accordingly, the medical expenses arising from the patronage of private service are not reimbursable.

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.  Civil service eligible persons 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, the latter will receive the fixed subsidy of $5,000 from HA.  Civil service eligible persons may apply to DH for reimbursement of co-payment.  Details of the pilot scheme and the list of private ophthalmologists participating in this scheme are available at the HA website at www.ha.org.hk/ppi/cataract.  Civil service eligible persons may refer to the detailed note setting out the arrangement for reimbursement of co-payment under the scheme.

Application Form for Reimbursement / Direct Payment of Medical Expenses (Except Cancer Drugs Provided by the Hospital Authority)

Application for reimbursement / direct payment of medical expenses should be made by the civil servant / pensioner.  Applicants should complete the Application Form for Reimbursement / Direct Payment of Medical Expenses (Except Cancer Drugs Provided by the Hospital Authority) and submit the completed form, together with the original itemised bill / receipt*, to DH for processing (Attn : Medical Reimbursement Section, Finance Division, Unit 1107-1108, 11/F, 248 Queen's Road East, Wan Chai, Hong Kong). For applications in respect of expenses on drugs purchased outside the HA, the applicant should attach the prescription issued by the attending HA doctor to the reimbursement application form as well. Applicants are advised to submit their applications within three months of the purchase of the medical items as far as practicable to facilitate timely processing by DH.  

(* For pensioners without Hong Kong Identity (HKID) cards and their eligible dependants without HKID cards or Hong Kong Birth Certificate (for dependent children under the age of 11), they are also required to attach a valid Try. 447 (revised 2008) to the reimbursement application form.)

Civil service eligible persons are advised, having regard to their own circumstances, to bring along the reimbursement application form as far as possible when they attend medical consultation at HA facilities for their own convenience. Arrangements have been made with HA for a limited quantity of the application forms to be placed at major HA hospitals for use by civil service eligible persons who may not have brought along a form for medical certification.

Application Form for Direct Payment Arrangement for Cancer Drugs Provided by HA

Applications for direct payment of cancer drugs provided by HA pharmacies should be made by the civil servant or pensioner under normal circumstances.  Applicants should complete the Application Form for Direct Payment of Medical Expenses on Cancer Drugs Provided by the Hospital Authority.  Civil service eligible persons who are hospitalised are only required to submit an application for direct payment of cancer drugs once within the same episode of hospitalisation in the same hospital.  For civil service eligible persons using outpatient services and civil service eligible persons who are discharged from hospitals, a fresh application should be submitted each time when cancer drug(s) is / are prescribed.  The duly completed form together with the invoice should be submitted to the shroff of HA hospitals / clinics concerned.  Upon checking the eligibility, the shroff will issue a receipt to the civil service eligible person who should present the receipt to the ward / pharmacy for obtaining the prescribed cancer drugs.  Civil service eligible persons may refer to the brief guide on the procedures for application for direct payment of cancer drugs provided by HA.

The application form may be obtained from the shroff of HA hospitals / clinics with oncology drug dispensing service and offices at major HA hospitals.

The above direct payment arrangement does not apply to cancer drugs purchased from non-HA pharmacies.  For such cases, Application Form for Reimbursement / Direct Payment of Medical Expenses (Except Cancer Drugs Provided by the Hospital Authority) should be used instead.

Pensioners

To tie in with the full roll-out of the Medical and Dental Benefits Eligibility Checking System (ECS) on 30 June 2008, pensioners covered by the ECS applying for reimbursement of medical expenses are no longer required to attach a Try. 447 to the reimbursement application form.  For those pensioners not covered by the ECS (i.e. pensioners without Hong Kong Identity cards), they should attach a valid Try. 447 (revised 2008) to the reimbursement application form.  Irrespective of whether a pensioner is covered by the ECS or not, if a retired officer whose pension or annual allowance has been suspended under the pensions legislation, he/she and his/her dependants are not eligible for civil service medical benefits and the relevant medical expenses will not be reimbursable.

Drugs Provided at DH's Families Clinics

Civil service eligible persons are entitled to free services and drugs provided at DH's families clinics as staff benefits.  Under the existing arrangement, the attending doctors of families clinics would prescribe drugs available in DH's dispensaries to civil service eligible persons having regard to their medical condition.  DH regularly reviews the list of drugs provided at its dispensaries to cater for changing service needs.  In case the attending doctor of families clinics prescribe drugs which form an essential part of the medical treatment to the patient on medical grounds but such drugs are not available in DH's dispensaries, the civil servant or pensioner concerned may apply to DH for reimbursement of medical expenses incurred on the drugs.  The Application Form for Reimbursement / Direct Payment of Medical Expenses (Except Cancer Drugs Provided by the Hospital Authority) is applicable for this purpose.

For enquiries concerning processing of applications and related payment and accounting arrangements, please contact the Medical Reimbursement Section, Finance Division of DH (2961 8612, 2961 8445 or 2961 8656). 

For pensioners, they may contact the Pensioner Services Unit of this Bureau (2810 3850) or the Treasury Pensions Enquiry Office (2829 5113 or 2829 5114).

Application Form for Reimbursement / Direct Payment of Medical Expenses (Except Cancer Drugs Provided by the Hospital Authority) (PDF Format)

Application Form for Direct Payment of Medical Expenses on Cancer Drugs Provided by the Hospital Authority (PDF Format)

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