Fees and Charges for Health Care Services

 

The Health Care Reform Consultation Document published by the Government in December 2000 set out one of the strategic directions on health care financing as to revamp the fee structure of the public health care sector to ensure the financial sustainability of the public health care system.

Given the finite resources and ever increasing costs and public demands for medical services, moderate fee revision and new fees have been introduced in the past few years. This would ensure that public funds could be channelled to assist elderly with little income and assets, chronically ill patients and lower income group, and to services which pose major financial risks to patients. The revision of fees would also ensure that the current high standard of public health care services can be maintained and that patients are provided with appropriate care.

 

Waiver Mechanism

It has always been the Government's fundamental philosophy that no one will be denied adequate medical care due to lack of means. To ensure that this principle is upheld, recipients of Comprehensive Social Security Assistance (CSSA) are waived from payment of their medical expenses of public health care services. To assist the three vulnerable groups in the community, i.e., the low income group, chronically ill patients and elderly patients who have little income or assets, who are not CSSA recipients, the medical fee waiver mechanism is in place to provide effective protection from undue financial burden to them.

The guiding principles of the waiver mechanism are: (1) Public funds should be channeled to the vulnerable groups and to services which carry major financial risks to patients; (2) There should be a set of objective and transparent criteria to assess a patient's eligibility for exemption from payment of public medical fees. Both financial and non-financial factors should be considered; and (3) The mechanism should facilitate accessibility to services while maintaining the low administrative and operating costs.

Patients who have financial difficulties in paying medical fees should approach the Medical Social Workers to apply for a waiver.

Fees Revision in Recent Years

Fees introduced on 1 April 2003

These include the admission fee for acute general hospitals, Specialist Out-patient (SOP) clinic first attendance fees, and SOPD drug charges (effective from 1 May 2003).

As more diagnostic procedures are usually conducted during the first day of hospitalisation, an additional $50 admission fee for the first day of hospitalisation is charged. The admission fee will be exempted if the patient is referred from A&E Departments.

In view of the comprehensive services, including testing and investigations, provided during the patient's first attendance at an SOP clinic and to discourage patients from making multiple SOP appointments, $100 is charged when a patient visits an SOP clinic for the first time.

Many countries charge patients for drugs and this has been proved effective in ensuring better compliance of medication use and unnecessary wastage. A nominal fee of $10 will be levied on each drug item as per prescription period. The prescription items and the duration, which usually lasts for a few days to 16 weeks, are purely clinical decisions. For example, if the prescription duration for a particular drug item is 20 weeks, the charges will be $20.  

 

Fees revised on 1 September 2005

To ensure that there is a rational basis for the allocation of HA's resources and to ensure the service priority for “eligible person” expectant mothers, the minimum obstetric package charge of $20,000 for “non-eligible person” was introduced on 1 September 2005.

Moreover, the private consultation fees were revised from fixed standard charges to pre-set ranges to reflect variations in the complexity of the patients' clinical conditions and in the expertise that might be required for treatment.  

 

Fees revised on 1 February 2007

With effect from 1 February 2007, the minimum obstetric package charge introduced on 1 September 2005 is revised to discourage undesirable behaviour of Non-Eligible Persons of delivering babies in HA hospitals with no antenatal care. The minimum obstetric package charge is $39,000 for those who have made a confirmed booking for their delivery and have undergone the antenatal checkup provided by the Hospital Authority during the pregnancy concerned (i.e. booked cases). This minimum charge is non-refundable except in those circumstances set out below where refund may be considered upon application:-

(1)       in cases involving miscarriage, termination of pregnancy or still birth, a partial refund of not more than $20,000 may be made subject to deduction of those charges for the hospital services which the patient has received for the concerned pregnancy; or

(2)       in cases involving a change in the patient’s status from a Non-Eligible Person to Eligible Person after payment of this minimum rate but before the delivery, a full refund may be made subject to deduction of those charges for the hospital services which the patient has received for the concerned pregnancy.


For patients who have not made a confirmed booking and/or have not undergone the antenatal checkup provided by the Hospital Authority during the pregnancy concerned (i.e. non-booked cases), a minimum obstetric package charge of $48,000 will be charged.

Fees & Charges

Medical services are charged as per the Gazette. Eligible Persons of public health services are holders of Hong Kong Identity Card issued under the Registration of Persons Ordinance or children under 11 years of age with Hong Kong resident status. Persons who are not Eligible Persons will be classified as Non-Eligible Persons.

Fees & Charges for Eligible Persons

Service

Fees

Accident & Emergency

$100 per attendance

In-patient (general acute beds)

$50 admission fee, plus $100 per dayN1

In-patient (convalescent, rehabilitation, infirmary & psychiatric beds)

$68 per day N1

Specialist out-patient (including allied health services)

$100 for the 1st attendance, $60 per subsequent attendance, $10 per drug item

Day procedure and treatment at Clinical Oncology Clinic and Renal Clinic

$80 per attendance

General out-patient

$45 per attendance

Dressing & Injection

$17 per attendance

Geriatric, Psychiatric & Rehabilitation day hospital

$55 per attendance

Community nursing (general)

$80 per visit

Community nursing (psychiatric)

Free

Community allied health services

$64 per treatment

 
Fees & Charges for Non-eligible Persons

Service

Fees

Accident & Emergency

$570 per attendance

In-patient (general hospitals)

$3,300 per day N1

In-patient (psychiatric hospitals)

$1,200 per day N1

Special intensive care ward/unit

$18,100 per day N1

Intensive care ward/unit

$13,900 per day N1

High dependency ward/unit

$9,800 per day N1

Nursery

$640 per day N1

Obstetrics package charge

For booked cases, include 

·    one antenatal checkup;

·    delivery / delivery care service; and

·    three days (two nights) hospitalization in a public general ward related to the delivery / delivery care service

 

For non-booked cases, includes

·    delivery / delivery care service; and

·    three days (two nights) of hospitalization in a public general ward related to the delivery


$39,000





 

$48,000

Specialist out-patient (including allied health services)

$700 per attendance

Day Procedure and Treatment at Clinical Oncology Clinic

$600 per attendance

Day Procedure and Treatment at Ophthalmic Clinic

$460 per attendance

General out-patient

$215 per attendance

Dressing & Injection

$70 per attendance

Geriatric & Rehabilitation day hospital

$1,400 per attendance

Psychiatric day hospital

$880 per attendance

Community nursing (general)

$340 per visit

Community nursing (psychiatric)

$1,050 per visit

Community allied health services

$1,050 per treatment

 

 Fees & Charges for Private Services

Service

Fees

In-patient (acute hospitals) N2
1st class
2nd class
Nursery


$3,900 per day  N1
$2,600 per day N1
$640 per day N1

In-patient (other hospitals) N2
1st class
2nd class


$3,300 per day N1
$2,200 per day N1

Special intensive care ward /unit N2

$12,700 per day N1

Intensive care ward/unit N2

$9,900 per day N1

High dependency ward/unit N2

$7,000 per day N1

In-patient consultation (per specialty)

$550 - $2,250 per visit

Out-patient consultation N3 (per specialty)

    Initial consultation
    Subsequent follow up consultation

$550 - $1,750 per attendance
$450 - $1,150 per attendance

Others (e.g. pathology services, diagnostic procedures)

Per Gazette (s.s. No. 4 to Gazette No. 13/2003)

Details can be obtained at the admission office / shroff office of HA hospitals


N1 The rate of maintenance fee is per day or part thereof.

N2 In-patient fee covers general nursing, core pathology investigations, catering and domestic services.

N3 Outpatient consultation fee does not include the supply of medicines, prostheses, diagnostic services or therapeutic treatments referred to in Sections 3 to 7 of the Gazette (s.s. No. 4 to Gazette No. 13/2003).  Medication and prostheses will be separately charged at cost.  Alternatively, patients may purchase the medication and prostheses privately.

 

 

 

Imposition of Administrative Charge on 1 July 2007

 

To discourage late or non-payment of medical fees, an administrative charge is imposed on late payments of medical fees and charges for medical services provided on or after 1 July 2007.

 

Administrative charge is applicable to all outstanding medical fees and charges, including Self-financed Items (SFI), drug charges, drug handling charges and Privately Purchased Medical Items (PPMI).

 

1st Administrative Charge

5% of the outstanding fees overdue for 60 days from issuance of the bills, subject to a cap of $1,000 for each bill

2nd Administrative Charge

An additional 10% on the outstanding fees if the bills remain outstanding 90 days from issuance of the bills, subject to a cap of $10,000 for each bill (excluding unpaid 1st administrative charge)

 

The maximum total amount of 1st and 2nd administrative charges would be 15% of the outstanding fees, subject to a cap of $11,000.

  

 

Examples:

                                                                                      

 

Day 1

Day 15

Day 16-60

  Day 61   

Day 62-90

Day 91  

 

 

 

Procedure

 

 

Issue a bill

 

 

 

 

 

 

 

Issue a final notice

 

Receive partial payment

 

Impose 5% administrative charge

 

Receive partial payment

 

Impose additional 10% administrative charge

 

Total administrative charge

Example 1

$1,500

-

$75

($1,500 x 5%)

-

$150

($1,500 X 10%)

$225

($75 + $150)

 

Example 2

 

$1,500

 

$300

$60

[($1,500 - $300) x 5%]

 

$400

$80

[($1,500 - $300 - $400) X 10%]

$140

($60 + $80)

 

 

Example 3

 

 

$220,000

-

$1,000

($220,000 x 5% = $11,000, subject to the cap of $1,000)

 

 

-

 

$10,000

($220,000 X 10% = $22,000, subject to the cap of $10,000)

$11,000

($1,000 + $10,000)

 

 

Payment Methods

 

1.      In Person

Payment by cheque, cash, EPS or credit card will be accepted during normal office hours at the Accounts Office of any hospitals under the Hospital Authority.  Payment may also be made at the Accident and Emergency Registration Counter of the hospitals (except St. John Hospital) when the Accounts Office is closed.

 

2.      By Post

Please send a crossed cheque, bank draft or cashier order made payable to “Hospital Authority” and post to the Accounts Office of the address given on the bill.  Patient’s name and bill number should be written on the back of your cheque / bank draft / cashier order, and allow sufficient mailing time. Do NOT send cash by post.

 

3.      Payment by Phone Services (PPS)

After opening account at any PPS Terminals, payment can be settled via PPS Hotline 18031 or “PPS on Internet” at www.ppshk.com. For details, please call PPS Pre-recorded Information Hotline 900 00 222 329. The merchant code of Hospital Authority is 83.

 

4.      Internet Banking

Payment can be made via internet services provided by banks.

 

5.      By Automated Teller Machine (ATM)

Payment can be made at any ATMs with “JET PAYMENT” signage using any JETCO member bank’s ATM card or credit card with cash withdrawal function. The merchant code of Hospital Authority is 9083.

 

6.      Cash Payment at 7-Eleven

Cash payment can be made at any 7-Eleven convenience stores in Hong Kong by presenting the bill. The maximum cash payment per transaction is HK$5,000.

 

Remarks

 

i.        Time for payment processing

At least three working days should be allowed for processing payment.

 

ii.      Issuance of receipts

Receipt will NOT be issued for payment by post, PPS, internet banking, ATM or 7-Eleven convenience store. Please retain the original bill / PPS reference number / internet transaction record / receipts provided by ATM or 7-Eleven convenience store for record.