Financial Assessment



(a) Application for Non-drug Items

All applications are to be assessed on a household basis, taking into account the income and assets of the patient and his / her household members living under the same roof. The patient's household income include salary, pension, regular financial contributions from relatives and / or friends not living with the patient, income generated from the assets and / or properties of the patient and his / her household members, other income / compensation received on a regular basis. Normal Disability Allowance, Higher Disability Allowance, Normal Old Age Allowance, and Higher Old Age Allowance, should not be taken into account as household income.

The patient's household assets include savings, investments in stocks and shares, insurance, valuable possessions, properties, lump-sum compensation and other liquidable assets. The flat owned and resided in by the patient's household and the tools of trade of the patient's household are excluded from the calculation.

In assessing the financial condition of patient, medical social worker would make reference to the Median Monthly Domestic Household Income (MMDHI) (Table 1) by Household Size based on the General Household Survey (GHS) conducted regularly by the Census and Statistics Department. If household income of the patient is below the MMDHI and assets not exceeding three times of the item cost, he / she would generally receive assistance from the Fund.

For patient whose monthly household income is above the MMDHI corresponding to the patient's household size, OR the patient's liquidable household assets is above three times that of the cost of the item concerned, assistance from the Fund would not normally be made. However, the Fund would consider on a discretionary basis the applications with overriding social grounds.


Table 1 Median Monthly Domestic Household Income (update in regular base)

Household Size

Median Monthly Domestic Household Income (HK$)
(4th Quarter 2013)
1 7,500
2 16,100
3 23,900
4 30,700
5 39,800
6 or above 44,200


(b) Application for Drug Items

The financial assessment includes assessment on patient’s household income, expenditures and capital assets.

Annual disposable financial resources are taken as the annual household disposable income plus the disposable capital.

Annual household disposable income is the annual household gross income less allowable deductions during the period.

Household gross income includes salary, pension, financial contributions from children, relatives and friends, income generated from the assets and properties of the patient’s household and compensation received. Allowances such as Normal Disability Allowance, Higher Disability Allowance, Normal Old Age Allowance, Higher Old Age Allowance and grant / loan received from the Tertiary Student Finance Scheme are excluded from the calculation.

Allowable deductions include rental or mortgage payment, rates, Government rents, property management fee of the property occupied by the patient’s household (total deduction of not more than one-half of the household gross income), salary taxes, personal allowances (Table 2) for the patient’s household, child care expenses, provident fund contribution, school fees of children (up to age of 21) who are at secondary level or below (other expenses, such as school activity fees, board & lodging fees, will not be counted as the allowable deductible item) and medical expenses at public hospitals/clinics (other than the drug(s) subsidized by the SF and /or Community Care Fund Medical Assistance Programme and drug payment under this application) for the last 12 months.

Table 2 - Personal Allowances (as at 1 March 2014)


Number of Household Member(s)
(including the Patient)
Total Personal Allowances
(HK $ )
1 Person 5,930
2 Persons 10,160
3 Persons 13,270
4 Persons 16,700
5 Persons 20,360
6 Persons 22,660
7 or more Persons 24,370

The figures are adjusted every year in line with the Consumer Price Index A, and every five years in line with the latest Household Expenditure Survey conducted by the Census and Statistics Department.



Disposable capital includes cash owned by the patient’s household at the time of the application and such which have been accrued through past savings from any sources or which have just been acquired, investments in stocks and shares, insurance (refer to investment-linked insurance policies and dividend provided by life insurance policies, but cash value under a life insurance policy should not be counted), valuable possessions, property (for example, land, car park and flat owned in Hong Kong and outside Hong Kong), lump-sum compensation and other realizable assets. The flat owned and resided in by the patient’s household and, the tools of trade of the patient’s household are excluded from the calculation.

Deductible Allowance (Table 3) is provided when calculating the total value of disposable capital of patient’s household. The amount of deductible allowance depends on the patient’s household size. If the disposable capital of the patient’s household is below the deductible allowance, the amount of deductible will be capped at the disposable capital of the patient’s household. It is set with reference to the prevailing asset limit in assessing eligibilities for applications for the Waiting List of Public Rental Housing (PRH). The level of allowance will be regularly reviewed with reference to the PRH’s asset limit which is subject to annual review under an established mechanism.

Table 3 – Deductible Allowance (as at 1 April 2014)


Number of Household Member(s)
(including the Patient)
Allowance to be deducted from Disposable Capital
(HK$)
1 Person 221,000
2 Persons 299,000
3 Persons 390,000
4 Persons 455,000
5 Persons 506,000
6 Persons 547,000
7 Persons 585,000
8 Persons 613,000
9 Persons 677,000
10 or more Persons 729,000

The figures are subject to annual review.

Patient's Contribution to Drug Cost

Patient’s contribution is determined by the disposable financial resources and the estimated drug cost that is required to pay, with the latter being determined by multiplying the unit drug cost by the total units of drug consumption. The maximum contribution is capped according to Table 4.

Where the estimated cost of the applied drug is below the maximum contribution payable, patient is required to pay the drug cost and no assistance will be granted. Where the estimated drug cost is above the maximum contribution payable, the SF will pay the outstanding balance.

Table 4 - Sliding Scale


(A)

Annual Disposable
Financial Resources
(ADFR) ($)


(B)

Contribution
Ratio (%)



(C)

Maximum Annual
Contribution from Patient
($)

(C) = (A) x (B)
(D)

ADFR after deducting
Annual Contribution
($)

(D) = (A) - (C)
0 - 20,000 - 0 0 - 20,000
20,001 - 40,000 - 1,000 19,001 - 39,000
40,001 - 60,000 # - 2,000 38,001 - 58,000
60,001 - 100,000 5 3,000 - 5,000 57,001 - 95,000
100,001 - 140,000 10 10,000 - 14,000 90,001 - 126,000
140,001 - 180,000 15 21,000 - 27,000 119,001 - 153,000
180,001 - 280,000 20 36,000 - 56,000 144,001 - 224,000
280,001 - 380,000 20 56,000 - 76,000 224,001 - 304,000
380,001 - 480,000 20 76,000 - 96,000 304,001 - 384,000
480,001 - 580,000 20 96,000 - 116,000 384,001 - 464,000
580,001 - 680,000 20 116,000 - 136,000 464,001 - 544,000
680,001 - 780,000 20 136,000 - 156,000 544,001 - 624,000
780,001 - 880,000 20 156,000 - 176,000 624,001 - 704,000
880,001 - 980,000 20 176,000 - 196,000 704,001 - 784,000
980,001 - 1,080,000 20 196,000 - 216,000 784,001 - 864,000
≥ 1,080,001 20* as calculated

# Fixed contribution amount is required from patients whose household’s annual disposable financial resources are $60,000 or below, the formula calculating the applicant’s annual contribution in the above table is not applicable.

* Capped at a flat contribution ratio of 20%.


(c) Important Points to Note

HA may refuse to consider or reject any application if the declaration and/or the supporting data for assessment are not provided.

Provision of incomplete, inaccurate, not up-to-date or false information by way of declaration or supporting data may result in rejection of the application or the withdrawal of financial assistance (in whole or in part) if approved and / or criminal prosecution. Any paid financial assistance prior to withdrawal shall be recoverable by the HA as a debt or otherwise repayable on demand and the Patient / Applicant should undertake to repay to the HA the paid financial assistance.

If the financial status of the patient’s household / CSSA status of the patient changes after the submission of the application or the provision of declaration so as to affect the patient’s eligibility for financial assistance under the SF, the patient must notify the HA immediately and provide all relevant information to MSW for financial reassessment as appropriate. The HA may withdraw and/or vary the terms and conditions of any financial assistance (in whole or in part) in the event of any such change. The patient’s failure to notify the HA of his / her change of financial / CSSA status may result in rejection of the application or withdrawal of approved financial assistance (in whole or in part) and / or criminal prosecution. Any paid financial assistance prior to withdrawal shall be recoverable by the HA as a debt or otherwise repayable on demand and the patient / applicant should undertake to repay to the HA the paid financial assistance.

When you provide Personal Data to the HA in relation to your application, please make sure that such data is accurate and complete. Failure to provide accurate / complete information may affect your application. Please refer to “Notice to Client” prepared for the SF on collection and transfer of personal data before providing your personal data to the HA.