Referral and Application Procedures

(a) Referral Procedures

If the patient is required to purchase the item required in the course of medical treatment, the doctor in charge will inform the patient of the need to pay for the item and the estimated cost involved.

Known Comprehensive Social Security Assistance Scheme (CSSA) recipients* and patients who indicate difficulties in meeting the cost of the items would be referred by doctors to MSWs for assessment of the eligibility for assistance.

For urgent cases (only applicable for cardiac items supported by SF), the doctor in charge may apply for conditional application (CAP) so that the procedure or treatment could be performed without delay. The patient / applicant should approach the MSWs as soon as possible to proceed the proper SF application procedures and submit all the necessary documents for financial assessment. The patient / applicant is required to sign an Undertaking Form to confirm understanding of the terms of CAP application and patient’s responsibility. Under normal circumstances, patient / applicant is required to submit the completed application form and provide all the necessary information within 30 calendar days from the date of referral by attending doctor. If there are specific difficulties in submitting all the necessary information in time, the patient / applicant should notify MSWs beforehand, and MSWs will have discretion to extend the aforesaid application period on a case-by-case basis, but the extension cannot exceed 8 weeks from the date of referral by attending doctor. Otherwise, the application will be automatically cancelled. The eligibility for SF assistance and/or the subsidy amount is subject to the outcome of the financial assessment conducted by MSWs. If patient fails the financial assessment, or does not contact the MSWs and submit all the necessary documents within the specific time limit, or cancel the SF application afterwards, the patient has to pay for the cost of procedure or treatment.

(b) Application Procedures

The patient can approach the Medical Social Services Units (MSSU) during office hours to enquire about the application details. To process the application, the patient must bring along the originals as well as a copy for each of the relevant supporting documents.  Patient under the CSSA* is also required to put up application via the MSSU to cover the cost of medical item(s) / treatment and authorize SWD to reimburse the assistance granted to HA after the medical item(s) / treatment is obtained (if applicable). Another person may put up the application on behalf of the patient. For instance, a parent may apply on behalf of his / her child under the age of 18. A person duly authorized by the patient, or a guardian appointed under the Mental Health Ordinance (Cap.136), or any person (including relative or close friend) may apply as agent of an incapable / incompetent patient.

As application processing takes time, the patient / applicant should approach MSWs of respective hospitals / clinics as soon as possible upon referral by attending doctor / healthcare professional. In general, the patient / applicant should submit a completed application form and provide all the required information two weeks prior to the treatment commencement date to allow sufficient time for processing and approval. If the patient / applicant fails to submit the completed application form and provide all the necessary information within 30 calendar days from the date of referral by attending doctor / healthcare professional, the application will be automatically cancelled.

When patient has an approved drug application (“first application”) with submission of document(s) for the financial assessment, by fulfilling the following conditions, patient could make the same approved Patient Contribution upon his/her subsequent drug application(s) without submission of financial document(s) for the financial assessment:
(i) Regardless of the amount of Patient Contribution in the first application, patient is referred again within 2 months after approval of the first application; OR
(ii) The annual Patient Contribution in the first application was $2,000 or below, patient is referred again within 18 months after approval of the first application
If all related approved application(s) is/ are under financial re-assessment^# due to the changes in patient’s household financial / composition status, post-approval check or other reasons, the above streamline arrangement may be terminated immediately without prior notice.

* With effect from March 2017, the application procedures, eligibility and important points to note of CSSA recipients for SF are also applicable for Level 0 Voucher Holders of the Residential Care Service Voucher (RCSV) Scheme for the Elderly.

^# Please read the ‘Important Points to Note’ under the page of 'Financial Assessment' for the terms and conditions of financial re-assessment during the subsidized treatment period.