Elderly Health Care Voucher Scheme: What It Pays For

What the Elderly Health Care Voucher Scheme is

The Elderly Health Care Voucher Scheme is a Hong Kong Government programme that subsidises private primary healthcare for older people. It began on 1 January 2009 as a three-year pilot, under which five vouchers of $50 each were given annually to residents aged 70 or above. The pilot was extended in 2012, the annual amount rose to $1,000 in 2013, and from 2014 the Scheme became a recurrent programme rather than a pilot. The sequence is recorded on the background page of the Scheme website.

The Department of Health administers the Scheme. The stated objective is to supplement public healthcare rather than replace it: the annual amount is a financial incentive for an older person to choose private services that suit their own health needs, and to build a closer relationship with a doctor who knows their conditions. Public outpatient and specialist services remain available to the same people.

Who is eligible for the voucher

Eligibility rests on age and identity, not income. A person aged 65 or above who holds a valid Hong Kong Identity Card or a Certificate of Exemption issued by the Immigration Department is eligible to receive and use the vouchers for private primary healthcare services, as the Scheme's eligibility page states.

That page also sets out one exclusion: a person who obtained a Hong Kong Identity Card by virtue of a previous permission to land or remain in Hong Kong, where that permission has expired or ceased to be valid, is not eligible.

The age threshold was lowered from 70 to 65 with effect from 1 July 2017, which is why older summaries of the Scheme refer to a higher age. There is no separate application and nothing to collect. An enrolled healthcare service provider opens the voucher account free of charge when the person first uses vouchers, and the annual amount is deposited according to the year in which the person became eligible.

How much is deposited each year

The annual voucher amount is $2,000 for each eligible person, and it has been at that level every year since 2020. The Scheme's published table records the sequence: $250 from 2009 to 2011, $500 in 2012, $1,000 in 2013, and $2,000 each year from 2014, with one-off additions of $1,000 in 2018 and 2019.

The amount is credited automatically on 1 January each year, starting from the year in which the person becomes eligible. Vouchers are issued and used electronically through the eHealth System (Subsidies), so there is no paper voucher to lose, no need to preregister and nothing to collect in advance.

How long unused vouchers last

Unused amounts carry forward. The Scheme puts no limit on the number of years an elderly person may carry forward an unspent amount, but the total in the account on 1 January each year cannot exceed the accumulation limit, which is $8,000.

That limit was raised to $4,000 from 7 June 2014, to $5,000 from 8 June 2018, and to $8,000 from 26 June 2019 as a regular measure. The practical consequence is that a long period of low spending does not build an unlimited reserve, because the balance above the limit is forfeited at the start of the new scheme year. The balance enquiry service lists the amount due to be deposited and the amount expected to be forfeited on 1 January, which is the clearest way to see the rule at work.

What the voucher pays for

Vouchers pay for private primary healthcare services provided by healthcare professionals enrolled in the Scheme. Coverage now extends across 14 categories of healthcare profession: medical practitioners, Chinese medicine practitioners, dentists, nurses, physiotherapists, occupational therapists, radiographers, medical laboratory technologists, chiropractors and optometrists with Part I registration, plus audiologists, dietitians, clinical psychologists and speech therapists, whose services were added on 28 April 2023.

The Scheme describes the covered use as preventive, curative and rehabilitative primary care. In the announcement of that extension, the Department of Health reported more than 11,000 enrolled healthcare service providers and more than 33,000 service points across the 18 districts as at end March 2023, and estimated that almost 1.7 million eligible elderly persons could benefit. The full announcement is at the Government press release of 27 April 2023.

One service carries its own ceiling. Since 26 June 2019, no more than $2,000 of voucher spending every two years may go to optometry services.

What the voucher covers and what it does not

The boundary is easier to hold in mind as a list of items with a status against each one. The Department of Health summarised it when the profession coverage was extended in April 2023.

Two entries are easy to misread. Medical equipment is not covered as a purchase, but equipment such as a hearing aid provided by one of the four professions added in April 2023 after a professional assessment is covered. And the voucher follows a service received in person rather than an order placed in advance, which is why prepaid services and day surgery are excluded.

How the voucher is claimed at the counter

The claim is made by the healthcare service provider, not by the patient. The person presents a valid Hong Kong Identity Card or Certificate of Exemption, says that they wish to use the voucher, understands and agrees the amount, and gives consent electronically by inserting the identity card into the provider's card reader. Where the reader cannot be used, for example because the person holds a Certificate of Exemption or the chip of the identity card is damaged, a paper consent form is used instead. The Scheme's page on creating an account and using vouchers sets out each step.

After the service, the provider submits the claim and gives the person a Notice on Use of Health Care Voucher showing the amount used and the balance afterwards. A person using vouchers has to provide an SMS-enabled mobile number, or the number of a family member or carer, and the system sends a message confirming the amount used. A balance can be checked before a consultation through the balance enquiry service, through the eHealth App for people registered with eHealth, or through the hotline 2838 0511.

The Scheme is explicit on one point that families ask about: using vouchers should not change the fee charged, and a claim should not involve a handling fee or an administrative fee. Asking about the fee list before the consultation is the straightforward protection, since the decision to use vouchers belongs to the patient.

Spouse sharing and the Pilot Reward Scheme

From 28 July 2023, two people in a spousal relationship, both aged 65 or above and both eligible, may pair their voucher accounts and, once one account is exhausted, use the balance in the other. Pairing takes place at a participating provider's practice with both people present, requires a declaration of the spousal relationship and consent rather than documentary proof, and may be reversed later. The Department of Health said at the time that over 950,000 elderly persons aged 65 and above in Hong Kong were married. The announcement is at the Government press release of 24 July 2023.

From 13 November 2023, a three-year Elderly Health Care Voucher Pilot Reward Scheme runs alongside the annual amount. In each year of that period, an eligible person who accumulates at least $1,000 of voucher spending on designated primary healthcare services within the same year is allotted an automatic $500 reward into the same voucher account. The full terms are in the Department of Health announcement of 9 November 2023.

Four terms of the reward shape how a family should plan. The reward is deducted before the annual voucher balance when a designated service is paid for. It cannot itself count towards earning another reward. It expires on 31 December of the following year, and unused reward is not accumulated. The reward is kept separate from the annual amount, so the $8,000 accumulation limit is unaffected. The announcement adds that shared use of the reward between spouses is not allowed, even where the voucher accounts have been paired.

Using vouchers in the Greater Bay Area

The voucher is not confined to Hong Kong. The Scheme has allowed its use at the University of Hong Kong-Shenzhen Hospital since 6 October 2015 for designated outpatient clinics and departments, and from 17 April 2023 covered the community health service centre set up by that hospital. The Scheme's history then records a Greater Bay Area Pilot Scheme under which designated medical institutions began accepting vouchers for designated outpatient services, and the coverage was extended to reach all nine mainland cities of the Greater Bay Area. Because that list of institutions changes, families should check the current designated list on the Scheme website rather than a list printed earlier.

The planning point is the combination of a fixed annual amount and a capped balance. A person who spends little over several years does not build an unlimited reserve, because the excess is forfeited at the start of a new scheme year. Deciding in advance what the annual amount should cover, including the health assessments and chronic disease follow-up that count towards the reward, usually matters more than the nominal total.

Whether a particular service is clinically appropriate, and whether it can be used alongside public care the person already receives, are questions for the treating healthcare professional and for the Scheme's own enquiry service rather than for a page like this one.