Do I Need Health Insurance in Hong Kong?

In Hong Kong, the answer to "Do I need health insurance?" is almost always "It depends."

21 Sep 2018 — By Michael Lamb / Essential HK / Health

“Do I need health insurance?”

Depending on where in the world you call home this question can be extremely simple to answer. In the USA, with the highest costs of healthcare in the world, the answer would be a resounding “yes”; in the UK or Canada where there are excellent government-operated healthcare services the answer is going to be “no.”

Hong Kong, however, exists in a unique place amongst all the world’s healthcare systems in that it has both a low-cost and accessible public healthcare system, and the 2nd highest private healthcare costs in the world. As such, the answer to whether you need health insurance in Hong Kong is almost always “it depends.”

The Public and Private Systems Compared

Anyone who has experienced the extensive bureaucracy of government-operated national healthcare services will immediately understand the primary drawback of the public healthcare system in Hong Kong; namely, it can take a significant amount of time to receive treatment.

Government clinics and emergency departments at a Hospital like Queen Mary are operated on a triage basis. This means that individuals with less serious medical complaints will have to wait longer than individuals who have more life-threatening conditions. Additionally, clinics are always operated on a first-come first-serve basis, and a queue will start to form many hours before the facilities officially open.

As such, getting low-cost healthcare through the Government healthcare system can often prove to be a logistical nightmare. Never mind the grim conditions of the facilities – a complaint about a sore back will often mean sitting for hours in a straight backed chair in a waiting room, hardly the ideal solution for easing the original complaint!

The contrast to this can be found in the private healthcare system at a hospital like the Adventist on Stubbs Road.

In all the of the private hospitals and clinics in Hong Kong it can actually be relatively quick and easy to get treatment – the average outpatient waiting time is 15 minutes at the Adventist compared to 4 hours at Queen Mary. The facilities, too, are much more comfortable with clean restrooms, free drinking water, and waiting areas that are well fitted out.

However, there is a significant price difference between the same services at the Adventist and Queen Mary Hospitals. An outpatient consultation at the Adventist will usually run around HK$ 1,500 excluding the costs of any medication and equipment. That same consultation at Queen Mary will cost HK$ 100, no matter what you have been treated for.

There is nothing inherently wrong with the public system, but it is important to realize that the services offered are extremely basic, and rife with red-tape and regulations, especially when compared to private system counterparts. Despite these drawbacks, however, it is a provider of comprehensive treatment options – it may just take some time to navigate the system fluently.

Nowhere is this duality more obvious than with services related to maternity.

A Hong Kong Healthcare Case Study Through Maternity

As with all of your healthcare decisions in Hong Kong, when giving birth in the city residents have the choice between receiving their pre-natal care and delivering their child through either the Public System or Private System.

Giving Birth in Hong Kong Through the Public System

Giving birth through the public healthcare system is relatively straight forward, pick your hospital sign up to see an OBGYN and you’re essentially all set. Expecting mothers will have 3 to 4 pre-natal consultations at standard costs, and will only receive a maximum of 2 ultrasound scans before the delivery for routine pregnancies.

In terms of the delivery the mother will be placed in a labour ward when contractions start, and will only be taken to a birthing room once in active labour. This means that there could be a significant amount of time spent in the general ward, with no visitors allowed. As such, many individuals choose to delay going to the hospital until the very last minute – which can be a logistical challenge, especially for families living on an outlying island like Lamma or Lantau.

While some of the niceties may not be available (it is, for example, always recommended to bring an extra roll of toilet paper with you if you are choosing to give birth in a public hospital), the intervention rates for emergency procedures (like C-sections) in the public system are much lower than comparable private services, and the cost of delivery at a public hospital is capped at HK$ 100 per day.

You won’t get to choose your OBGYN, and will have to spend a significant amount of time navigating the system, but the no-frills services will get the job done.

Giving Birth in Hong Kong Through the Private System

The immediate contrast to public system deliveries, especially at a facility like the Peak’s Matilda Hospital, is the cost of treatment. Routine vaginal deliveries at the Matilda will start in the region of HK$150,000 for a 2-night 3-day stay in a private room, this includes doctors’ fees as well as the hospital’s own charges. This price tag can quickly increase when adding epidurals, episiotomies, and other interventions – an emergency delivery at the Matilda through a C-section can exceed HK$250,000 if a patient opts for a private room.

Private patients can manage their budget through their choice of hospital, room type and doctor, but there’s no denying that the price tag for a private hospital will always be significantly more than the HK$100 a day offered through the public system. And becomes a startling reality to face when considering the roughly 50% intervention rate for deliveries at private hospitals in the city.

However, in the private system you have unlimited choice – you choose the OBGYN you are comfortable with, the hospital you would like to deliver in, and the type of room you will take during the hospital stay. The services are far more tailored to your specific needs rather than the one-size-fits all solutions provided through government facilities. But the costs of delivering a at a private hospital will quickly exceed the out-of-pocket means for all but the city’s richest residents. Meaning that insurance, and adequate planning, is a virtual necessity.

Learn more about maternity insurance options in this article.

Do I need Health Insurance in Hong Kong?

As stated above, in contrast to many countries and cities around the world, there is no easy or definitive answer to this question in Hong Kong.

A single young professional aged 29 would probably be able to live a comfortable and carefree life without comprehensive insurance coverage in Hong Kong – being able to rely on the public system might not be the most comfortable outcome, but the care that is needed is available, and at a much lower price point that would be realised in the private system.

In contrast, a family of 4 with young children may decide that the cost of insurance coverage is outweighed by the easy access to high quality and comfortable healthcare services – especially if they are considering having more children.

Unfortunately, there really is no firm answer to this question. This is, consequently, why CCW Global recommends that anyone considering a health insurance purchase in Hong Kong should speak to an expert health insurance broker who understands the various pitfalls and obstacles within both of the healthcare systems operated locally.

Ultimately, the question of whether you need health insurance or not will come down to a personal choice, and it is important to realize that unlike the rest of the world there is no one solution to what you should do in Hong Kong when it comes to healthcare.

For more information about the Hong Kong Healthcare system, or to understand if Hong Kong Health insurance is the right choice for you, please contact CCW Global today.