Health insurance in Hong Kong operates on a co-pay system: it gives universal coverage for everyone, including expats, but you will have to pay a small fee (around HKD 100: £10) for a clinic visit, for instance. You will pay about the same for a night in a hospital ward, with a HKD 50 admission fee, but the Hong Kong government operates a fee-waiver system for people on very low incomes, so if you are not able to afford this, you will still be treated. It is a model which seeks to be as inclusive as possible.

You will need a Hong Kong identity card if you are a resident (staying more than 180 days), but the system is open to tourists, too.

Reforms have been underway, for instance involving the new Voluntary Health Insurance Scheme (VHIS), launched by the Food and Health Bureau in 2019, which encourages more affluent citizens to use private health care facilities. This is halfway between full private cover and comprehensive state insurance, the idea being to take the pressure off the overstretched public system.

Private plans which fall under the aegis of the new VHIS scheme will involve:

• guaranteed renewal up to the age of 100 regardless of change in the health conditions of the insured persons
• no limit on "lifetime benefit"
• coverage extended to cover unknown pre-existing conditions and day case surgical procedures
• tax deduction for taxpayers who purchase Certified Plans for themselves or specified relatives
• transparency on the premiums of Certified Plans

The original policy was designed to attract younger Hong Kong residents with tax incentives to pay into the new system. It replaced a compulsory contributions scheme.

VHIS means that there is now effectively a three-tier health insurance model in place in Hong Kong.

Everyone is eligible, including expats and tourists, although the latter may need to pay for emergency care. This will not be very expensive, but you may wish to take out travel insurance before you arrive.

Everyone in Hong Kong is automatically covered under the state health insurance system once they have been issued with an ID card.

Visits to primary healthcare clinics, specialist clinics and hospitals will be covered. Healthcare in Hong Kong is organized in regions, so each area has a range of medical facilities to provide for its residents. It is well provided for, too – Hong Kong has over 40 public hospitals.

If you are retired and living in Hong Kong, you will be covered by public health insurance if you have a Hong Kong ID card.

Many retired expats also take out private cover and the new VHIS scheme has been popular among this age group.

Health insurance for students is not compulsory but some educational institutions may request that students take out cover for accident, hospitalisation and evacuation coverage before undertaking studies. Travel insurance or an international student insurance plan are recommended.

Some educational institutions offer basic group plans.

Your family will be covered if they have Hong Kong ID cards.

Some employers offer group plans which will also cover your spouse and children, so check whether this is the case.

The state system does not cover dental treatment, except in emergency cases. Dental patients will either have to be prepared to pay upfront, or take out private cover.

Contributions will be income-related but are about 5% of your monthly or annual earnings. Your employer must pay a similar mandatory rate.

Public health facilities are often busy and may involve lengthy waiting times. Clinics work on a first-come-first-served basis and hospitals deal with serious cases first, so if you have a chronic condition, you may have a long wait for treatment.

Medical facilities have also been described as not being particularly ‘patient-oriented’ and some expats have reported having to deal with medical personnel who do not speak good English. In contrast, private facilities have short waiting times, usually around 15 minutes.

Note that, as above, reforms have recently been introduced in the form of the VHIS, so you may want to look at this option as well. Under the new scheme, you will be paying around HKD 4000 per annum (approximately €450). Critics of the VHIS have warned that this is higher than some other private products, and that the 25 companies chosen to provide cover under the new system are very similar.

Private hospitals are linked to the UK for healthcare accreditation: these are known as Trent hospitals.

Speed of access for treatment and comfort are factors in taking out private insurance, but tailored plans may also include advanced dental care, enhanced maternity care, preventative measures, check-ups and options for traditional Chinese medicine.

Costs will also depend on any pre-existing conditions, and factors such as your age, in addition to the kind of package you choose. However, the average cost for an adult around 30 years of age ranges from 2,000-25,000 HKD (250-3,200 USD), depending on the details of your personal insurance plan.

For those seeking international private medical insurance (iPMI) cover for multiple countries including Hong Kong, numerous variables can have an impact on the cost.

The most important variables are:

• age (the higher the more expensive)
• area of cover (i.e. in addition to Hong Kong, which other areas is coverage required in? If those other areas include any of the US, the Caribbean, Singapore, China or Dubai this can significantly increase the overall price)
• product choice (higher end insurance products are more expensive)

Other variables include:

• deductibles
• co-insurance
• payment frequency
• gender
• nationality
• country of residence

As so many variables have an effect on the cost of international private medical insurance in Hong Kong it becomes very difficult to give accurate estimates without knowing the full details of the coverage required. However, as a very rough guide, using a standard profile of a 40 year old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. Were coverage to be expanded to include the US then the premium could increase to almost double that amount.

The big internationals all provide cover for Hong Kong and some are providers for VHIS:

• AIA
• AXA
• Bupa Global
• Cigna Global
• HSBC Life
• Manulife
• Prudential

If you are a tourist, it is always advisable to take out travel insurance for emergency cover, but HK Immigration do not make it compulsory.

Hong Kong is an English-speaking country.