Public hospital charges increase: How should employers budget for their domestic helper’s medical expenses?

The Hospital Authority’s revised charges took effect on 1 January 2026. Individuals holding a valid Hong Kong Identity Card and immigration status are generally eligible for subsidised public healthcare charges. Domestic helpers should present valid identification and immigration documents during medical visits. Eligibility will be determined by the hospital or clinic.

The government has also introduced an annual cap of HK$10,000 on specified public healthcare charges. Eligible individuals who reach the cap may apply under the relevant mechanism. Self-financed services are not included. Employers should note that this arrangement does not automatically exempt them from their medical responsibilities, and not all public healthcare services are counted towards the cap. Always refer to the latest guidelines provided by the Hospital Authority.

The following examples use published public healthcare charges for eligible persons and assumed private clinic fees to help estimate potential medical expenses. Actual costs may vary depending on clinic pricing, medications prescribed, tests performed, duration of hospitalisation and treatment required.

For example, if a domestic helper requires four family medicine clinic visits, one non-urgent A&E consultation and a five-day stay in hospital within a year, the estimated public healthcare expenditure would be approximately HK$2,540. Adding one specialist follow-up consultation with two medications would increase the total to around HK$2,830. These figures are illustrative only. Actual expenses may be higher due to laboratory tests, advanced imaging, self-financed medications or private healthcare services.

When a domestic helper falls ill, employers may prefer a nearby private clinic to reduce waiting times and enable the helper to recover sooner.
Assuming a private general practitioner consultation with basic medication costs approximately HK$400 per visit, four visits per year would amount to HK$1,600.

Employers who frequently use private clinics should compare the clinic’s fees against the insurance policy’s per-visit and annual outpatient reimbursement limits. It is also important to check whether medications are covered, whether designated clinics are required and what exclusions apply.

Employers must purchase Employees’ Compensation Insurance for domestic helpers to cover legal liabilities arising from work-related injuries or occupational diseases. However, statutory employees’ compensation insurance is not the same as comprehensive domestic helper medical insurance.

For instance, if a helper contracts influenza, experiences sudden abdominal pain or is hospitalised due to an injury that occurs during non-working hours, these situations may fall outside employees’ compensation coverage. Nevertheless, the employer may still be responsible for medical costs under the employment contract.

A comprehensive healthcare budget should therefore consider three levels: 1. daily outpatient healthcare expenses; 2. major risks such as emergency treatment, hospitalisation or surgery; 3. statutory liabilities arising from work-related injuries.

When selecting domestic helper insurance, employers should confirm whether the policy includes outpatient treatment, hospitalisation and surgery benefits, dental care and employees’ compensation coverage, rather than comparing premiums alone.

Taking MSIG iHelper Insurance as an example, the Essential, Standard and Enhanced plans all include HK$100 million in Employees’ Compensation coverage per incident. Outpatient and hospitalisation benefits vary by plan:

• Essential Plan: No outpatient medical expense coverage
• Standard Plan: Annual outpatient limit of HK$3,000; limit per visit of HK$200; annual surgical and hospitalisation limit of HK$25,000
• Enhanced Plan: Annual outpatient limit of HK$4,000; limit per visit of HK$200; annual surgical and hospitalisation limit of HK$30,000
• Optional clinical expense top-up: Standard Plan annual outpatient limit increases to HK$5,000, Standard Plan annual outpatient limit increases to HK$6,000. Per-visit outpatient limit increases to HK$400 for both plans. Not available under the Essential Plan.

Applying these benefit limits to the charges above: A family medicine clinic visit costing HK$160 would generally be covered within the HK$200 per-visit limit. A specialist consultation costing HK$290 or a non-urgent A&E visit costing HK$400 may exceed the standard HK$200 limit. The upgraded HK$400 per-visit limit provides broader protection against such expenses. Claims remain subject to policy terms, supporting documents, actual medical conditions and final claims assessment.

Instead of focusing only on annual limits such as HK$5,000 or HK$6,000, compare the following: 1. expected number of medical visits; 2. average cost per visit, and 3. policy per-visit and annual reimbursement limits.

1. Infrequent medical visits and primarily public healthcare usage
   A HK$200 per-visit outpatient limit is generally sufficient for the HK$160 family medicine clinic consultation example, although employers should still budget for exclusions and uncovered items.
2. Specialist consultations, A&E visits, or greater private healthcare flexibility
   A HK$400 per-visit outpatient benefit offers greater protection and reduces the likelihood of exhausting annual limits after multiple consultations.
3. Existing plan has no outpatient coverage
   Employers looking to reduce their out-of-pocket outpatient expenses may consider plans that include outpatient benefits, while balancing premium differences, waiting periods and personal affordability.

Employers should also note that, under MSIG iHelper Insurance, outpatient, hospitalisation and surgery, service interruption and dental benefits generally carry a 14-day waiting period. Vaccinations, preventive treatment, routine health screening, convalescent care, and certain pre-existing or specified conditions may not be covered.

Domestic helper medical insurance does not cover all medical expenses arising from pre-existing conditions, and policyholders should not assume that the per-visit limit guarantees full reimbursement for every illness.

1. Verify eligibility: Confirm that the domestic helper’s Hong Kong Identity Card and immigration status remain valid to ensure accurate assessment of public healthcare eligibility and charges.
2. Estimate healthcare costs: Use the previous 12 months’ consultation frequency multiplied by average medical costs and set aside an emergency fund for hospitalisation or unexpected treatment.
3. Compare coverage beyond premiums: Review per-visit limits, annual limits, waiting periods, panel doctor requirements, referral requirements and exclusions rather than focusing solely on premium costs.
4. Keep complete medical records: Retain doctor diagnoses, original receipts, prescriptions, referral letters, hospital bills and discharge summaries. Submit claims within the policy’s stated deadlines.

To conclude, with the implementation of revised public healthcare charges in 2026, employers should proactively budget for outpatient treatment, emergency care and hospitalisation expenses for their domestic helpers.

A practical approach is to estimate routine medical spending based on historical healthcare usage and then identify any protection gaps by comparing expected costs against policy per-visit and annual limits. For employers concerned about future increases in outpatient consultations, specialist follow-up visits or emergency treatment arising from newly developed medical conditions, additional outpatient coverage may provide meaningful financial protection.

All coverage, premiums, promotional offers, limits and exclusions are subject to the latest policy wording and application materials.

1. What are the key changes to public hospital charges in 2026?

   Effective from 1 January 2026, charges for eligible persons using public healthcare services have been revised. Family medicine clinic consultations cost HK$150 per visit, non-urgent A&E consultations cost HK$400 per visit, acute general beds cost HK$300 per day and specialist outpatient consultations cost HK$250 per visit. Medication charges are calculated separately.

2. Can domestic helpers use public hospitals at subsidised rates?

   Individuals holding a valid Hong Kong Identity Card and valid immigration status are generally eligible for subsidised public healthcare charges. Domestic helpers should present valid identification and immigration documents during registration, subject to confirmation by the healthcare provider.

3. Must employers pay for their domestic helpers medical expenses?

   Yes. Under the Standard Employment Contract, employers must provide free medical treatment when a domestic helper becomes ill or injured during employment and while staying in Hong Kong. Employees’ Compensation Insurance only covers work-related injuries and occupational diseases and is not a substitute for comprehensive medical coverage.

4. What does domestic helper outpatient insurance usually cover?

   Depending on policy terms, coverage may include eligible general practitioner and specialist outpatient consultations. Policies typically impose per-visit and annual limits and may include waiting periods, panel doctor requirements, referral requirements and exclusions.

5. When should employers consider increasing outpatient coverage?

   Additional outpatient coverage may be worth considering if a domestic helper is likely to require more frequent consultations, specialist follow-ups, emergency treatment or if existing benefit limits fall below estimated medical expenses. Premium increases and the employer’s own affordability should also be considered.

6. Does the HK$566 two-year premium for MSIG iHelper Insurance include the outpatient upgrade?

   No. The approximately HK$566 represents the promotional premium for the Standard Plan based on a regular two-year premium of HK$1,028 with a current 45% discount, excluding the Insurance Authority levy. Under the same promotional pricing, the optional outpatient upgrade costs an additional HK$275 for the Standard Plan and HK$363 for the Enhanced Plan. Actual premiums, promotional eligibility and coverage details are subject to the latest information available at the point of purchase.