LCQ8: Shared use of health care vouchers between elderly spouses
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Question:
The Elderly Health Care Voucher Scheme currently allows the shared use of health care vouchers (HCVs) between two eligible elderly persons who are in a spousal relationship upon their mutual consent and completion of procedures to pair up their HCV accounts. However, the relevant consent notification will become invalid upon the death of either spouse. It is learnt that at present, once the Department of Health (DH) has obtained the death registration information of an HCV user, it will automatically freeze the healthcare account of the deceased elderly person, without requiring the family members to make a declaration to the DH on their own initiative. Nevertheless, before the death registration procedure of the deceased spouse is completed, the elderly person may have inadvertently used the HCV subsidy of the deceased partner, resulting in the person concerned and the doctors or Chinese medicine practitioners, etc of the relevant medical units having to be invited by the Police to assist in investigations. In this connection, will the Government inform this Council:
(1) since the implementation of the scheme for the shared use of HCV between spouses, of the number of cases identified by the authorities involving the use of HCV subsidy of a deceased partner; of the respective numbers of cases confirmed to be deliberate abuse and inadvertent misuse among them; as well as of the number of cases currently still under investigation; and
(2) in the event that an elderly person receiving HCVs passes away locally, whether the information about the decease can be transmitted instantly to the HCV system through electronic channels, so as to prevent members of the public from abusing or inadvertently misusing the subsidy of a deceased partner, avoid implicating medical institutions thereby causing them financial and time losses, and save the resources required for police investigations; if not, of the specific plans the authorities have in place to fully link up the information across various systems?
Reply:
President,
In consultation with the Department of Health (DH), the consolidated reply to the question raised by Professor the Hon William Wong is as follows:
The Elderly Health Care Voucher Scheme (EHVS) aims at providing financial incentives for the eligible elderly persons to choose private primary healthcare services that best suit their health needs, so as to provide them with additional choices on top of the existing public primary healthcare services. Elderly persons should produce their valid Hong Kong identity cards (HKICs) and need to receive the healthcare services provided by the enrolled healthcare service providers in person in order to use the vouchers.
To facilitate elderly persons to better use Elderly Health Care Vouchers (EHCVs) more flexibly, the government allowed shared use of EHCVs between spouses in July 2023. An elderly person and his/her spouse (both parties aged 65 or above) only need to attend the practice place of any healthcare service provider together in person to pair up their EHCV accounts, when either party uses the EHCV to pay for healthcare services. Once the accounts are paired up, the elderly person and his/her spouse can, upon exhaustion of his/her own EHCV account balance, use the EHCV balance in the spouse's account. Every time a spouse's EHCVs are used, the elderly person is required to provide a copy of the latest HKIC (or Certificate of Exemption) of the spouse to the healthcare service provider for verification.
As at end December 2025, over 178 000 elderly couples (representing approximately 356 000 elderly persons) have registered to pair up their EHCV accounts. During the same period, there were over 670 000 EHCV claim transactions related to shared use of vouchers, involving a total claimed amount at approximately $410 million.
Under the EHVS, upon the passing of an elderly person, his/her EHCVs within the account shall immediately become invalid. Even after registering for shared use of EHCVs, the remaining EHCV account balance of the deceased will not be transferred to the EHCV account of the surviving spouse, nor will it be treated as part of the estate for any individual. No person shall use the healthcare vouchers of a deceased elderly person by using their identity document. This includes elderly persons who have registered for the shared use of vouchers, who must not use the identity documents of their deceased spouses to share their vouchers. Failure to comply is a breach of regulations and may lead to prosecution for crimes such as fraud.
To ensure that eligible elderly persons understand the operation of the EHVS, including the arrangements for shared use of EHCVs between spouses, the DH has implemented the following measures:
- Dissemination of relevant information and reminders through various channels, including leaflets, dedicated webpage and social media;
- Starting from June 2024, eligible elderly person are required to confirm with the healthcare service providers that his/her spouse is still alive before he/she can use the EHCVs from the spouse's account; and
- Healthcare service providers also have the responsibility to comply with the terms and conditions of the EHVS agreement and to verify the identity of voucher recipients when providing healthcare services. The DH has been conducting promotion to healthcare service providers through various channels, including organising briefing sessions, mailing leaflets and issuing relevant reminders regularly via the eHealth System (Subsidies) (eHS(S)), etc.
Regarding the information system, the DH has established a notification mechanism with the Immigration Department for registered death cases. Upon the passing of an elderly person, his/her EHCV account in the eHS(S), which supports the operation of EHVS, shall immediately become invalid. The surviving spouse will not be able to access or transfer the EHCV account balance under the name of the deceased. Having regard that the majority of elderly persons pass away in public hospitals, the DH has established an hourly death notification mechanism with the Hospital Authority since June 2024 to further enhance the reporting efficiency. If an elderly person registered with eHealth passes away in a public hospital, their EHCV account in the eHS(S) will be frozen immediately, and no one will be able to use the EHCVs of the deceased.
To ensure the proper use of public money, the DH adopts a monitoring mechanism to proactively investigate and handle reports. The DH will follow up on all cases stringently and will refer cases involving suspected fraud or false declarations to law enforcement agencies for investigation. Since the implementation of the shared use of vouchers between spouses, as at end December 2025, the DH has identified about 383 cases involving the suspected use of deceased spouse's EHCVs that required further follow-up through the monitoring mechanism. These cases involved 524 transactions, accounting for about 0.08 per cent of the total EHCV transactions in paired EHCV accounts. Among the 383 cases requiring further follow-up, 351 cases have been referred to the police for further investigation following preliminary investigation and verification by the DH, while the remaining 32 cases are still under preliminary investigation and verification by the DH. In determining whether to take further legal action, the Government will holistically review the actual circumstances and evidence of each case, including verifying whether criminal intent was involved, and will seek legal advice where necessary. During the same period, the DH has recorded one case of successful prosecution involving a voucher recipient who was charged with fraud for using the EHCVs of the deceased spouse, resulting in a fine and a suspended prison sentence.
In addition, as at end April 2026, the DH identified 31 cases where healthcare service providers violated the terms and conditions of the EHVS agreement concerning the arrangements for shared use of EHCVs between spouses. For these cases, the DH will take appropriate actions or measures based on the specific circumstances, including issuing advisory/warning letters to the concerned healthcare service providers, withholding reimbursement of claims and recovering disbursed reimbursements, etc.
The Government will continue to monitor the usage of EHCVs and explore feasible measures to further enhance supervision, so as to ensure that EHCVs are put to good use and to prevent abuse.
Ends/Wednesday, May 6, 2026
Issued at HKT 17:42
Issued at HKT 17:42
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