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Medical

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Contents:
Overview
The 4 Health Funds
Changing Your Health Fund
Additional/Supplemental Coverage
Private Health Insurance
Well Baby/Child Care
Relevant Links

Overview

Israel works on a national socialized medical system.  5% of wages is subtracted from everyone's paychecks and used to pay for the national health system (consider it your medical insurance premium).  For those not working, a payment of ~NIS 60 per family member is required (though new immigrants are given their first 6 months free and children are always free).  Normal medical services (the health "basket" of services) are basically free, though occasionally a small (really small) deductible applies.  Supplemental insurance is available for most services not covered in the basic health basket.  The National Health Insurance law provides via 4 health funds a statutory basket
of services to every resident of Israel without regard to age, health status or country of origin.  Translation - pre-existing conditions are coverage. 

Medical care in Israel is modern and up-to-date.  Israel has the 3rd highest life expectancy in the world (way ahead of the US in the list) for both men and women and one of the lowest infant mortality rates as well (lower than the US).

This doesn't mean that every hospital has the latest MRI or CAT scan machine.  Some medical facilities are obviously in need of money as basic infrastructure is under poor repair.

The 4 Health Funds

The government provides funding for the operation of 4 nationwide health funds.  Each one of these funds operates under a different system and general philosophy.  On arrival to Israel you will be required to join a fund within your first week in-country.  You may change to a different fund only during the enrollment period and only if you have been in your existing fund at least 6 months.

Choice of health fund should be made by asking friends and neighbors, understanding each funds philosophy and determining their facilities in your area (for example, if you choose to live in an out-of-the-way location and a particular fund has the only nearby clinic, they're the ones to choose).

If you are working, you will pay for coverage directly from your paycheck.  If not, go to any office of Bituach Leumi - National Insurance and register for payment of your health tax.  There is a minimal payment of ~NIS 60 per month per adult.  Children are free. 

Kupot Holim Clalit

Clalit is the oldest and largest health fund in Israel.  They operate under a very strict HMO style policy.  You may only use their doctors, clinics, hospitals and pharmacies.  They own/operate about 40% of the hospitals in the country, some of which are very high quality.  However, at many of their clinics and facilities, lines may be long and quality not always the highest.

For the average American, the operational philosophy of Clalit will make them uncomfortable.  The doctor is always right and long waits to get appointments (or event to fill a prescription) are normal.  However, they do have the most extensive system in the country.  If you choose to live in an "out-of-the-way" area and a Clalit clinic is the only one locally, then you've made your choice by default.

Macabbi Heath Services

Macabbi is the most popular fund with Western immigrants.  They operate clinics and hospitals (though not as many as Clalit) but also have independent doctors who subscribe to their network.  (This means you can go see your doctor in his own office.)  They have a wide selection of doctors in all specialties. 

Mehuhedet & Leumit

Unfortunately, I don't have any firsthand info on these 2 funds.  (Anyone with such is invited to provide some info.)

Changing Your Health Fund

You can change your health fund 2 times each year.  To change your fund, you must request it 90 days before the official change date, which is January 1 and July 1.

To change your fund, go to the post office with your national id card (teudat zehut) including the little white supplement that lists family members.  Spouses, parents and children can be covered under different funds (though this might make for massive personal confusion).  Technically, to change your spouses fund you should have his/her id card and a letter of permission, though it depends on the attitude of the postal clerk you deal with.

The change costs ~NIS 10 per person.  You will be given a printed notice to take to your new health fund of choice (make a copy of it!).  Take the notice to your new fund right away.

As noted above, some of the funds offer supplemental coverage.  Since this coverage has a waiting period (usually 1 year), you may want to inquire whether you can enroll in the plan early (and start paying early), even before you have switched funds.  This way you will be covered under the supplemental plan sooner.

If you currently have supplemental coverage with your current fund, verify and double-check that it has been terminated.  (Since they charge it via an automatic withdrawal from your bank account, they have been known to forget to stop charging you and it can take months to get the money back.)

In Israel, doctors and hospitals can have a very hard time requesting a copy of your records.  Therefore, it is best for you to get (and keep) a copy of your medical records yourself.  This is especially important if you are under any kind of medical care at the time you change funds.  (When providing this info to your new doctor/fund, only give them copies!)

Additional/Supplemental Coverage

Additional health services are provided by the 4 health funds and pays for a number of services not included in the statutory basket of services.  With the exception of long-term care (nursing care) the additional health services are open to all members of a health fund without regard to age, health status or country of origin.  There are however, waiting periods for service which vary from 3 months to 2 years.  However, there is a per family member monthly payment for this coverage, which increases with age.  (Though it's still pretty reasonable).  This coverage includes:
Inoculations and vaccinations
Private surgery (from a particular list of specialists)
Convalescent care after major surgery and certain heart related problems
Transplants and special procedures needed to preserve life not available in Israel
Dental treatment discounts (not all funds offer this)
Free check-up's (well care) in the fund's clinics
Some medications not included in the National Health Insurance list (of medications all funds must cover)
Long-term care is sometimes included and sometimes offered separately as an insurance policy depending on the fund

These additional health services are not insurance.  They are not guaranteed and the conditions may be changed from time to time.  They are not secured by insurance reserves so that if the budget is used for that year the patient may not be able to use the
service needed.  The amounts paid may not be full.  In many cases the services are subject to managerial approval of the fund and in some cases such as transplants unless the fund has authorized payment the additional health services will not authorize any
additional payment.  About 70% of the population has additional health services.

Private Health Insurance

The third level of health care is private health insurance.  This is designed to supplement National Health Insurance through the 4 health funds.  Most people who purchase this do so in addition to additional health services.  Private health insurance is offered through private insurance companies.  There are a number of options available and they are continually developing new options.  Private health insurance guarantees contractually whatever it promises.  The most basic feature is private surgery in Israel.  The more comprehensive plans will pay for the full cost of any surgery.  An additional feature which is often available is worldwide option for surgery.  Other features available include: transplants, outpatient care not related to surgery, medications not provided by National Health Insurance, Alternative health care and there are others.  The big limitation of private health insurance is that pre-existing conditions are generally excluded and/or result in higher premiums, and unlike in the U.S. the exclusion is usually lifetime.  So it is best to enter private health insurance before a person has accumulated too many chronic health problems.  About 30% of the population has private health insurance.

Well Baby/Child Care

Well child care is via a different system from the national heath funds.  There is a national well child care network that examines, immunizes and offers pre-natal care as well.  It's
very low cost (something like NIS 20 per month) and called the Tipat Chalav (literal A Drop of Milk).  It's an interesting organization that also tends to be pro-active, if you don't come on time to bring your child for an immunization, they will start calling up and harassing you.

The actual care at these centers tends to be ok to poor.  They have a reputation for over-reacting to any variation from expected standards.  Meaning, if your child/baby is large or small for his/her age, they'll immediately send you to your doctor for an emergency check.  (It's hard to fault them for being very careful, but they have sent many an unwary immigrant parent into a fit.)

Relevant Links

Macabbi Health Fund
Kupot Holim Clalit

This page was created in collaboration with Mr. Steven Kelter.  If you have additional questions on health insurance coverage and options in Israel, contact:

Steven Kelter, M.S.W., AACI Insurance Agent
Goldfus Insurance, 9 Diskin St., Level B Villa 11A, Jerusalem 96440
Tel. 972-2-5612223,  972-52-873887,
Fax.972-2-5612225, e-mail: kelter@pobox.com    

Steven Kelter, M.S.W., is an Israeli insurance agent originally from the U.S. and Canada. He specializes in health, long-term care, life, disability, pension and travel insurance. Together with Goldfus Insurance he provides a full range of insurance services including car, home, business, and other property and liability insurance.  Mr. Kelter represents AACI, the Association of Americans and Canadians in Israel in their insurance program.

 


Last Updated: 07-02-2000
Copyright 1999-2001 by Akiva M
E-mail to akivam .a.t. gmail 'd'o't com with questions/comments.