Navigating the healthcare system in a new country can be daunting, especially in a place like Israel, where the system is both comprehensive and complex. This guide aims to provide a detailed overview of Israeli health insurance, helping new immigrants (olim) and long-term residents understand their options and make informed decisions about their healthcare coverage.
The National Health Insurance Law
In 1995, Israel implemented the National Health Insurance Law, which mandates that all Israeli citizens and permanent residents must be covered by one of four non-profit health maintenance organizations (HMOs), known as “Kupot Cholim.” These HMOs are:
- Clalit
- Maccabi
- Meuhedet
- Leumit
The law ensures that every resident has access to a comprehensive basket of medical services, including hospitalization, physician visits, diagnostic tests, and various treatments and medications. The basket of services is determined annually by the government and is uniform across all four HMOs[1][2].
Enrolling in an HMO
New immigrants and permanent residents must enroll in one of the four HMOs within 90 days of their arrival in Israel. The enrollment process is straightforward, and you can choose any HMO based on your preferences, such as location, reputation, or recommendations from friends and family. Once enrolled, you will be assigned a primary care physician (family doctor) and a clinic within your chosen HMO’s network. This physician will be your first point of contact for most medical needs and will provide referrals to specialists or hospitals if necessary[1][3].
Contributions and Copayments
The Israeli health insurance system is funded through a combination of government subsidies and individual contributions. All Israeli residents aged 18 and older are required to pay a monthly health tax, which is a percentage of their income (currently 3.1% for employees and 5% for self-employed individuals). This tax is automatically deducted from salaries or paid directly to the National Insurance Institute (Bituach Leumi)[1][3].
In addition to the monthly health tax, there are copayments (known as “mas-sachbir”) for certain services, such as visits to specialists, diagnostic tests, and medications. These copayments are generally affordable, ranging from a few shekels to a few hundred shekels, depending on the service. However, certain groups, such as children, pregnant women, and individuals with specific medical conditions, are exempt from copayments[1][3].
Supplemental Health Insurance (Shaban)
While the basic basket of services provided by the HMOs is comprehensive, it does not cover everything. To address this gap, the HMOs offer supplemental health insurance plans, known as “Shaban” or “Mashlim.” These plans provide additional coverage for services not included in the basic basket, such as:
- Dental care
- Alternative medicine (e.g., acupuncture, homeopathy)
- Expanded medication coverage
- Private hospital rooms
- Specialist consultations without referrals
- Treatments abroad
The cost of supplemental health insurance varies depending on the HMO, the level of coverage, and the age of the insured individual. Generally, the premiums range from a few hundred shekels per year for basic coverage to several thousand shekels per year for more comprehensive plans[1][3].
It’s important to note that while supplemental health insurance is optional, many Israelis choose to purchase it to ensure broader coverage and access to additional services.
Private Health Insurance
In addition to the public health insurance system and supplemental plans offered by the HMOs, Israelis also have the option to purchase private health insurance from commercial insurance companies. Private health insurance can provide even more extensive coverage, including:
- Access to private hospitals and clinics
- Choice of physicians and specialists
- Shorter waiting times for elective procedures
- Coverage for experimental treatments or medications not included in the public system
Private health insurance premiums are generally higher than supplemental plans and can vary significantly based on factors such as age, medical history, and the level of coverage desired. However, private insurance can be a valuable option for those seeking additional flexibility, choice, and access to premium medical services[1][3][4].
Healthcare for Tourists and Temporary Visitors
If you are visiting Israel for a short period as a tourist or temporary visitor, you will not be eligible for the national health insurance system. In this case, it is highly recommended to purchase travel health insurance or international health insurance before your trip.
Travel health insurance policies typically cover emergency medical expenses, such as hospitalizations, accidents, and acute illnesses, during your stay in Israel. These policies can be purchased for a specific duration and may have limitations or exclusions, so it’s essential to review the coverage details carefully.
International health insurance plans, on the other hand, provide more comprehensive coverage and can be suitable for longer stays or for individuals who frequently travel abroad. These plans often include coverage for routine medical care, prescription medications, and even medical evacuation or repatriation if necessary[1][2].
Healthcare for Students and Researchers
International students and researchers studying or working in Israel are generally not eligible for the national health insurance system unless they have obtained permanent residency. However, many universities and research institutions in Israel require international students and researchers to have adequate health insurance coverage as a condition of enrollment or employment.
In these cases, students and researchers can purchase private health insurance plans specifically designed for international students and scholars. These plans typically provide comprehensive coverage for medical expenses, including hospitalizations, physician visits, prescription medications, and emergency services.
Some universities and institutions may also offer group health insurance plans for their international students and researchers, which can be more cost-effective than individual plans. It’s important to check with your institution regarding their specific health insurance requirements and options[1][4].
Navigating the Healthcare System
Once you have enrolled in an HMO or obtained private health insurance, navigating the Israeli healthcare system can be challenging, especially if you are unfamiliar with the language or cultural norms. Here are some tips to help you make the most of your healthcare experience:
- Learn basic Hebrew medical terminology: While many healthcare professionals in Israel speak English, having a basic understanding of Hebrew medical terms can be helpful in communicating your symptoms and concerns.
- Understand the referral system: In the public system, you will typically need a referral from your primary care physician to see a specialist or receive certain diagnostic tests or treatments. Be prepared to explain your medical history and concerns to your primary care physician first.
- Be patient and persistent: The Israeli healthcare system can be bureaucratic and may involve long wait times, especially for non-urgent procedures or appointments. Be patient and persistent in advocating for your healthcare needs.
- Seek support from immigrant organizations: Many organizations and support groups exist to assist new immigrants (olim) in navigating the Israeli healthcare system. These resources can provide valuable guidance and advice.
- Consider hiring a medical translator or advocate: If you are facing significant language or cultural barriers, you may want to consider hiring a professional medical translator or patient advocate to assist you in communicating with healthcare providers and understanding your treatment options.
Choosing the Right Health Insurance Plan
Choosing the right health insurance plan in Israel depends on your specific needs, circumstances, and preferences. Here are some factors to consider when selecting a plan:
- Employment Status: If you are employed by an Israeli employer, you will be automatically enrolled in the state insurance, and your employer may also provide private insurance. If you are self-employed, a digital nomad, or retired, you may need to consider international or private health insurance options[1][2].
- Residency Status: Permanent residents and citizens are covered by the national health insurance system. However, if you are a temporary resident, student, or researcher, you will need to obtain private health insurance[1][4].
- Coverage Needs: Assess your healthcare needs and preferences. If you require extensive coverage, including access to private hospitals, choice of specialists, and shorter wait times, private health insurance may be the best option. If you are looking for additional coverage beyond the basic basket of services, consider purchasing supplemental health insurance from your HMO[1][3][4].
- Budget: Consider your budget and the cost of premiums, copayments, and out-of-pocket expenses. Private health insurance premiums can vary significantly, so it’s important to compare different plans and choose one that fits your financial situation[1][3][5].
- Pre-existing Conditions: If you have pre-existing medical conditions, check whether the insurance plan covers them. Some private insurance plans may exclude coverage for pre-existing conditions or have waiting periods before coverage begins[1][3][5].
Conclusion
The Israeli health insurance system is comprehensive and provides universal coverage to all citizens and permanent residents. However, it can be complex and may require supplemental or private insurance to ensure broader coverage and access to additional services.
By understanding the different components of the system, the enrollment process, and the available options, you can make informed decisions about your healthcare coverage and ensure that you and your family receive the medical care you need.
Remember, navigating a new healthcare system can be challenging, but with patience, persistence, and the right resources, you can successfully access the high-quality medical care available in Israel.
Additional Resources
For more information on health insurance in Israel, you can visit the following websites:
These resources provide valuable information and guidance to help you navigate the Israeli healthcare system and choose the right health insurance plan for your needs.
Citations:
[1] https://www.internationalinsurance.com/health/asia/israel/
[2] https://i-brokers.com/expat-guide-healthcare-insurance-israel/
[3] https://www.internations.org/israel-expats/guide/healthcare
[4] https://international.tau.ac.il/about-healthinsurance
[5] https://www.nbn.org.il/life-in-israel/healthcare-in-israel/private-healthcare/private-health-insurance-in-israel/
[6] https://www.nbn.org.il/life-in-israel/healthcare-in-israel/overview-of-israeli-healthcare-system/
[7] https://www.yedidim-health.co.il/tourists
[8] https://www.internationalinsurance.com/health/systems/israel/
[9] https://goldfus-ins.co.il/en/health-life-insurance/private-health-insurance/
[10] https://en.wikipedia.org/wiki/Healthcare_in_Israel
[11] https://www.nbn.org.il/life-in-israel/healthcare-in-israel/kupot-cholim/kupot-cholim/
[12] https://chaimvchessed.com/information/medical/kupat-cholim/
[13] https://international.tau.ac.il/independent-health-insurance
[14] https://www.yadlolim.org/healthcare/supplemental-insurance
[15] https://www.btl.gov.il/English%20Homepage/Insurance/Health%20Insurance/Pages/default.aspx
[16] https://www.btl.gov.il/English%20Homepage/Insurance/Health%20Insurance/Pages/HealthInsuranceLaw.aspx
[17] https://www.tel-aviv.gov.il/en/Live/HealthAndWelfare/Pages/MedicalInsurance.aspx
[18] https://www.gov.il/en/departments/topics/rights_of_policyholders/govil-landing-page
[19] https://www.kamaze.co.il/health/reviews/14722/health-fund-transition/hmo
[20] https://www.gov.il/en/pages/selection-arrangement