Additional health services supplied by the health plans

 
Additional Services (Shaban) include: Supplementary Insurance, Long-Term Care Insurance, and Private Health Insurance

Supplementary Insurance

  • Supplementary health services are medical services which the health plan offers its members in addition to the health services included in the basic health services basket.

  • Receipt of the services is conditional on joining the supplementary health services plan and requires payment.

  • Each plan is free to choose which services it will offer its members as part of its supplementary plan, providing that these services are not included in the basic health services basket.

  • There are differences in the supplementary plans offered by the different health plans.

  • As a general rule, a health plan may introduce changes in its supplementary plan (e.g.: payments, addition or removal of medical services, etc.) only after receiving Ministry of Health approval .

  • Conditions and Limitations – The health plan is obligated to accept any member requesting to join the plan regardless of his state of health, and the rights of an enrolling member may not be made conditional or be restricted in any way.

  • Waiting Period – The health plan may set a reasonable "qualification period" (waiting period), i.e. a certain period between the date when the member joined the supplementary plan and the date when he will be entitled to rights under the plan. (There are health plans that exempt a person switching from another health plan in which he was insured under a supplementary plan from all or a part of the waiting period).

  • Rates – The price of the plan must be uniform for each age group, regardless of the number of years of membership in the plan or the member's state of health or finances.

  • Health plans are forbidden from making the providing of services included in the basic health services basket conditional on enrollment or membership in a supplementary health services plan.

 

Long-Term Care Insurance

Long-term care insurance does not form part of the supplementary insurance and it is a group insurance plan provided by the health plan in association with an insurance company. The following should be noted:

  • Acceptance of members – There is no obligation to accept every applicant to this plan.
  • The group insurance is for a limited period, and the insurance company is entitled not to renew it at the end of the period.
  • It is recommended to examine the terms of the proposed policy, to determine whether it is suitable, in the same way that one examines any health policy before purchasing it.
  • Click here to see the Ministry of Finance's comprehensive booklet regarding long-term care insurance (in Hebrew).

 

Private Health Insurance

  •   Some of the health plans allow members to purchase group health insurance through an insurance company.
  • This insurance has no connection to the health services basket and should be regarded the same as any group health insurance policy.
  • Acceptance of members – There is no obligation to accept every applicant to such a plan.
  • The group insurance is for a limited period, and the insurance company is entitled not to renew it at the end of the period.
  • It is recommended to examine the terms of the proposed policy, to determine whether it is suitable, just as one examines any health policy before purchasing it.

 

 

 

 

Translated by The Shira Pransky Project