Evacuation and Transportation by Ambulance

An insured who was evacuated and hospitalized

A person who was evacuated in a regular ambulance/intensive care ambulance/mobile intensive care unit and hospitalized in a hospital located close to his place of residence is entitled to a full refund.

Transfer from one hospital to another

• He was hospitalized in a hospital and transferred to another hospital, including to a rehabilitation hospital.
• He was transferred from an emergency room of one hospital to an emergency room of another hospital.
• He was transferred from one hospital to another for treatment during hospitalization (the transfer is usually at the expense of the hospital and sometimes at the expense of the health fund – the patient does not pay in any event).

The exemption does not apply to a transfer to a nursing home.

An insured who was evacuated and not hospitalized

• If the evacuation was in a regular ambulance – the insured is not entitled to any refund.
• If the evacuation was in an intensive care ambulance or mobile intensive care unit – the insured is entitled to a refund at 50% of the MDA rate.
• The number of hours a person spent in the emergency room is immaterial. As long as he was not hospitalized, he is entitled/not entitled to a refund as explained in this chapter.

Evacuation from a clinic

• An insured individual who visited a clinic and was evacuated on the instructions of the medical personnel by regular ambulance/intensive care ambulance/mobile intensive care unit to a hospital is not entitled by law to an exceptional refund.
• Nevertheless, some health funds approve a full refund in these cases – details are available at the health fund branches.

Evacuation from the street

An insured individual who lost consciousness in the public domain and was evacuated to a hospital in a regular ambulance or intensive care ambulance or mobile intensive care unit that was ordered for him is entitled to a full refund, even if he was not hospitalized.

Transfer from the hospital to the insured's home

The insured bears the cost of transportation from the hospital to his home, and he is not entitled to participation from any entity, except for patients as detailed in the chapter "Travel Costs."

Removal of a deceased person's body

The health fund covers the cost of removal only where death occurred in the deceased's home during treatment by the medical team of the ambulance or during evacuation to the hospital.

Evacuation of a work accident victim

A work accident victim is entitled to a full refund of the cost of evacuation, whether he was hospitalized or only spent time in the emergency room.

• Initial evacuation following the accident – Payment for this evacuation is made by the National Insurance Institute.
• Additional evacuation on a day other than that of the accident – If the patient needs to be evacuated on a day other than that of the accident, he will receive the refund through the health fund. He must apply to the health fund in which he is insured and present a certificate from the National Insurance Institute confirming that the accident has been recognized as a work accident.

Evacuation to delivery room

• The cost of evacuating a woman in labor is borne by the National Insurance Institute, which participates in the cost of transport to the hospital only if the distance between the location of the woman in labor and the nearest hospital to which she was evacuated is more than 40 kilometers.
• If this distance is more than 40 kilometers, the woman in labor will pay for the first 20 kilometers, and the balance will be paid by the National Insurance Institute, which settles accounts directly with MDA.
• Participation by the National Insurance Institute is conditional on the woman having delivered or an ultrasound test in the hospital showing that the woman had labor pains even if she did not give birth on the day of the evacuation.

Translated by The Shira Pransky Project

Procedure for payment/receipt of a refund from the health fund

Some health funds require that members pay for their evacuation by ambulance and to request a refund afterwards, while others require members only to present a signed payment commitment. Members should check this at the branch of the health fund to which they belong.

•  In any event, to receive the refund, the insured must present either a payment commitment or a payment receipt (depending on the health fund), as well as the MDA's report on the evacuation.
•  Evacuation from a clinic – Some health funds pay the MDA directly, while others require the patient to pay from his pocket and to collect the refund afterwards from the branch to which he belongs.
• Amount of the refund – The MDA charges two different rates according to the payment method – one rate for cash payment, and another for payment by credit (against the patient's signature on a payment commitment). The health funds refund the amount of the cash payment, which is slightly lower than the amount paid by credit.

Road accident victims

Rules of payment

A person who was injured in a road accident and evacuated by ambulance is required to pay according to the MDA schedule of rates for road accident victims.

To whom should one turn for a refund?

• Drivers – should turn to their insurance agent or to the insurance company that issued compulsory insurance for the vehicle.
• Passengers – should turn to the insurance company that issued compulsory insurance for the vehicle in which they were riding.
• Pedestrians – should turn to the insurance company that issued compulsory insurance for the vehicle that hit them.
• Victims of hit-and-run accidents – should turn to the Karnit Road Accident Victims Compensation Fund.

How does one know which insurance company is liable?

A road accident victim must apply to the police for a "police certificate" regarding the accident. The certificate includes the names of the insurers of the vehicles that were involved in the accident.

Procedure vis-à-vis insurance companies

• Each insurance company has its own policy regarding payment for evacuation. Some companies accept the commitment form and pay the MDA directly, while others are only willing to deal with the matter after payment has been made. This must be checked with the insurance company that bears the insurance liability.
• When submitting an application to the insurance company, one should attach (in addition to the commitment form or the payment receipt discussed in the preceding section) the police certificate and MDA's report on the evacuation.

Below are the categories of patients who are entitled to participation in travel costs:

• Dialysis patients – Dialysis patients traveling for dialysis treatment at an institute included in a service provider agreement.
• Oncology patients – Oncology patients traveling for treatment in a hospital (chemotherapy, radiation, hemodialysis).
• Recipients of bone marrow transplants – Recipients of bone marrow transplants are entitled to a refund of the cost of traveling for treatments during three months from the date of the transplant.

Amount of the refund
The patient is entitled to a full refund of the costs of travelling from his home to the hospital and back (refund for both ways) by public transportation. He must present a certificate from the hospital showing the dates of the treatments. A patient who is transported by ambulance or by taxi will be refunded 50% of the cost.

Topic D – Organizations that Offer Transportation Assistance

• Yad Sarah – The organization transports wheelchair-bound patients or disabled persons in special vans in which special lifts are installed. All the vans are air conditioned and fitted with special safety features to ensure passenger safety. The vans are driven by professional drivers who have been specially trained for transporting handicapped people. The service is provided to enable traveling for tests and treatments and also to family and social events. To order transportation, the organization should be contacted 24 hours in advance. Email: internet@yadsarah.org.il.
• Ezer Mizion – To arrange for ambulance transportation, free of charge (24 hours in advance), contact telephone 03-5742742. Transportation in regular vehicles by volunteer drivers can also be arranged. Website: http://www.ami.org.il.
• Umbrella Organization of Associations for the Disabled in Israel – 57A Frishman St., Tel Aviv 64383, telephone 03-5238799, fax 03-5240265, email: info@buildagate.com

Translated by The Shira Pransky Project

Question 1: Can a health fund restrict patients to traveling with an ambulance/taxi company with which it has an arrangement?

Answer 1: No. Selection arrangements do not apply to transportation. In other words, a health fund cannot obligate patients to travel with an ambulance/taxi company with which it has an arrangement.

Question 2: Can a health fund determine the transportation means by which a patient must travel?

Answer 2: No. Below is a quote from the report of the Ministry of Health ombudsman for 2005 (page 109): "…The ombudsman replied to the health fund that its stated position was not anchored in the law, and it was therefore obligated to continue giving the refunds it customarily gave also for trips by taxi from his home to the dialysis institute."

Translated by The Shira Pransky Project