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Health plan enrollment and payment

 
The Enrollment Process
  • Going to the Post Office – You must go personally to a post office branch with your identity card (Teudat Zehut) in order to enroll (the cost is approximately 15 NIS).
  • Completing Enrollment in a Health Plan (Kupat Cholim) – After enrolling at the post office branch, you must go to a branch of your health plan (Kupat Cholim) with your enrollment form in order to complete the required steps, get a magnetic card issued and enroll in the additional healthcare services (Additional Health Services- Shaban, Long-term care insurance).
  • The Right to Receive Health Services is only from the day on which the institution informs the National Insurance Institute (Bituach Leumi) that the person who submitted the request is entitled to be insured.
  • Changing Your Health Plan – A person who is insured and would like to change from one health plan (Kupat Cholim) to another can only do so after he/she belonged to their current health plan for at least 6 months. In order to do so, he/she must go to a post office branch and fill-out the change request form.
  • Beginning of Membership occurs in one of four months (January, April, July, September) according to the enrollment date.

Restrictions on Acceptance to a Health Plan
  • A health plan must accept every resident that requests to enroll in it.
  • Every insured person has the right to all of the services included in the healthcare basket immediately upon joining the health plan, independent of their state of health, income or any other reason (not including the Additional Health Services (Shaban)).
  • An employer is not entitled to stipulate work based on enrollment in a specific health plan, nor to obligate an employee to enroll in a specific health plan.
  • For addition information about the healthcare services basket under the responsibility of the health plans, click here.
 
Payment of Health Insurance Fees to the National Insurance Institute (Bituach Leumi)
  • The National Health Insurance Law created nearly complete separation between the obligation to pay health insurance fees and the right to receive healthcare services.
  • The health insurance fees are collected by the National Insurance Institute (Bituach Leumi), independent of the health plan to which the insured belongs.
  • Every worker, salaried or independent, must pay health care fees to the National Insurance Institute (Bituach Leumi) according to the amounts set in the National Health Insurance Law.
        • The National Insurance Institute (Bituach Leumi) transfers the money to the health plans according to two criteria: 1) The number of people with malignant diseases (AIDS, chronic liver disease, Gaucher's disease, hemophilia, thalassemia (blood disease)); 2) A special formula calculated based on the ages of the insured in each health plan.

           

  • Important to Know: Failure to pay or late payment of health insurance fees does not impact the rights of the insured and does not exempt the health plan from its obligation to provide the health services included in the basket.

Resident Who Lived Abroad and Returned to Israel
  • The law sets a detailed arrangement regarding the limitation of rights for a resident that lived abroad regarding receipt of health services upon his/her return to Israel – See Appendix H (Hebrew).
  • Israelis that return to Israel must wait approximately a month for every year they were not in Israel before receiving medical benefits. The waiting period cannot go above six months.
  • The National Insurance Institute (Bituach Leumi) may approve a shorter waiting period for Israelis who were abroad for purposes of receiving medical treatment.
  • The National Insurance Institute (Bituach Leumi) may approve payment of the healthcare fees in one payment instead of payment by six installments.
  • For additional information regarding the rights of Israelis who lived abroad as detailed on the Ministry of Health’s website, click here.
  • To see the National Health Insurance Law amendment regarding a returning resident, click here (Hebrew).
     
    For additional information regarding the National Insurance (Bituach Leumi) rights, click here.


    Note    : See Appendix A (Hebrew) for more information on these topics (enrollment in a health plan and payment of health insurance fees).


    For information from the Ministry of Health on changing health plans, click here.


     

     

     

     

 Translated by The Shira Pransky Project