Diabetes


Receiving Health Plan Services for Diabetes

As detailed on the Clalit health plan health services website (January 1, 2010)  


Insulin Pump

Clalit customers are entitled to receive an insulin pump free of charge under the following conditions with a referral from the treating doctor:

  • Children and adults with diabetes who suffer from hypoglycemic attacks marked by spontaneous loss of consciousness, confusion and change in behavior without prior warning.
  • Those who suffer from repeated attacks of ketosis, acidosis and hypoglycemia requiring hospitalization.
  • Diabetes patients whose HgA1c level is 7.5 and more.
  • Diabetes patients who received intensive treatment including three or more injections of insulin throughout the day; however, did not achieve the balance goals.
  • Women who suffered from diabetes in the period before pregnancy and during pregnancy.
  • Type 2 diabetes patients in cases of severe resistance to insulin and those treated with high doses of insulin who do not reach the recommended sugar level balance.
  • For those who suffer from pulmonary hypertension, the service is given with a recommendation from a hospital lung disease specialist. In cases of preliminary pulmonary hypertension, please get approval from the district medical administration.


Reimbursement for a sugar level measuring device

Clalit customers who require a sugar level measuring device may purchase it in a Clalit pharmacy and receive a reimbursement. In order to receive the reimbursement, please obtain a letter from a doctor specializing in diabetes or a family health specialist. The recommendation must be approved by the clinic manager. Additionally, a tax invoice or original receipt indicating the name of the device and the customer for whom the device was purchased must be attached. Such a reimbursement may be given once every three years.


The health plans are responsible for providing device supplies

The Ministry of Health has made it obligatory for the health plans to provide patients with the supplies required to operate an appliance or device which is included in the basket without a co-payment. Click here to view the Ministry of Health notice regarding such supplies (Hebrew).


Syringes for personal use

Diabetes patients who require syringes for personal use may obtain them from Clalit free of charge.


Needles for diabetes patient self-examinations

Diabetes patients who require needles for self-examinations are entitled to a 90% discount in Clalit pharmacies.


Strips for checking blood sugar

Diabetes patients who require strips for checking their own blood sugar are entitled to a 90% discount in Clalit pharmacies.


Nocturnal erection testing, such as RigiScan

The service is provided to the patient in his home using a designated device in the following cases:

  • The patient suffers from impotence and is a prosthesis transplant candidate.
  • The patient suffers from impotence due to diabetes and/or high blood pressure.


Laparoscopic surgery without a band

The service is provided in the following cases according to a referral from the treating doctor:

BMI above 40

or
BMI above 35 with one of the following risk factors:

  • Moderate to severe sleep apnea.
  • Right heart failure.
  • Diabetes which is unbalanced under insulin treatment of 100 units per day and more.
  • High blood pressure that cannot be balanced using the best pharmaceutical treatment (make sure to obtain approval from a district-certified doctor).
  • Gallbladder stones (when operating on the gallbladder).
  • Joint replacement due to obesity.
  • Cicatricial hernia or major hiatal hernia.


General Rights for the Chronically Ill and/or Disabled

 

Medication Co-Payment Ceiling

Diabetes patients are chronically ill and it is their responsibility to ensure that they are considered as such by their health plan. Being defined as chronically ill is primarily important because it entitles the insured to pay less for medications, up to the ceiling which changes every year. Currently, the payment ceiling is 265 NIS per month. Click here to download a Ministry of Health notice regarding the co-payment ceiling for diabetes patients’ medication purchasing.


Please note: When calculating the cumulative cost of co-payments, purchases of supplies (syringes, bandages, etc.) must also be included.


National Insurance Rights


General Disability – Anyone who is ill and above the age of 18 is entitled to submit a disability claim to the National Insurance Institute.

 

The disability rating is defined in proportion to the medical problem, its severity or complications connected to it. Attention must be paid to the existence of complications which raise the disability rating, even if they are not treated on a daily basis.

 

If the claimant has been defined as at least 40% medically disabled and he/she lost the ability to earn a living, either fully or partially, he/she will be eligible for a disability allowance from the National Insurance Institute.

 

Click here to see more information about general National Insurance and disability rights.


Disable child benefit - For detailed instructions on submitting a request, click here to visit the Juvenile Diabetes Research Foundation in Israel's English website.


Income Tax and Municipal Tax Benefits


Income Tax

Parents of children with diabetes are entitled to income tax and municipal tax benefits. Diabetes patients do not generally receive income tax benefits. Those whose disability has been defined as above 90% are entitled to an income tax exemption.


Municipal Tax

The discounts depend on the municipal authority and should be checked on a case by case basis.

Click here to see more information about general National Insurance and disability rights.


Other Information


Military and National Service enlistment

  • All recruits with juvenile diabetes are assigned a profile of 25. The profile automatically entails exemption from military service for health reasons but does not reflect any type of mental health problems .
  • Diabetics may volunteer to serve in the military as regular soldiers with certain restrictions, although those with an HbA1c level over 9% are not approved to volunteer .
  • Those with diabetes may not enlist as combat soldiers in combat units, but may serve in combat units, as combat support staff .
  • Volunteers receive a general supplement of about 100 NIS per month designated for the purchase of medications .
  • A release grant   is given to volunteers like to any other discharged soldier, according to the number of months served .
  • Those who are not interested in the military may volunteer for national service  and enjoy rights like those given to people who have performed military service .

 

Click here to visit the Juvenile Diabetes Research Foundation website page regarding this topic (Hebrew).


Education

  • Diabetic children can join in all the activities in kindergarten and school .
  • It is important to note that if the school or kindergarten tries to limit the child's activities in any way, parents are entitled to contest this and demand that the child be integrated into all activities .
  • If parents encounter problems with the educational system, they should contact:

Naama, a social worker at The Juvenile Diabetes Research Foundation
Phone: 03-5160171
Email: naama@jdrf.org.il


Irit Livne, health supervisor in the Ministry of Education
Phone: 02-5603451

            Email: Iritli@education.gov.il 

 

Driver's License

  • According to current Israeli law, diabetics can get a license to drive a private car, commercial vehicle (truck up to 3 tons) and two-wheeled vehicles (motorcycle up to 500 cc).
  • The regulations prohibit insulin-dependent diabetics to have a public vehicle driver's license (land, air or sea), such as an ambulance, taxi, airplane or heavy commercial vehicle .
  • Anyone who wants to get a driver's license, must know that he/she cannot take the theory test or the practical test, until the Ministry of Vehicle Licensing (Misrad HaRishui) receives approval from the National Traffic Safety Institute. Therefore, it is advisable to start the process with the Ministry of Vehicle Licensing (Misrad HaRishui) even before beginning to take driving lessons, in order to avoid unnecessary delays in the process .
  • According to the official procedures, there is a form especially for diabetics. This form has two parts: a declaration of diabetes to be filled out before a lawyer and a medical form to be filled out by the doctor treating the diabetes. Applicants must make sure to write their full name and identification number (teudat zehut) on each form individually .
  • It is recommended to photocopy all material submitted to the Ministry of Vehicle Licensing (Misrad HaRishui) and inquiry as to the application's status once a month .
  • It is important to know that the Institute for Road Safety thoroughly checks the balance of applicants, and this criterion is central and essential to the Institute's decision of whether or not to approve an application to take the driving tests .
  • After receiving a driver's license, diabetics are required to have sweets in the vehicle at all times in case of a hypoglycemic episode .
  • In order to renew a driver's license, diabetic drivers must undergo a review of their diabetic condition every two years .
  • Useful Contact Information:

   The Ministry of Vehicle Licensing's National Call Center (Human Response): 1-222-5678

   The Medical Institute for Road Safety:
            HaArbaa Street 12, Tel Aviv

            Tel: 03-5634702

            Fax: 03-5626022

Telephone availability hours: Sunday, Monday, Wednesday, Thursday from 10:00-11:00

            Office hours: Tuesday from 12:00-14:00 

 

Employment

  • Diabetics for whom disability of at least 20% has been determined are entitled to vocational rehabilitation.
  • In principle there is no reason that diabetics should be prevented from working in any profession or under various working conditions. Nonetheless, the reality is that diabetics sometimes have to fight for the right to certain jobs. The Equal Employment Opportunities Law and     The Equal Rights for People with Disabilities Law  are designed to protect workers against discrimination in employment . 

 

Insurance companies

Additional rights to which diabetes patients are entitled are rooted in claims against insurance companies for those with policies including coverage for loss of work capacity if their earning was damaged as the result of diabetes or the detection of serious illness.


Click here for The Israel Diabetes Association's English website.

Click here  to visit the Juvenile Diabetes Research Foundation in Israel's English website. 

 

 

 

 

Translated by The Shira Pransky Project