The following post will attempt to cover all the different kinds of health insurance in Israel.
There are three layers of health insurance in Israel:
National Layer: Bituach Leumi (through your Kupat Cholim): Thank God, Israel is a first rate western country that provides an extraordinary level of medical care for all of its citizens. If an emergency comes up, you can go to the hospital and pay nothing. When you need to see a doctor, you can just sign up online and the cost is very small co-pay. Most medicines are subsidized, as are surgeries and other treatments. But there are still some things that aren’t covered. Instead, they are covered by the next two layers:
Shaban Layer: Additional Health Insurance through Kuppat Cholim: If you have something like Magen Zahav of Meuhedet Adif, you have what is called shaban (שב”ן – שירותי בריאות נוספים). Shaban covers you for additional medicines that affect quality of life (ie treating a kidney stones in a way that hurts much less). Shaban cannot offer any additional protection for anything that can save your life. For that, you’ll have to turn to…
Private Health Insurance Layer: Almost all the insurance companies in Israel (not kuppot cholim) offer private health insurance. These private policies can usually be divided into three groups:
- The first level of this insurance covers you for a certain amount towards transplants and/or additional drugs not subsidized by the government and/or surgeries abroad in the case of emergency.
- The second level offers a slightly higher level that covers a wider range of emergencies not covered by kupat cholim, as well as certain quality of life treatments as well. This level is usually called something like mashlim shaban – since it complements (להשלים) the insurance offered by the shaban – where the shaban pays for a part, the private insurance picks up the rest of the tab. Alternatively, some policies allow you to have a higher deductible in the event that you need a surgery.
- The third and highest level covers a large plethora of emergencies and illnesses and pays you irrespective of whatever is covered by kupat cholim and the shaban. These policies are cover you from the first shekel you pay and are therefore called “מהשקל הראשון” (literally “from the first shekel”)
In addition to the basic insurance laid out above, there are several kinds of “riders” or mini-policies which you can stick on your medical policy. The most popular riders are
(a) ambulatory – outpatient care, preventative medicine
(b) quick diagnosis – if you meet certain criteria you can go to a private hospital they have where they will run a full diagnosis and figure out whatever you have. Imagine House M.D. from the TV show.
(c) alternative medicine – This includes a lot of alternatives to traditional pills and surgeries. This is legit stuff, not some new age shaman who burns herbs and pray to Zeus on your behalf.
(c) on-line consultations – meet with a doctor and get prescriptions via an online meeting. This is kind of like a doctor coming to your home, but he meets you online so he doesn’t have to physically come to your home.
(d) special services for children – additional coverage for developmental issues – ie paying for speech therapy or occupational therapy.
Some of them, specifically ambulatory, are so popular that they offer it as a completely different policy, even though it is really just a level 3 mentioned above + the additional rider.
When you buy an insurance policy, ask your agent to break it down so you know what you are getting. Then you can determine if you are getting what you need or additional stuff you don’t.