Assistance Purchasing Rehabilitation Devices (Right)

From All Rights (Kol-Zchut) (www.kolzchut.org.il)

הקדמה:

The Ministry of Health provides financial assistance towards the purchase of rehabilitation devices
The assistance is for 75% of the established price, according to the type of device
A Ministry of Health office should be contacted before purchasing a device
Within the expansion of The Healthcare Basket services for 2015, financing of devices for augmentative and alternative communication has been added
For more information, see "Assistance Funding Rehabilitation and Ambulatory Assistance Devices" on the Ministry of Health's English website
  • The Ministry of Health provides financial assistance towards the purchase of rehabilitation, mobility (ambulatory) and walking devices; this page provides information about rehabilitation devices.
  • The assistance is for 75% of the established price, according to two categories of devices:
    • Devices for which a maximum sum has been established (which is not the full price of the device).
    • Devices for which 3 price quotes must be obtained and the price will then be established according to the lowest quote.
  • The recipient co-payment is 25% of the the price established by the Ministry of Health (except for cases in which an exemption is granted, as detailed below).
  • For details regarding assistance from the Ministry of Health in financing additional devices, see:

Who is Eligible?

  • Those with a permanent disability who require a mobility device and live in the community (meaning they are not hospitalized in any type of long-term/rehabilitation framework).
  • Minors without legal status who have health insurance for non-resident children in Israel are entitled to the same assistance as minors who are residents.

Who is Not Eligible?

Co-Payment Exemptions

  • Recipients of the following benefits are exempt from paying a co-payment (relevant approvals and documentation regarding the benefits must be presented):
  • Those who have financial difficulties may contact a Ministry of Health office social worker with proof of income for the applicant and his/her spouse (pay/pension/benefit slip, tax assessor statement for the self-employed, and any other required documentation).
  • The social worker may increase the Ministry of Health contribution to up to 90% of the cost in the following cases:
    • Another device was purchased the same year.
    • There are other people in the applicant's family who are eligible for financial assistance towards purchasing a device.
    • The applicant had other expenses related to the disorder in the same year for which no financial assistance from any source was received.
    • The applicant's family is paying for another first degree family member to reside in an institutional arrangement.

List of Rehabilitation Devices

  • The devices included in accordance with the third addendum to The National Health Insurance Law include:
    • Hearing devices and F.M. devices for children up to 18 years old.
    • Prosthetic eyes - For recipients of all ages. As of 2012, the funding is also given for scleral prostheses.
    • Vision assistive devices (telescopic and microscopic eyeglasses) for children up to 18 years old.
    • Contact lenses for children up to 18 years old in cases where eyeglasses are ineffective (including scleral contact lenses).
    • Facial prosthetics - Including nose/ear/orbital
    • Prosthetic breasts - One every two years
    • Bra for prosthetic breasts - Provided one time only
  • For more information, see the Ministry of Health procedures: Rehabilitation and Mobility Device Approval

How to Claim It?

  • Applicants must see a relevant physician at the health plan (see below for details) in order to receive a recommendation.
  • The following documents are required for the assistance request:
    • For hearing devices - Referral from an ENT doctor and a recommendation from a communication clinician with an attached audiology test
    • For vision assistive devices (including prosthetic eyes) - Recommendation from an ophthalmalogist
    • For prosthetic breasts - Recommendation from a family doctor/internist/oncologist/surgeon
    • Photocopy of ID (teudat zehut)
  • The documents may be submitted to the Ministry of Health office by the health plan or by the patient/an authorized representative of the patient.
  • The request, along with the required documentation, must be submitted to the devices coordinator in the department of protracted diseases and rehabilitation in the closest Ministry of Health office.
  • The forms may be submitted during the department’s opening hours, by mail or by fax.
  • A local committee will discuss each request which it is authorized to discuss (either approving or rejecting it), and a written response will be sent to the applicant.
  • Instructions regarding the rest of the process will be detailed in the written response to those whose request has been approved.
  • Those who receive approval of eligibility for independent purchase should provide the health office the following documents in order to receive reimbursement:
    • The benefit approval
    • Device receipt authorization form (signed)
    • Original invoice and receipt
    • Bank account details for those who have been approved to buy a device on their own (photocopy of a canceled check)

Appeals

  • Those whose application for assistance has been rejected may appeal the committee's decision.
  • The appeal will be sent in writing through the Ministry of Health office.
  • The hearing in the appeals committee will take place within 30 days of receiving the appeal and its processing by the Ministry of Health office.

Please Note

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