Funding of Ambulance Evacuation Costs (Right)

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

הקדמה:

Anyone covered by national health insurance who is evacuated to a hospital by Magen David Adom (MDA) and is subsequently hospitalized is automatically entitled to full funding of ambulance evacuation costs
Anyone covered by national health insurance who is evacuated by MDA in a mobile intensive care unit ("NATAN") and is not subsequently hospitalized is entitled to partial funding of the evacuation costs
In certain cases, even those who are not hospitalized are entitled to full funding of evacuation costs
Patients must contact their health plan within one month to arrange for payment
For more information, see the Ministry of Health's English website


Those evacuated to a hospital by ambulance are entitled to partial or full funding of the evacuation costs, in accordance with the specific circumstances.

Who is Eligible?

  • Health insurance policyholders evacuated to a hospital by ambulance or urgent care mobile unit, according to the following circumstances:
  • Full funding of ambulance costs:
  • Those who were evacuated and hospitalized - Entitled to full funding of ambulance costs from their health plan.
  • Those who were transferred from a hospital emergency room and taken for continuation of treatment at another hospital - Entitled to full funding of ambulance costs from their health plan.
  • Those who were transferred from one hospital to another - Entitled to full funding of ambulance costs from the referring hospital (unless the patient was transferred to a nursing facility).
  • Those who were transferred from a hospital to a rehabilitation or complex long-term care framework - Entitled to full funding of ambulance costs from their health plan.
  • Partial funding of ambulance costs:
  • Those who have been evacuated by a mobile intensive care unit ("NATAN"), and were not hospitalized - Entitled to funding of 50% of ambulance costs from their health plan.
  • Some health plans offer benefits in addition to the basic entitlement (see details on the Health Ministry Information website), It is recommended to contact the health plan in order to clarify conditions of eligibility and available benefits.
Tip:
Senior citizens who are members of the Supportive Community Program can call in an emergency with an alert button, without a doctor's authorization, with nominal cost participation.

Who is Not Entitled

  • Those who have been evacuated by regular ambulance (not a mobile intensive care unit ("NATAN" or "ATAN"), and were not hospitalized - Are required to fund the evacuation costs themselves.

Specific Circumstances

  • Road accident victims - Entitled to full funding of evacuation costs from their health plan if the evacuation is performed by a mobile intensive care unit (NATAN)/mobile intensive care ambulance (ATAN), but must fund all evacuation costs themselves if by means of a regular ambulance. For more information, see: Funding of Ambulance Evacuation Costs for Road Accident Victims.
  • Work accident victims - The National Insurance Institute covers all evacuation costs. For more information, see: Medical Treatment for Work Injury Victims.
  • Pregnant women evacuated to a hospital who give birth - Entitled to full funding of evacuation costs by the National Insurance Institute and not by their health plan. For more information, see: Ambulance Services During Labor.
  • IDF soldiers - The IDF covers all evacuation costs. For more information, see: Evacuation by Ambulance for a Soldier.
  • Epilepsy - Those with epilepsy are entitled to full funding of evacuation costs under specific circumstances. For more information, see: Epilepsy.
  • Oncology and dialysis patients - Oncology and dialysis patients who must travel for treatment and there is medical justification for transportation by ambulance are entitled to have their health plan cover 50% of the ambulance costs. The health plans are permitted to have arrangements with a specific ambulance company whereby policyholders must use that company's ambulance services in order to receive funding from the health plan. It is recommended to clarify specifics with the health plan in advance.
  • Victims of a hostile act - The National Insurance Institute covers all evacuation costs. For more information, see: Funding of Ambulance Evacuation Costs for Victims of a Hostile Act.
  • Policyholders transferred from a nursing/long-term care facility to a hospital - Policyholders hospitalized in a nursing/long-term care facility, funding for which comes from the Ministry of Health ("code hospitalization"), are entitled to funding of the ambulance costs from the institution in which they are hospitalized, in accordance with arrangements between the Ministry of Health and the "code hospitalization" facility.
  • Policyholders that died at home - according to Rights booklet for the elderly population for "Leumit" members, the fund finances payment in the event that an ambulance or an Intensive Care Unit has been called, but the insured dies at home.

How to Claim It?

When the Health Plan Pays

  • When evacuation to a hospital is performed by an MDA ambulance -
    • Contact the health fund within 60 days of the evacuation with the MDA request for payment. The fund will transfer payment directly to MDA (depending on the case, the fund will collect a partial payment).
    • If 60 days have elapsed from the date of the evacuation, contact MDA for payment of the evacuation. At the same time, contact the health fund with the request for payment and receipt in order to receive a refund (full or partial, as the case may be).
  • When evacuation to a hospital is performed by an ambulance operated by an organization other than MDA - The patient should clarify payment arrangements with that organization and the health plan.

When the National Insurance Institute Pays

  • In all of the following cases, the National Insurance Institute is required to pay, and not the health plans:

When the IDF Pays

Discounts and Exemptions From MDA

Please Note

  • It is important to confirm that payment is transferred to MDA within 90 days of the evacuation, otherwise interest and indexing will be added to the cost.
  • Those who have been charged additional charges for interest and indexing due to delay in payment may submit a request to the director of MDA to remove all or some of these additional charges. The request must provide an explanation of the reasons for the delay and show that these reasons were out of their control. The director of MDA has the authority to cancel any charges, added interest and/or indexing in whole or in part.

Aid Organizations

  • For a comprehensive categorized listing of healthcare organizations offering assistance and support, click here.

Government Agencies

Laws and Regulations

Additional Publications


Sources