Health Plan Fee Exemptions for the Seriously Ill (Right)

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

הקדמה:

Policyholders who have a serious illnesses are exempt from paying the health plan's deductible for various medications and services
Those who are eligible must verify that the information regarding their illness is up-to-date in their health plan's computer system
For more information, see the Ministry of Health's English website
  • Patients with an illness classified by the Ministry of Health as a "serious illness" (see the list below) are exempt from paying for medications through their health fund, according to the regulations of their insurance. They are also exempt from paying for certain medical services included in the healthcare basket.
  • If Payment Form (Form 17) is necessary, the patient will be exempt from paying the deductible from issuing the form.

Medical Services

  • The following services are ones in which the patient will receive a deductible exemption from payment:
    • Visits to institutes (i.e. for x-rays) and out-patient facilities
    • Primary doctor visits - The doctor to whom the patient would turn first. General physicians and specialists in the following fields are included in this category: family medicine, pediatrics, internal medicine and gynecology.
    • Secondary doctor visits - Medical specialists not included in the above definition of primary doctors, including ophthalmologists, podiatrists, and dietitians.
  • Such patients are also exempt from paying for medications according to each health plan's regulations:
  • For a description of services, see the Ministry of Health's English site.

Medications

  • The exemption for medication payments is regulated by each health fund:
    • Clalit Health Services: Oncology patients are exempt from paying for medications which are in the health basket and are specifically for that illness.For more information, see the Clalit website (located on the continuation of the page,in the section entitled populations eligible for an exemption/discount).
    • Maccabi Health Services: People with a serious illness are exempt from paying for all medications which are in the health basket. For more information, see the Maccabi website.
    • Leumit: People with a serious illness are exempt from paying for medications which are in the health basket and are specifically for that illness. For more information, see the Leumit website. (Section B - description of discounts and exemptions).
    • Meuhedet: People with a serious illness are exempt from paying for all medications which are in the health basket specified for their illness. For more information, see Meuhedet website.
  • Patients who are not eligible for an exemption from payment for medication, are likely eligible for a payment ceiling for the chronically ill.

Who is Eligible?

How to Claim It?

  • The right is granted automatically, however patients should verify that the information regarding their illness is correct and up-to-date in the health plan computer system.

Government Agencies

Laws and Regulations

Additional Publications

Sources