According to the National Health Insurance Law, the health plans are permitted to offer plans including additional health services (SHABAN) beyond those included in the basic healthcare basket.
- This supplementary insurance constitutes an additional level of the basic healthcare basket and can include three principle types of coverage:
- Added Insurance - Services that are not included in the healthcare basket such as dental care and long-term care insurance.
- Expanded Insurance - Expansion of the services included in the healthcare basket such as increased financial health plan coverage of transplants in Israel and abroad.
- Alternative Insurance - Qualitative replacement of services provided in the healthcare basket, such as compensation for hospitalization expenses incurred at a private hospital.
- All insurance policyholders are entitled to join a supplementary insurance plan and receive all services offered as part of it, regardless of medical condition, age, or financial status. This principle is the main essential difference between the additional health services plans and private insurance offered by insurance companies, which are based on screening out applicants determined to be an "insurance risk" due to their medical condition.
- Policyholders may not be members in one health plan and join an additional health services plan offered by another health plan.
- Payment for joining supplementary services program is the same for all policyholders of the same age and the same plan.
Who is Eligible?
- All Israeli citizens.
How to Claim It?
- Those interested in joining an additional health services plan may do so by signing an enrollment form in accordance with each health plan's specific policies.
- Enrollment forms may be signed and submitted at any health plan branch.
- Health plans must inform policyholders within 30 days of receiving an enrollment form that they have been added to the additional health services plan. The notification will include the additional health services plan's regulations, a copy of the enrollment form and signed payment instructions.
- For all intents and purposes, the signing date is considered the date of enrollment.
- The health plans may include a health declaration and waiver of medical confidentiality with the enrollment form on the condition that the signature on these forms is considered only to be a optional and not required.
- To clarify details about the supplementary insurance program, see Contact Details for HMOs on the Ministry of Health's website.
- The sole condition for receiving services as part of an additional health services plan is the qualification (waiting) period which is determined by the health plan and is different for every service.
- Policyholders are not eligible to receive a specific service as long as they are in its waiting period.
- The waiting periods also differ according to health plan and are detailed according to each medical service in the health plan's regulations. Some medical services are exempt from having a qualification period, and in no case may a waiting period be longer than 24 months.
- There are medical services that are exempt from qualification periods.
- Additional health services plans are not permitted to include components related to those that are in the basic healthcare basket, such as a discount on co-payments for medications included in the healthcare basket, or shortened waiting periods for specific appointments.
- The additional health services plans vary between health plans. All policyholders are entitled to receive a copy of the additional health services plan offered by the health plan to which they belong.
- Due to the fact that additional health services plans are required to cover their own costs, most of the services included in them require a co-payment from the policyholder.
- The health plans are permitted to discontinue a policyholder's membership in an additional health services plan due to non-payment. In such a case, the health plan is required to give the policyholder at least two months advance warning, provided that the policyholder is given an opportunity for a hearing.
- Long-term care insurance for health plan members is separate from the additional health services plans, despite the fact that they are sometimes together; it is commercial insurance with separate terms and conditions which must be clarified with the health plan.
- There are different levels of insurance within the additional health services plans (such as "Regil", "Zahav", "Platinum"), each of which contains different services.
- A person can not be a policyholder in one health plan and join the additional health services plan of a different one.
- When switching health plans, the rights provided by an additional health services plan are retained in the new health plan at the same level.
- Starting from the 01.07.2016 certain services that were offered as part of the supplementary insurance are restricted by law for all policyholders. It is recommended to contact the health fund for clarification of eligibility.
- The Mazor Center for the Legal Rights of Patients in Israel
- The Society for Patient's Rights in Israel
- The Dolev Foundation for Medical Justice
Laws and Regulations
- The National Health Insurance Law - Section 10
- National Health Insurance Regulations (Additional Service Plan and Changes Therein), 5759-1998
- General information about supplementary insurance on the The Society for Patients Rights in Israel's English website
- Information in English on the Clalit health plan's additional health services plans from the Clalit website
- Information in English on the Maccabi health plan's additional health services plans from the Maccabi website
- Information in English on the Leumit health plan's additional health services plans from the Leumit website
- Informational leaflet in English on the Meuhedet Adif plan from the Meuhedet health plan's website
- Information in English on the Meuhedet C plan from the Meuhedet website
- The basis of this entry was written by Reut Malka, as part of Dr. Nili Karako Eyal's course at the College of Management's Mazor Clinical Center - Providing Legal Advice Regarding Patients Rights in Israel.
- Original translation by AACI's Shira Pransky Project.