Funding of Ambulance Evacuation Costs (Right)

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

Introduction:

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
One who is evacuated by a regular ambulance (not an intensive care unit) and not hospitalized must pay for the evacuation except in the cases detailed below
For more information, see the "Kol HaBriut website and 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, depending on the specific circumstances.

  • One who is evacuated by a regular ambulance (not an intensive care unit) and not hospitalized must pay for the evacuation themselves except in the cases detailed below.

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

  • Someone who looses consciousness (faints) in a public space is eligible to a full evacuation reimbursement from all of the health plans.
  • 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 - Reimbursements are given by the health plans for ambulance evacuations on the day of the accident. 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 if she gives birth within 72 hours of the evacuation.

If she gives birth more than 72 hours later, her health plan provides the reimbursement. 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 health fund covers the payment in the event that an ambulance or an Intensive Care Unit has been called, but the person dies at home.

Funded by the Health Fund

When evacuation to a hospital is performed by a (Magen David Adom) MDA ambulance

  • If the patient is insured by the Clalit or Maccabi health funds:
    • The commitment form (hitchayvut) is sent directly by MDA to the patient's health fund where the eligibility for covering costs is assessed.
    • If the entire cost of the evacuation is covered, the patient's health fund will transfer the payment directly to MDA and the patient does not have to worry about transferring the information between the parties.
    • If it is determined that the patient is not eligible for any coverage of costs from his/her health fun, he/she will receive a letter from MDA detailing the health fund's decision with the instruction to arrange payment directly with MDA.
    • If it is determined that the patient is entitled to partial coverage from his/her health fund, he/she will receive a letter from MDA regarding the remaining amount that must be paid and the deadline to pay it. The patient needs to arrange to pay that directly with MDA.
  • If the patient is insured by the Leumit or Meuchedet health funds:
    • The patient should contact the health fund within 60 days of the evacuation with the MDA request for payment. The health 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).
  • For contact details of the MDA collection department, see the MDA website.

When evacuation to a hospital is performed by an ambulance operated by an organization other than MDA

  • The patient should contact the ambulance organization and his/her health plan to clarify payment arrangements.

Funded by the National Insurance Institute

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

Funded by the IDF

Discounts and Exemptions From MDA

  • In some cases, those who have not received assistance in funding for transportation in an MDA ambulance can apply to the discounts committee.
  • The eligibility criteria for applying - financial status, medical condition, holocaust survivors, "insolvent", homeless, terminally ill patients, orphans of both parents up to age 18.
  • The request is submitted via the application form for determining a discount/exemption from payment of an emergency transportation fee, with the relevant documents specified in the form attached.
  • Applications should be submitted within 60 days of receipt of the transportation service. If the application is filed after this date, the reason for the delay should be explained.
  • For more information on the eligibility criteria, see the uniform criteria for granting discounts/exemptions for MDA charges at the Magen David Adom site.
  • The request will be directed to the MDA collection department. For the collection department's contact information see the MDA website.

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.

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