Health Plans - Community Medicine (Kupot Cholim)
Hebrew source: קופות חולים - רפואת הקהילה
From All Rights (Kol-Zchut) (www.kolzchut.org.il)
This portal contains important information for understanding patients' rights as they pertain to the health plans, including policyholders' rights, switching health plans, various discounts and benefits and the process of referal to a hospital.
A significant part of the healthcare system takes place within the community through the health plan clinics. For this reason we consolidated the information on this topic, including your rights if you are referred to the hospital.
Health Plan Guides to Rights and Services
- Kol HaBriut - Comparison of rights and prices for medical services between the health plans and the supplemental health funds.
- Clalit Health Services Guide (for the English website, click here)
- Meuhedet Health Plan Guide (for the English website, click here)
- Maccabi Health Services Guide (for the English website, click here)
- Leumit Health Plan Guide (for the English website, click here)
Receiving Medical Services
- Choosing Medical Service Providers
- Health Plan Choice of Service Provider Arrangements
- Obtaining a Payment Voucher (Form 17) from the Health Plan
- Maintaining Continuity of Care (Principle of Treatment Continuity)
- Surgery Wait Times for Cancer and Blood Disorder Patients
- Referal to the Arrangements Office to Schedule a Surgery
- Specialized Medical Service
- Funding Medical Treatment Abroad
- Coverage of Travel Expenses for Medical Treatment
- Additional Medical Opinions
- Social Work Assistance in the Health Services Framework
- Supportive Home Care (Palliative Care)
Choosing a Health Plan and Switching Health Plans
Complaints and Appeals
Patient Privacy
- Maintaining Patient Dignity and Privacy During Medical Treatment
- Presence of a Family Member or Other Person During Medical Examinations
- Presence of a Family Member During Physical Examinations and Medical Treatment of Minors
- Prevention of a parent who has been accused or convicted of physical or sexual abuse from being involved in the medical treatment of his/her child
- Refusing the Presence of Students at Medical Examinations or Procedures
- Disclosing Medical Information to a Patient's Family
Exemptions and Discounts
Aid organizations
- Merkaz Mazor - Patients Rights Law in Israel
- The Society for Patient Rights in Israel
- Friends for Health - assistance in finding and purchasing medications
- Physicians for Human Rights - Israel
- Dolev Foundation for Medical Justice
Government agencies
Court Rulings
- The health plan must provide reimbursement due to delayed treatment
- Reimbursement for surgery performed abroad in case of a complete lack of experience in performing the operation in Israel
- The health plan was obligated to pay for catheterization for a resident of the North who decided to have the procedure performed at a hospital in the center of the country
Laws & Regulations
- The National Health Insurance Law
- National Health Insurance Regulations (Arrangements for Selection of Service Providers), 5765-2005
- National Health Insurance Regulations (Health Services in Foreign Countries), 5755-1995
- National Health Insurance Regulations (Procedures for Health Plan Registration and Change), 5755-1995.
- National Health Insurance Regulations (Additional Services Plan and Changes Therein), 5759-1998
- Assistant Director of Health Plan and Additional Healthcare Services Supervision Circular 06/2011 from 09/06/2011 - Implementation of National Health Insurance Regulations (Arrangements for Selection of Service Providers), 5765-2005
- Ministry of Health Director Circular 2/99 "Trapped Doctors - Preserving Trust in the Era of Conflicting Interests"
Additional publications
- The Knesset Research and Information Center - "The Impact of Payment Arrangements between the Health Plans and the Public Hospitals on the Options for Service Providers Offered by the Health Plans to their Members"
Credits
- Original translation performed by The Shira Pransky Project as part of a grant from The Fellowship Fund.