Children diagnosed as being on the autism spectrum are entitled to receive paramedical treatments from their health plans or, depending on conditions, to be reimbursed for private treatments.
- Since 2010, the Health Basket entitlement is for 3 treatments per week throughout the year.
- For information on additional treatments provided by the health fund's supplemental insurance, see the "Kol Habriut" website.
- The following types of treatments are included: occupational therapy, physical therapy, speech therapy, and treatment by a psychologist or social worker.
Who is eligible?
- Children with a diagnosis of being on the autism spectrum from the age of diagnosis until age 18.
Who is not eligible?
- Children up to age 7 who receive services through preventative care treatments.
How to claim it?
- In order to receive the services, contact the Child Development Institutes or clinics.
- In a case where the appropriate treatments are not offered in the child development institute, the institute will refer the parents to a list of treatment providers to choose, from that have an agreement with the kupat cholim.
- Each treatment requires a co-payment except in cases where the child is below age 3 or the family is eligible for income support.
- For updated information on the co-payments amounts see the Ministry of Health website.
- For more information see the Kupot Cholim websites:
- In the event that the waiting time for treatment is greater than three months, you may contact a private therapist and receive reimbursement from the health fund, provided the therapist has advance authorization by the health fund. The health fund office is permitted to ask for a copy of the therapist's license in order to give authorization.
- Reimbursement for treatment will be given upon presenting the receipt, and corresponding with the Ministry of Health rates in the child development field (minus the co-payment amount, except for those exempt from it).
- The health fund may periodically request that the parents provide brief summaries from the therapist, including the goals of treatment.
Maintaining Continuity of Care
- If the child can be treated by a therapist with the Health Fund, the fund is not allowed to transfer the child to another therapist for budgetary reasons.
- If treatment by a private therapist has been approved due to a long waiting time, and later the fund offered treatment within a reasonable time, parents will be entitled to continue treatment with the private practitioner and receive a refund.
- Coverage of 3 hours, weekly, refers to various professions, according to the needs of each child. A child that does not need a particular type of treatment, but needs more than an hour per week in another area, may exercise his right to the full time coverage in dividing the treatment types accordingly (for example, 2 hours of occupational therapy and 1 hour of speech therapy).
- Receiving paramedical treatment as part of the special education system does not revoke your eligibility to receive treatment from your health plan (except in the situation of preventative care).
- For a list of organizations that assist with health related issues
- For a list of organizations that assist with the general population of people with disabilities
- For a list of organizations that help people on the autism spectrum
- The Ministry of Health
- Kol Habriut - The Ministry of Health call center
- National Health Insurance Law Ombudsman
- The Health Funds (Kupot Cholim)
- The fact that a child is in special education does not exempt health plans from providing paramedical treatments for that child.
Laws & Regulations
- The National Health Insurance Law – Update No. 43
- Ministry of Health director general's circular number 3/09 from 06.01.2009 - Provision of services in the field of child development for children on the autism spectrum.
- Rights booklet for children on the autism spectrum from ALUT
- Paramedical treatments on the ALUT website