Introduction:

Health plan policyholders are entitled to a quarterly, per family, payment ceiling for co-payments for various services
There are certain populations that are eligible for discounts and exemptions beyond this payment ceiling.
For information on the payment ceilings in the various health plans and additional information see the Ministry of Health's Kol HaBriut website.


Health plan policyholders are entitled to a quarterly, per family, payment ceiling on co-payments for various medical services as outlined below.

List of Services

  • Secondary Doctors: Specialty doctors, including psychiatrists that are not primary care doctors (see below) as well as dietitians and podiatrists.
    • Primary doctors are general doctors (that are not specialists) and specialty doctors in family medicine, internal medicine, gynecology and pediatrics. There are no co-payments for visits to primary care doctors.
  • Out-patient Clinics: Clinics run in the framework of general hospitals (including mental health clinics in general hospitals).
  • Institutes:
    • Imaging institutes: x-rays, ultrasounds, nuclear medicine, CT, echocardiograms, MRI.
    • Diagnostic institutes: EEG, EMG, audiometry, ergometry
    • Institute for gastroenterology and the institute for sleeping problems

Additional information

Who is Eligible?

How to Claim It?

  • The payment ceiling should go into effect automatically - When the family reaches the ceiling, the computerized system should no longer require payment for relevant services beyond the established limit.
  • The health plans send quarterly reports to their policyholders which detail the payments for that quarter.

Government Agencies

Laws and Regulations

Additional Publications

Credits