Introduction:

All Israeli residents are entitled to switch from one health plan to another
Policy holders can switch health plans twice in a 12 month period, beginning from the time they registered for a health plan
Switching health plans does not impact the rights to which policyholders are entitled to as part of the healthcare basket
When switching health plans, the policyholder's seniority (ותק) is maintained with regard to additional health services (supplementary insurance) at the same level (i.e. gold, platinum, etc.); however there may be a qualifying period for new services. Those with supplementary insurance are therefore advised to clarify such details before switching health plans

All Israeli residents are entitled to switch from one health plan to another. They are entitled to up to two switches in a 12 month period, beginning from the time they registered with a health plan.

  • Switching from one health plan to another does not impact policyholders' rights:
    1. Policyholders will be entitled to receive all services to which they are entitled as part of the healthcare basket from the health plan they are leaving until the switch comes into effect.
    2. From the moment the switch comes into effect, policyholders are entitled to receive all services to which they are entitled as part of the healthcare basket from their new health plan without any conditions or restrictions.

Who is Eligible?

How to Claim It?

  • Switching health plans may be done in one of the following ways:
    1. Through the postal service by going to the local post office in person with your national identification card (תעודת זהות) and purchasing a transfer form, which costs 15 NIS.
    2. By filling out a request to switch health plans on the National Insurance Institute website.
  • Health plan transfers only go into effect on one of six yearly transfer enrollment activation dates, as detailed below.
  • After enrolling at the post office or through the National Insurance Institute website, applicants must go to a branch of the health plan they are joining with the enrollment form in order to complete the enrollment process, have a membership card issued and register for any additional services (such as supplementary insurance or long-term care insurance).

Transfer Enrollment Activation Dates

Date transfer form submitted Transfer enrollment activation date
16.09 - 15.11 01.01
16.11 - 15.01 01.03
16.01 - 15.03 01.05
16.03 - 15.05 01.07
16.05 - 15.07 01.09
16.07 - 15.09 01.11
  • In the following cases, a resident's enrollment will take place immediately and s/he will be entitled to immediately receive medical services through the health plan s/he has enrolled in or transferred to.
  • Those between age 18 and 18 1/2 years old.
  • New immigrants, if it is their first time enrolling in an Israeli health plan.
  • Newborns between 0 and 6 months old, if it is their first time being enrolled in a health plan.

Cancelling a Transfer

  • Someone who has requested to switch health plans and who would like to cancel the transfer may do so by submitting an enrollment cancellation form at the post office.
  • The cancellation form may be submitted until the last day of each enrollment period according to the table above.
  • Someone who submits a cancellation request after this date will not be able to cancel the transfer and will have to wait until the following enrollment activation date for any changes to go into effect.

Registration and Transferring of Health Plans for Babies and Children

  • At birth, every child automatically becomes a member of the health plan to which the parent who receives the child allowance belongs (usually the mother), unless the parents enroll the child in a different health plan within 6 months of birth.
  • Initial enrollment of a newborn within 6 months of birth goes into effect retroactively from the date of birth.
  • In order to switch a baby's health plan after the initial enrollment or after the baby is 6 months old, the general rules (as detailed above) apply.

Separated Parents

Annual Transfer Limit

  • Policyholders may only switch health plans twice within any 12 month period.
  • For someone who cancels a transfer and then requests another transfer during the same enrollment period, the enrollment will only be processed and go into effect from the following enrollment activation date.

Ramifications of Switching Health Plans on Supplementary Insurance Rights

  • Health plans are permitted to establish a reasonable qualification period (wait period) as a condition for receiving rights and services that are part of supplementary insurance.
  • If there is an established wait period as part of a health plan's supplementary insurance program, policyholders are not entitled to receive specific services included as part of that supplementary insurance until the end of the qualification period even if they are enrolled in it and continue to pay for it.
  • A policyholder who switches health plans who was enrolled in supplementary insurance in the previous health plan and enrolls in supplementary insurance with the new health plan within 90 days of joining, will be exempt from any relevant wait periods in accordance with the time s/he was enrolled in supplementary insurance at the previous health plan, as long as the supplementary insurance plans are of the same level.
Example
A policyholder who was a member of Meuhedet's "Adif" supplementary insurance plan for a year and then joined Maccabi's "Magen Kesef" supplementary insurance plan will have the year he/she was a member of "Adif" deducted from any relevant qualification periods at Maccabi.
  • If a policyholder switches from a "lower level" supplementary insurance plan to a "higher level" supplementary insurance plan, relevant qualifications periods for the new plan will apply.
  • The qualification periods are different for different services and levels of supplementary insurance, and are detailed in health plan regulations.
  • Before switching from one health plan to another, it is recommended to clarify whether there is an exemption from the wait period in the new plan or not. If there is no exemption established in the health plan's regulations it is important to check how long the wait period is..

Maintaining Long-Term Health Care Insurance when Switching Health Plans

  • A person who is ensured through a group long-term health care insurance policy through his health plan, is entitled to switch health plans and maintain his insurance policy without having to undergo an additional medical examination at the time of the switch.
  • Switching to a policy in the new kupat cholim is not automatic. A policy holder who wishes to switch health plans is required to present a documentation that he was insured with long-term care insurance by his old health plan, within 180 days from the date on which the new plan requested it from him.
Tip
  • The insurance company that insured the policy holder in the health plan that he left is obligated to send the policy holder a letter shortly after the switch, detailing the information required for the transition between the insurance policies, and serves as confirmation that he was insured through the previous health plan's group long-term care insurance.
  • In addition, the insurance company of the new health plan, is required to inform the policyholder of his right to join its long-term care insurance policy with insurance continuity.
  • In the event that the insurance company does not comply with these actions a complaint can be submitted to the Capital Market Authority's public inquiry department.

Transfer of Medical Information

  • When a policyholder switches health plans, the health plan is responsible for transferring all essential medical information regarding the policyholder to the new health plan. Transfer of medical information for purposes of medical care will be performed at no cost to the policyholder.
  • After both health plans receive notification that the policyholder is switching funds, both are required to notify him by direct mail of his rights to receive a summary of his medical information in one of the following ways:
    • Receiving it directly at the clinic.
    • Receiving it through registered mail.
    • Receiving it via email.
    • Downloading it from the health plan's website using a username and password.
  • The policyholder can also choose whether the information should be transferred directly from the old health plan to the new one or whether it should be transferred through him.
  • The medical summary that is transferred at the policyholder's request should include the information that it is listed in appendix a of the Health Director's Circular.
Tip
The right of the policyholder to receive his medical summaries free of charge when transferring health plans is in addition to the right to Obtaining Information from the Medical Record that has a service fee.

Please Note

  • Employers are not allowed to make employment conditional on membership in any specific health plan or require employees to join a specific health plan.
  • Health plans are prohibited from making provision of medical services or medications conditional or limited in any way solely because a policyholder who is switching health plans may use the medication after switching to a different health plan.


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