Introduction:

A temporary long term care benefit is given in situations in which the policyholder's situation is expected to improve (for example after recovery from surgery)
In claims where detailed medical documents are provided it is possible to fast-track eligibility for the benefit based on the documents alone without the need for a dependency test in the person's home
Policyholders age 80 and above, who are granted a temporary benefit will undergo a dependency test at the end of their period of eligibility in order to determine if they are eligible for the benefit to continue

Eligibility for a Long-Term Care Benefit is established based on the policyholder's ability to perform daily activities or on the degree of his/her need for supervision.

  • The general process to claim the benefit is shown in the following diagram:
ADL Dependence Test
for the applicability of the
Conditions of Eligibility
Determining Dependence Level
by the claim clerk
Approval of a Temporary Benefit
or permanent benefit at level
A / B / C
or
Rejection of the claim
If the condition has deteriorated of a benefit recipient at level A or B
it is possible to request reassessment
  • Eligibility for a temporary long-term care benefit (for a period up to 60 days) is given when the person's ability to function is expected to significantly improve.
Example
Policyholders that are released from the hospital with a broken leg, bypass surgery, abdominal surgery or pneumonia and their conditions are expected to improve after a recovery period or after medicinal or physiotherapy treatment.

Who is Eligible?

  • A Long-Term Care benefit is paid to those who meet all of the following conditions:
  • This is the first time he/she is granted a long-term care benefit.
  • He/she does not suffer from mental, intellectual or cognitive disabilities.
  • He/she depends significantly on another person to perform most daily functions (i.e. he/she meets the conditions to receive a Level 1 long-term care benefit).
  • The patient's doctor signs the appropriate form stating that the patient suffers from a temporary disability that should not continue for over 2 months.

How to Claim It?

  • A Long-Term Benefit Claim should be submitted along with a professional medical opinion stating the need for temporary long term care.
  • Someone who is hospitalized can submit the claim form through the hospital social worker.
  • In accordance with the National Insurance Institute Circular, a claim in which detailed medical documents are provided it is possible to fast-track eligibility for the benefit based on the documents alone without the need for a dependency test in the person's home.

Continuing the Process

Policyholders Age 80 and Above

  • Those age 80 and above that were granted a temporary benefit have the right to have their eligibility checked again (through a National Insurance Institute initiative) towards they end of the temporary eligibility period.
Example
An 81 year woman who is functionally independent, underwent hip replacement surgery. After the surgery the woman needed help with bathing, dressing and other day to day activities. The National Insurance Institute approved a temporary long-term care benefit for 60 days for her. Towards the end of that period a physiotherapist was sent to her house and checked her level of dependency. The therapist determined that she had recovered from the surgery and was able to function independently again. Therefore her right to the benefit was not renewed.

Policyholders Under Age 80

  • For those who are not yet 80 as of the month that their temporary eligibility for a long-term care benefit begins, the benefit will automatically end when the period of eligibility ends without performance of a dependency test, unless the person asks to be checked.
  • The message the policyholder receives granting his/her temporary eligibility (and the reminder sent approximately two months before the period ends) notes that the benefit ends automatically without any further assessment unless the person requests a dependency test.
  • The temporary benefit will stop automatically for anyone who does not request to be tested.
  • Anyone who wants to have an additional dependency test performed on them may contact their National Insurance Institute branch by:
  • Faxing the branch's long-term care department.
  • Calling the Senior Citizen Advice Center that will pass the request onto the long-term care branch.
  • It is recommended to submit the request approximately a month before the temporary eligibility is scheduled to end.
  • One who submits the request up to two weeks after the temporary eligibility ends will have someone sent to his/her house to check him/her. If he/she is eligible, the benefit will continue without a break.
  • One who submits the request between two weeks and a month after the temporary edibility ends and the dependency tests determines that he/she is eligible for a long-term care benefit, will begin receiving the benefit from the 1st of the month after submitting the request.
  • If more than a month has passed since the period of temporary eligibility ended, a new long-term care benefit claim should be submitted.

Aid Organizations


Government Agencies

Government Agency Website Rights and Areas of Responsibility
*6050 hotlines - The National Insurance Institute Senior Citizens' Rights on the National Insurance Institute's website. Rights to various allowances given based on age and economic situation.
*9696 hotline - The National Insurance Institute's Call Center for Senior Citizen Counseling Services Senior Citizens' Rights on the National Insurance Institute's website. Free aid provided through counseling services for senior citizens and the call center for senior citizens and their families.
*8840 Ministry for Social Equality - Hotline for Public Inquiries Ministry for Social Equality website The *8840 hotline run by the Ministry for Social Equality gives the elderly a central address to direct all of their questions, provide information regarding rights, services and benefits entitled to the elderly. It also helps them actualize these rights.
Segula Unit - Hotline to help senior citizens in the hospital The Ministry for Social Equality A health hotline for senior citizens, to assist them and their families know their rights during the period of hospitalization.
The Ministry of Labor, Social Affairs and Social Services

Shil - Citizens Advice Service hotline - 118

Senior Citizens on the Ministry of Labor, Social Affairs and Social Services website Funding of Nursing Homes for independent and frail seniors. Various services are also provided within the community.
The Ministry of Health

*5400 "Kol HaBriut" Ministry of Health Hotline

Senior Health on the Ministry of Health website. Health Insurance and assistance for those suffering from age related health problems.
*5442 The Ministry of Housing and Construction Call Center The Ministry of Construction and Housing website Housing Assistance and Problem Solving for Senior Citizens


Laws and Regulations

Additional Publications

Credits