Introduction:

All children up to age 12 are entitled to dental care through their health plan as part of the healthcare services basket
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Children up to age 12 are entitled to free dental care through the health plans as part of the healthcare services basket.

Who is Eligible?

  • Those covered by the National Health Insurance Law who are younger than 12 years old when treatment is requested.

How to Claim It?

  • All children are automatically covered by the health plan where they are registered and where they receive the healthcare basket services.
  • The services are provided in health plan clinics or clinics that have an arrangement with the health plan that meet the Dental Care Division's professional standards.
  • Listings of clinics that provide the services according to health plan:

Treatments Included in the Basket

  • The dental treatments included in the healthcare basket are those which are intended to preserve and maintain healthy oral health including the following, among others:
  • Annual check-up by a dentist (a second time in one year is permitted if justified by a medical opinion)
  • Routine check-ups and follow-up as part of medical care
  • X-rays as part of the treatment process
  • Fillings
  • First aid
  • Crowns
  • Prefabricated crowns in posterior and anterior teeth
  • Extractions (including surgical extractions)
  • Use of anesthetics/nitrous oxide
  • Dental care under anesthesia for children up to age 5 with early childhood caries

Treatments Not Included in the Basket

  • Orthodontic procedures are not included in the basket and neither are treatments which do not appear on the listing of dental services included in the basket, which is published by the Ministry of Health.

Co-Payments

  • Some procedures are provided free of charge without a co-payment, such as: periodic check-ups, x-rays as part of treatment, annual cleanings, routine check-ups.
  • Some procedures require a co-payment of between 20 NIS and 40 NIS (for visits that include 2 or more procedures requiring a co-payment, such as crowns, extractions, and prefabricated crowns).
  • When one procedure continues over the course of a number of visits, the co-payment is for the procedure and is not dependent on the number of visits required for its completion.
Example
A root canal requiring 2 visits requires a total co-payment of 20 NIS for the procedure

Standards According to Ministry of Health Directives

  • The health plans are required to provide the dental services required by law according to the relevant professional opinion. The quality of the services must be reasonable, and they must be supplied within a reasonable period of time, and within a reasonable distance from the patient's place of residence.
  • First aid - The health plans are responsible for making a center for dental first aid available to their policyholders, which is open past normal clinic hours, and which will provide urgent procedures to policyholders and be within a reasonable distance of their place of residence.
  • The wait period for a periodic examination and preparation of a treatment plan may not exceed 30 treatment days from the date of the request.
  • The wait period to begin treatment according to a treatment plan prepared by a dentist on behalf of the service provider may not exceed 14 days from the date the plan was prepared.
  • The wait period may exceed those indicated above with parental approval.
  • All children who have requested dental treatment included in the basket while they are of an eligible age are entitled to have the health plan prepare a treatment plan to be performed completely even if the procedures included in it continue until after the child is no longer eligible due to his/her age.

Complaints

Aid Organizations

  • For a comprehensive categorized listing of healthcare organizations offering assistance and support, click here.

Government Agencies

Laws and Regulations

Additional Publications

Sources