Cheryl Burnat (talk | contribs)
(Created page with "{{עצם העניין}}{{סוג ערך|זכות}} {{תקציר |תוכן= {{דגשים | מידע = As of 01.02.2019, senior citizens above age 75, are entitled to preservati...")
 
Cheryl Burnat (talk | contribs)
 
(5 intermediate revisions by the same user not shown)
Line 30: Line 30:
 
*For additional information see [[Dental Care for Senior Citizens]].
 
*For additional information see [[Dental Care for Senior Citizens]].
 
== Who is Eligible? == <!--מי זכאי-->
 
== Who is Eligible? == <!--מי זכאי-->
−
* Those who are covered by National [[Health Insurance]] who are younger than 18 years old on the day they are referred for treatment.
+
*Senior citizens age 75 and above are entitled to preventative and preservative dental treatment.
 +
*Senior citizens age 80 and above are also entitled to rehabilitative dental treatments.
  
 
== How to Claim It? == <!--תהליך מימוש הזכות-->
 
== How to Claim It? == <!--תהליך מימוש הזכות-->
−
*All children are automatically covered by the health plan where they are registered and where they receive the healthcare basket services.
+
*The senior citizen should contact the HMO he is insured by to receive a diagnosis and treatment.
−
*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.
+
=== Preventative and preservative treatments ===
−
*Listings of clinics that provide the services according to health plan:
+
* '''The following treatments are given free of charge and don't require a co-payment:'''
−
**[http://www.clalit.co.il/he/clalit_smile/Pages/default.aspx Clalit]
+
**Annual check-up by a dentist.
−
**[http://serguide.maccabi4u.co.il/heb/DentistOffices/ Maccabi]
 
−
**[http://www.leumit.co.il/heb/servicesearch/dentics/ Leumit]
 
−
**[https://www.meuhedet.co.il/meuhedet/views/engine?rnd=0.5899724602447313&templateName=menu.txt&idorItemId=topMenu&realSubject=995473824372&mainView=article&mainId=1277206659875&menuBarView=menu&menuBarstartmenuParam=subSubject&menuBarSubjectParam=9954738243 Meuhedet]
 
−
*'''Please note:''' Treatments performed privately and not through the HMO will not be reimbursed.
 
−
 
 
−
== Treatments Included in the Basket ==
 
−
* '''Treatments given free of charge:'''
 
−
**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
 
−
**Guidance and preparation of a treatment plan.
 
−
**X-rays as part of the treatment process
 
 
**A pair of bite wing x-rays during the routine exam.
 
**A pair of bite wing x-rays during the routine exam.
−
**Instruction in oral hygiene (up to twice a year).
+
**Plaque removal once a year.   
−
**Plaque removal once a year.  Youth between age 17 and 18 are entitled to 2 treatments a year at no cost.
+
*'''The following treatments are given with a co-payment of 34 NIS:'''
−
**Topical prevention treatment
+
**Urgent first aid care when the person will suffer from a delay in treatment, such as: pain relief, giving a prescription or surgical treatment in cases of a severe infection, tooth decay removal, and temporary restoration.
−
**Filling of holes and cracks (preventative treatment)
+
**X-rays (with the exception of the bite wing ones that are given for free as part of the annual exam).
−
*'''Treatments that require a co-payment''' (24 NIS per treatment):
+
**Preventive treatment with a local fluoride or fluoride application - once a year.
−
**First aid
+
**Extractions (except for surgical extractions which cost 68 NIS).
−
**Reconstruction with amalgam and other materials ("fillings")
+
**Apicoectomy treatment.
−
**Treatment of the pulp of the tooth in baby and permanent teeth (including root canal)
+
**Reconstruction (Composite resin (white filling) and amalgam).
−
**Crowns (immediate and more permanent)
+
**Immediate construction.
−
**Preliminary crowns in posterior and anterior teeth
+
*'''The following treatments are given with the co-payment amounts assigned to them:'''
−
**Extractions (including surgical extractions)
+
**Root canal and root canal renewal - 136 NIS
−
**Preservation of the space after extraction
+
**Surgical extraction - 68 NIS
−
**Use of sedation/nitrous oxide
+
**Root coverage - 102 NIS
−
:*Dental care under anesthesia for children up to age 5 with early childhood tooth decays.  
+
===Rehabilitative treatments===
−
*When one procedure continues over the course of a number of visits, the co-payment is one time for the procedure and covers all of the visits connected to that procedure.
+
*In addition to preventative and preservative treatments, seniors age 80 and above are entitled to rehabilitative treatments (such as: preparing dentures, repairing cracks, adding teeth to dentures, crowns etc.).
−
{{דוגמה | A root canal requiring 2 visits requires a total co-payment of 24 NIS for the procedure}}
+
*The treatments are given in part up to a certain limit and require a co-payment.
−
 
+
*For a list of treatments and their conditions of eligibility see [https://www.health.gov.il/NewsAndEvents/SpokemanMesseges/Documents/06012019_1_1.pdf#page=2 details of the dental care services basket for people age 80 and above] on the Ministry of Health website.
−
=== Treatments Not Included in the Basket ===
+
== Please Note ==<!--חשוב לדעת-->
−
*There are certain treatments, including straightening of teeth (orthodontic procedures) that are not included in the basket and do not appear on the listing (published by the Ministry of Health) of included dental services.
+
*In the following cases, and only in the following cases, the HMO is responsible for providing transportation for [[:he:חולה מרותק בית|home-bound]] senior citizens to receive treatment:
−
 
+
**Transportation for [[Complex Long-Term Care Patient|complex long-term care patients]] that need emergency care.
−
==Standards According to Ministry of Health Directives==
+
**Transportation for [[Complex Long-Term Care Patient|complex long-term care patients]] that have been hospitalized for over 3 months for prosthetic treatments (rehabilitative treatments).
−
*The health plans are required to provide the dental services according to the guidelines given by law.  The treatment must be done with medical discretion, and be of reasonable quality, performed within a reasonable amount of time and be reasonably located to the patient's place of residence.
 
−
*'''First aid''' - The health plans are responsible for providing 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 before they turn 18, are entitled to have the health plan prepare a treatment plan to be performed completely even if the procedures included in it continue after the child turns 18.
 
−
 
 
−
==Complaints==
 
−
* Complaints regarding treatment or non-provision of services may be submitted to the [[Submitting a Complaint to the Health Fund|HMO Ombudsman]] or the [[Submitting a Complaint to the National Health Insurance Law Ombudsman|National Health Insurance Law Ombudsman]].
 
−
<!--== Please Note ==--> <!--חשוב לדעת--><!--== Court Rulings ==--> <!--פסקי דין-->
 
−
 
 
−
== Aid Organizations == <!--ארגוני סיוע-->
 
−
* For a comprehensive categorized listing of healthcare organizations offering assistance and support, [[Health and Illness/Aid Organizations | click here]].
 
−
 
 
 
== Government Agencies == <!--גורמי ממשל-->
 
== Government Agencies == <!--גורמי ממשל-->
−
* [[:he:משרד הבריאות|The Ministry of Health]]
+
{{הטמעת כותרת|Old Age and Aging#Government agencies}}
  
 
== Laws and Regulations == <!--חקיקה ונהלים-->
 
== Laws and Regulations == <!--חקיקה ונהלים-->
−
*[[:he:חוק ביטוח בריאות ממלכתי|The National Health Insurance Law]]
+
*[[The Healthcare Basket]]
−
*[http://www.health.gov.il/hozer/mr20_2010.pdf Medical Administration Circular 20/2010 from 17.06.10] - Dental services for children in the The National Health Insurance Law
 
−
* [http://www.health.gov.il/hozer/sbn12_2010.pdf Deputy Director of Supervision of Health Plans and Additional Health Services Circular 12/10 from 12.9.2010] regarding dental care for children in the The National Health Insurance Law - Guidelines for establishing standards of service
 
−
*[https://www.health.gov.il/hozer/DT08_02_29672312.pdf Guidelines for the Provision of Dental Care to Students no. 8.2 from 07.07.2016]
 
−
*[https://www.health.gov.il/hozer/mk02_2017.pdf Ministry of Health Director Circular no. 2/2017 from 24.01.2017] - Broadening the Dental Care offered in the healthcare basket.
 
−
*[https://www.health.gov.il/hozer/mk03_2018.pdf Ministry of Health Director Circular no. 3/2018 from 10.01.2018] - Broadening the Dental Care offered in the healthcare basket for 2018.
 
−
 
 
−
== Additional Publications == <!--הרחבות ופרסומים-->
 
−
*[http://www.health.gov.il/English/Topics/Dental_Health/ChildrenDentalTreatmentsReform/Pages/default.aspx The Ministry of Health's Children's Dental Care Reform Page]
 
−
*[https://www.health.gov.il/NewsAndEvents/SpokemanMesseges/Pages/08012017_3.aspx Press release regarding the expansion of dental services for children up to age 15] on the Ministry of Health website.
 
−
 
 
 
== Credits == <!--מקורות-->
 
== Credits == <!--מקורות-->
 
*Original information provided by the [[:he:ההסתדרות הרפואית בישראל|IMA]].
 
*Original information provided by the [[:he:ההסתדרות הרפואית בישראל|IMA]].

Latest revision as of 20:33, 2 December 2019

Introduction:

As of 01.02.2019, senior citizens above age 75, are entitled to preservative and preventative dental care as part of the healthcare services basket.
As of 01.201.2019, senior citizens above age 80 are also entitled to rehabilitative dental treatments (see details below)
Some of the treatments are given free of charge and some require various co-pay amounts
For additional information see the Ministry of Health website


Senior citizens above age 75 are entitled to dental treatment as part of The Healthcare Basket.

  • As of 01.02.2019, senior citizens above age 75, are entitled to preservative and preventative dental care as part of the
  • As of 01.201.2019, senior citizens above age 80 are also entitled to rehabilitative dental treatments.
  • Dental treatments are provided by the HMOs and vary in cost based on the type of treatment.

{{טיפ|*Senior citizens that are not yet 75, may be entitled to subsidized dental treatment through their local welfare services, according to their need.

Who is Eligible?

  • Senior citizens age 75 and above are entitled to preventative and preservative dental treatment.
  • Senior citizens age 80 and above are also entitled to rehabilitative dental treatments.

How to Claim It?

  • The senior citizen should contact the HMO he is insured by to receive a diagnosis and treatment.

Preventative and preservative treatments

  • The following treatments are given free of charge and don't require a co-payment:
    • Annual check-up by a dentist.
    • A pair of bite wing x-rays during the routine exam.
    • Plaque removal once a year.
  • The following treatments are given with a co-payment of 34 NIS:
    • Urgent first aid care when the person will suffer from a delay in treatment, such as: pain relief, giving a prescription or surgical treatment in cases of a severe infection, tooth decay removal, and temporary restoration.
    • X-rays (with the exception of the bite wing ones that are given for free as part of the annual exam).
    • Preventive treatment with a local fluoride or fluoride application - once a year.
    • Extractions (except for surgical extractions which cost 68 NIS).
    • Apicoectomy treatment.
    • Reconstruction (Composite resin (white filling) and amalgam).
    • Immediate construction.
  • The following treatments are given with the co-payment amounts assigned to them:
    • Root canal and root canal renewal - 136 NIS
    • Surgical extraction - 68 NIS
    • Root coverage - 102 NIS

Rehabilitative treatments

  • In addition to preventative and preservative treatments, seniors age 80 and above are entitled to rehabilitative treatments (such as: preparing dentures, repairing cracks, adding teeth to dentures, crowns etc.).
  • The treatments are given in part up to a certain limit and require a co-payment.
  • For a list of treatments and their conditions of eligibility see details of the dental care services basket for people age 80 and above on the Ministry of Health website.

Please Note

  • In the following cases, and only in the following cases, the HMO is responsible for providing transportation for home-bound senior citizens to receive treatment:

Government Agencies

Government Agency Website Rights and Areas of Responsibility
*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.
*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
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
Equal Employment Opportunities Commission- 02-6662701 Equal Employment Opportunities Commission website] The commission responsible for enforcing equality in the workplace and for handling cases of prohibited discrimination.
The Population and Immigration Authority - *3450 Population and Immigration Authority website Treatment of foreign workers, responsible for giving permits for the employment of foreign workers, managing the financial deposits that employers of foreign workers are required to deposit, oversight of the entrance and exit of foreign workers into Israel, issuing a death certificate, and updating the Population authority.


Laws and Regulations

Credits