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{{זכות/תחילת טור ימני}} {{דגשים | מידע = The health plans are required by law to provide the medications included in the [[The Healthcare Basket|healthcare basket]] to policyholders, subject to relevant [[:he:התוויה רפואית|medical indications]] and professional medical opinions | מידע2 = The list of medications included in the basket is closed, detailed in the [[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|National Health Insurance Ordinance]], and updated every year | איסור = <!-- דוגמה: אסור לעשות --> | חשוב = Hospitals are required to supply all necessary medications to hospitalized patients according to the attending physician's professional opinion, even if the medications are not included in the healthcare basket | פיצוי = By law, the health plans are permitted to collect a co-payment for medications included in the healthcare basket | שאלה = <!-- דוגמה: שאלה --> | ממשל = <!-- קישור לגורם ממשל אחראי --> }}<!-- פרמטרים סטנדרטיים: מידע/איסור/חשוב/פיצוי/שאלה/ממשל. ראו [[תבנית:דגשים]] למידע על אפשרויות הפרמטרים בתבנית --> *The list of medications included in the basket according to [[:he:חוק ביטוח בריאות ממלכתי|The National Health Insurance Law]] is detailed in the [[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|National Health Insurance Ordinance (Medications in the Healthcare Services Basket)]]. {{זכות/סיום הקדמה}} <!-- תבנית זו דואגת לכך שהכותרת הבאה בתור תתחיל רק מתחת לתוכן העניינים --> *The health plans are required by law to provide the medications included in the healthcare basket to policyholders, subject to relevant medical indications and professional medical opinions. *By law, the health plans are permitted to collect a co-payment for medications included in the healthcare basket. *The health plans are not required to provided medications not included in the healthcare basket, but they may do so. Accordingly, it is possible that one health plan may supply a specific medication not included in the healthcare basket, while another health plan does not do so. In such a case, a policyholder may choose to switch to a health plan that has decided to supply a specific medication. *The co-payments required for specific services and medications are not the same in all health plans, so one health plan may take a larger or smaller co-payment for an identical service or medication than a different health plan. *Policyholders may find out if a specific medication is included in the healthcare basket by reviewing the law or information published by the Ministry of Health. *The list of medications included in the basket is closed and updated every year. Any public or private entity (i.e. patients, patient organizations, doctors, companies, etc.) may submit a request to add new medications to the healthcare services basket. == Who is Eligible? == <!--מי זכאי--> *Anyone [[:he:ביטוח בריאות|insured]] according to The National Health Insurance Law. == How to Claim It? == <!--תהליך מימוש הזכות--> * Obtaining medications included in the healthcare basket is subject to relevant [[:he:התוויה רפואית|medical indications]] and a professional medical opinion of the attending physician. == Medications Included in the Healthcare Basket == *Information regarding the medications included in the healthcare basket can be found on the Ministry of Health and health plans' websites. *Information is provided on these sites regarding if a given medication is included in the basket, what the medical indications for its use are, if it may be acquired over the counter, and if a co-payment is required. * The Ministry of Health website: ** [http://www.old.health.gov.il/units/pharmacy/trufot/index.asp?safa=h The Ministry of Health's medications database] ** [http://www.old.health.gov.il/pages/default.asp?maincat=1&catId=111&PageId=827 Medications price listing on the Ministry of Health website] * Health plan websites: ** Maccabi Health Services - [http://www.maccabi4u.co.il/13084-he/Maccabi.aspx Co-payments for medications] ** Leumit Health Fund - [http://www.leumit.co.il/services_info.asp?pgId=1321&catID=226 Medication fees] ** Meuhedet Health Services - [https://www.meuhedet.co.il/meuhedet/views/engine?rnd=0.82017924921742&templateName=menu.txt&idorItemId=topMenu&menuBarView=menu&menuBarSubjectParam=1211196727562&menuBarStartMenuParam=subSubject&topMenuId=11&menuBarOpenCategoryParam=&mainView=article&mainId=&mainSubjectParam=1211196727562 Co-payments and exemptions] ** Clalit Health Services - [http://www.clalit.co.il/HE-IL/fee+for+servic/ Medication fees] ==Administrative Approval for Treatment with a Medication Included in the Healthcare Basket== *The health plans sometimes make provision of treatment with specific medications contingent on prior administrative approval (approval that is not from the attending physician). *Due to the fact that this approval process is liable to delay provision of essential treatment, the Ministry of Health has determined that health plans requesting to make provision of medications conditional may do so according to the following conditions: :*The approval is limited to a reduced number of medications for '''non-urgent''' treatments. :*A listing of the medications is published on the health plan's website. :*The conditional administrative approval is only for the the drug treatment's initial prescription. :*A response will be provided to the patient no more than four days from the date the request was submitted by the attending physician. If a response is not received in this period of time, it will be considered to be approval of the request. *The attending physician is responsible for making sure approval is obtained. *Any refusal of administrative approval must be explained and sent to the patient in writing. == Supply of Medications Not in the Healthcare Basket == * The health plans are not required to supply medications not included in the healthcare services basket to policyholders, but they may choose to do so. * Accordingly, it is possible that one health plan may supply a certain medication even if it is not included in basket, while another health plan may not do so. * In such a case, a policyholder desiring a specific medication not included in the basket but offered by another health plan may switch to that particular health plan. == Submitting a Complaint regarding Non-Provision of a Medication == * Policyholders wishing to complain regarding non-provision of a medication included in the healthcare basket may submit a complaint to the [[:he:נציבות קבילות הציבור לחוק ביטוח בריאות ממלכתי|National Health Insurance Law Ombudsman]]. For more information, see: [[new:Submitting a Complaint to the National Health Insurance Law Ombudsman|Submitting a Complaint to the National Health Insurance Law Ombudsman]]. == Please Note == <!--חשוב לדעת--> *The list of medications included in the basket is detailed in the [[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|National Health Insurance Order (Medications in the Healthcare Services Basket)]]. In most cases, the medications appear by their generic name (according to the active ingredient). Accordingly, under the generic name, there may be a number of commercial names for the drug, even if they do not explicitly appear in the Order. *All medications marketed in Israel must appear in the "Registry of Medical Products in Israel" (פנקס התכשירים הרפואיים בישראל) before being marketed. Registration and approval of a specification medication and its medical indications does not mean that it is included in the healthcare services basket. *Hospitals are required to supply all necessary medications to hospitalized patients according to the attending physician's professional opinion, even if the medications are not included in the healthcare basket. For hospitalization, policyholders receive a [[:he:קבלת טופס התחייבות (טופס 17) מקופת החולים|letter of financial obligation/payment voucher (Form 17, also know as התחייבות) from their health plan]], which covers all medications and services they may require during hospitalization according to the relevant medical opinions, whether they are included in the healthcare basket or not. == Legal Precedents == <!--תקדימים משפטיים--> * [[:he:אי הכללת תרופה בסל התרופות אינה שיקול לסירוב למתן תרופה לחולי סרטן|The fact that a medication is not included in the medication basket should not be considered when prescribing medications to a cancer patient]] == 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--> * [[:he:משרד הבריאות|The Ministry of Health]] * [[:he:נציבות קבילות הציבור לחוק ביטוח בריאות ממלכתי|The National Health Insurance Law Ombudsman]] * [[:he:המוסד לביטוח לאומי|The National Insurance Institute]] == Laws and Regulations == <!--חוקים ותקנות--> [[:he:חוק ביטוח בריאות ממלכתי|The National Health Insurance Law]] [[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|National Health Insurance Order (Medications in the Healthcare Services Basket)]] == Additional Publications == <!--הרחבות ופרסומים--> * [http://www.health.gov.il/hozer/sbn03_10.pdf Health Plan and Additional Health Services Supervision Division Circular 3/2010 from 16.3.2010] - Prior approval processes for the provision of treatment with medications included in the healthcare basket * [http://www.patients-rights.org/medicins.html Medications] on [[:he:האגודה לזכויות החולה בישראל|The Society for Patients Rights in Israel]]'s website * [http://www.old.health.gov.il/Download/pages/trufotSal2011.pdf Listing of medications included in the 2011 healthcare basket] on the Ministry of Health website * [http://www.health.gov.il/hozer/mk01_2012.pdf Ministry of Health Director Circular 1/12 from 10.01.2012] - Expansion of the healthcare services basket for 2012 * [http://www.clalit.co.il/HE-IL/Guides/medicines.htm Clalit Health Services Medications Guide] == Sources == <!--מקורות--> * Original information provided by the [[:he:המרכז הקליני מזו"ר - המשפט למען זכויות החולה בישראל|Mazor Clinical Center - Providing Legal Advice Regarding Patients Rights in Israel]]. *Original translation performed by [[The Shira Pransky Project]]-AACI. <!--כותרת דמה עבור הטמעת כותרת. לא לגעת! ==endarticle== כותרת דמה עבור הטמעת כותרת. לא לגעת!--> {{זכות/סיום טור ימני}} {{זכות/תחילת טור שמאלי}} {{זכות/ראו גם | [[The Healthcare Basket]] | [[Health and Illness]] | [[new:Submitting a Request to Include Treatments or Medications in the Healthcare Basket|Submitting a Request to Include Treatments or Medications in the Healthcare Basket]] | [[:he:קבלת תרופה אתית מסוימת (תרופת מקור)|Obtaining a Specific Name-Brand Medication]] | [[:he:קבלת תרופה גנרית מסוימת|Obtaining a Specific Generic Medication]] }} {{זכות/חדשות | 1 = | 2 = | 3 = }}<!-- עד 3 ידיעות. כל ידיעה מועברת כפרמטר (ממוספר) נפרד. הפורמט המומלץ הוא תאריך מודגש ולאחריו קישור לידיעה. התיבה לא תוצג אם הפרמטרים יישארו ריקים --> {{זכות/טפסים | 1 = | 2 = | 3 = }}<!-- רשימת טפסים למימוש הזכות. כל פרמטר מופיע בשורה משלו, כתבליט (בולט). התיבה לא תוצג אם הפרמטרים יישארו ריקים --> {{זכות/סיום טור שמאלי}} <!-- יש לכתוב תגיות כאן בתחתית --> [[קטגוריה:זכויות]] [[Category:Rights]]

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