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(Text replacement - "==( *)Sources( *)==" to "== Credits ==")
Cheryl Burnat (talk | contribs)
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<!--
 
<!--
 
| 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-->
 
| 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 = [[Definition of Chronic Illness|Chronically Ill Patients]], are exempt from paying a co-payment for medications included in the Healthcare basket, only on amounts [[Medication Payment Ceiling for the Chronically Ill|Above the ceiling]].
+
| פיצוי = [[Definition of Chronic Illness|Chronically Ill Patients]], are exempt from paying a co-payment for medications included in the Healthcare basket, on amounts [[Medication Payment Ceiling for the Chronically Ill|exceeding the payment ceiling]]
 
| שאלה  = <!-- דוגמה: שאלה -->
 
| שאלה  = <!-- דוגמה: שאלה -->
| 2חשוב =  If a medication is not included in the health basket, it may be obtained by other means for more information see [[:he:מדריך להשגת תרופות שאינן בסל הבריאות| Guide for obtaining medications not included in the Healthcare basket]].
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| 2חשוב =  If a medication is not included in the health basket, it may be obtained in other ways.  For more information see the [[:he:מדריך להשגת תרופות שאינן בסל הבריאות|Guide for obtaining medications not included in the Healthcare basket]]
| ממשל  =  The list of [[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|medications included in the health care basket]] is a detailed list that is updated each year.
+
| ממשל  =  The list of medications included in the health care basket is a closed list, detailed in the [[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|ordinance]] and is updated each year
 
}}
 
}}
 
{{תקציר/סיום}}
 
{{תקציר/סיום}}
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}}
 
}}
 
{{ראו גם  
 
{{ראו גם  
| [[The Healthcare Basket]]
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| [[:he:פטורים והנחות ברכישת תרופות|Exemptions and Discounts on Medications]]
 
| [[Health and Illness]]
 
| [[Health and Illness]]
| [[Submitting a Request to Include Treatments or Medications in the Healthcare Basket]]
 
 
| [[Obtaining a Specific Brand-Name Drug]]
 
| [[Obtaining a Specific Brand-Name Drug]]
 
| [[Obtaining a Specific Generic Drug]]
 
| [[Obtaining a Specific Generic Drug]]
 +
| [[:he:מדריך להשגת תרופות שאינן בסל הבריאות|Guide to Obtaining Medications not included in the Healthcare Basket]]
 
}}
 
}}
 
{{עצם העניין/סיום}}
 
{{עצם העניין/סיום}}
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* 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.
 
* 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.
 
* 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 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.-->
*[[Definition of Chronic Illness|Chronically Ill Patients]], are exempt from paying a co-payment for medications included in the Healthcare basket, only on amounts [[Medication Payment Ceiling for the Chronically Ill|Above the ceiling]].
 
 
* 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.
 
* 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.
+
*[[Definition of Chronic Illness|Chronically Ill Patients]], are exempt from paying a co-payment for medications included in the Healthcare basket, on amounts [[Medication Payment Ceiling for the Chronically Ill|exceeding the payment ceiling]].
* 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.
+
* Policyholders may find out if a specific medication is included in the healthcare basket by reviewing the law or information published by the [[:he:משרד הבריאות|Ministry of Health]].
 +
* The list of medications included in the basket is closed and is 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-->
 
== Who is Eligible? == <!--מי זכאי-->

Revision as of 19:40, 24 April 2018

Introduction:

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
Chronically Ill Patients, are exempt from paying a co-payment for medications included in the Healthcare basket, on amounts exceeding the payment ceiling
If a medication is not included in the health basket, it may be obtained in other ways. For more information see the Guide for obtaining medications not included in the Healthcare basket
The list of medications included in the health care basket is a closed list, detailed in the ordinance and is updated each year
</div></div>

</div>

The list of medications included in the basket according to The National Health Insurance Law is detailed in the National Health Insurance Ordinance (Medications in the Healthcare Services Basket).

  • 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 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.
  • Chronically Ill Patients, are exempt from paying a co-payment for medications included in the Healthcare basket, on amounts exceeding the payment ceiling.
  • 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 is 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?

  • Anyone insured according to The National Health Insurance Law.

How to Claim It?

  • Obtaining medications included in the healthcare basket is subject to relevant medical indications and a professional medical opinion of the attending physician.

Medications Included in the Healthcare Basket

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 choose not to.
  • In such a case, a policyholder desiring a specific medication not included in the basket but offered by one health plan and not another may switch to a health plan offering the desired medication.
  • If a medication is not included in the health care basket, it maybe be obtained by other means. For more information

Submitting a Complaint regarding Non-Provision of a Medication

Please Note

Court Rulings

Aid Organizations

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

Government Agencies

Laws and Regulations

The National Health Insurance Law National Health Insurance Order (Medications in the Healthcare Services Basket)

Additional Publications

Credits