m (Medications Included in the Healthcare Basket: עדכון הקישורים למחירוני התרופות באתר משרד הבריאות)
m (Text replacement - "תקדימים משפטיים" to "פסקי דין")
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{{עצם העניין}}{{סוג ערך|זכות}}
{{זכות/תחילת טור ימני}}
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{{תקציר}}
 
{{דגשים  
 
{{דגשים  
 
| מידע = The health plans are required by law to provide the medications included in [[The Healthcare Basket|the healthcare basket]] to policyholders, subject to relevant [[:he:התוויה רפואית|medical indications]] and professional medical opinions
 
| מידע = The health plans are required by law to provide the medications included in [[The Healthcare Basket|the healthcare basket]] to policyholders, subject to relevant [[:he:התוויה רפואית|medical indications]] and professional medical opinions
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| שאלה  = <!-- דוגמה: שאלה -->
 
| שאלה  = <!-- דוגמה: שאלה -->
 
| ממשל  = <!-- קישור לגורם ממשל אחראי -->
 
| ממשל  = <!-- קישור לגורם ממשל אחראי -->
}}<!-- פרמטרים סטנדרטיים: מידע/איסור/חשוב/פיצוי/שאלה/ממשל. ראו [[תבנית:דגשים]] למידע על אפשרויות הפרמטרים בתבנית -->
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}}
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{{תקציר/סיום}}
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{{טפסים
 +
| 1 =
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| 2 =
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| 3 =
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}}
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{{ראו גם
 +
| [[The Healthcare Basket]]
 +
| [[Health and Illness]]
 +
| [[Submitting a Request to Include Treatments or Medications in the Healthcare Basket]]
 +
| [[Obtaining a Specific Brand-Name Drug]]
 +
| [[Obtaining a Specific Generic Drug]]
 +
}}
 +
{{עצם העניין/סיום}}
 +
 
 
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)]].
 
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.
 
* 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.
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* 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 [[Obtaining a Payment Voucher (Form 17) from the Health Plan|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.
 
* 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 [[Obtaining a Payment Voucher (Form 17) from the Health Plan|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-->
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== Court Rulings == <!--פסקי דין-->
 
* [[: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]]
 
* [[: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]]
  
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* [[:he:נציבות קבילות הציבור לחוק ביטוח בריאות ממלכתי|The National Health Insurance Law Ombudsman]]
 
* [[:he:נציבות קבילות הציבור לחוק ביטוח בריאות ממלכתי|The National Health Insurance Law Ombudsman]]
 
* [[:he:המוסד לביטוח לאומי|The National Insurance Institute]]
 
* [[:he:המוסד לביטוח לאומי|The National Insurance Institute]]
== Laws and Regulations == <!--חוקים ותקנות-->
+
== Laws and Regulations == <!--חקיקה ונהלים-->
 
[[:he:חוק ביטוח בריאות ממלכתי|The National Health Insurance Law]]
 
[[: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)]]
 
[[:he:צו ביטוח בריאות ממלכתי (תרופות בסל שירותי הבריאות)|National Health Insurance Order (Medications in the Healthcare Services Basket)]]
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==endarticle==
 
==endarticle==
 
כותרת דמה עבור הטמעת כותרת. לא לגעת!-->
 
כותרת דמה עבור הטמעת כותרת. לא לגעת!-->
{{זכות/סיום טור ימני}}
 
 
{{זכות/תחילת טור שמאלי}}
 
{{זכות/ראו גם
 
| [[The Healthcare Basket]]
 
| [[Health and Illness]]
 
| [[Submitting a Request to Include Treatments or Medications in the Healthcare Basket]]
 
| [[Obtaining a Specific Brand-Name Drug]]
 
| [[Obtaining a Specific Generic Drug]]
 
}}
 
 
{{זכות/חדשות  
 
{{זכות/חדשות  
 
| 1 =  
 
| 1 =  
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| 3 =  
 
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}}<!-- עד 3 ידיעות. כל ידיעה מועברת כפרמטר (ממוספר) נפרד. הפורמט המומלץ הוא תאריך מודגש ולאחריו קישור לידיעה. התיבה לא תוצג אם הפרמטרים יישארו ריקים -->  
 
}}<!-- 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 -->
 
<!-- יש לכתוב תגיות כאן בתחתית -->
 
[[קטגוריה:זכויות]]
 
[[קטגוריה:זכויות]]

Revision as of 22:32, 29 April 2014

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
The list of medications included in the basket is closed, detailed in the National Health Insurance Ordinance, and updated every year
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
By law, the health plans are permitted to collect a co-payment for medications included in the healthcare basket
</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 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?

  • 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.

Submitting a Complaint regarding Non-Provision of a Medication

Please Note

  • The list of medications included in the basket is detailed in the 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 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.

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

Sources