Those recovering from a cardiac event are entitled, in certain cases, to rehabilitation services as part of the healthcare basket
Heart patients who are not entitled to free rehabilitation services may be eligible for rehabilitation they pay for themselves, or which they receive as part of supplementary health insurance
In most cases, the rehabilitation program is provided free of charge
- Heart patients who have undergone a cardiac event are entitled, in certain cases, to free rehabilitation services as part of the healthcare basket.
- The main objective of the rehabilitation services is to enable patients to return to an active and quality lifestyle within the limitations caused by their condition.
- The services are provided by the health plans at special cardiac rehabilitation facilities, or as part of other rehabilitation frameworks, by a professional multi-disciplinary staff including a cardiologist, nurse, social worker, dietician, physiologist, physical trainer, as well as a psychologist when necessary.
Who is Eligible?
Patients Entitled to Free Rehabilitation Services as Part of the Healthcare Basket
- Patients who have undergone a heart attack.
- Patients who have undergone coronary bypass surgery.
- Patients with type 2 or type 3 heart failure or an LVEF lower than 35%.
- Patients who have undergone a cardioverter defibrillator implant.
Patients whose Medical Condition Does Not Entitle Them to the Healthcare Basket Benefits
- The Ministry of Health recommends that even those patients whose medical condition does not entitle them to cardiac rehabilitation services as part of the healthcare basket (such as those who were hospitalized due to unstable angina or patients after therapeutic coronary catheterization) receive cardiac rehabilitation services.
- Patients who are not entitled to rehabilitation services included in the healthcare basket, but for whom an attending physician has recommended rehabilitation, may may receive services they pay for themselves, or which they receive as part of their health plan’s supplementary health insurance.
What is Included in Eligibility for Cardiac Rehabilitation?
- Rehabilitation program – The program includes instruction from a doctor, nurse, nutritionist, health counselors, as well as time-limited supervised exercise following the cardiac event.
- Recovery in a special facility under medical supervision – After a myocardial infarction or coronary bypass surgery, patients are entitled to stay in a convalescent facility.
- Heart rate monitoring using a personal monitoring device after heart surgery or an acute myocardial infarction.
- A rehabilitation program is comprised of three stages. The first two stages are included in the healthcare basket and are provided free of charge (to those who are eligible). The third stage is not included in the healthcare basket, but the Ministry of Health recommends that patients contact facilities where it is provided.
First Stage of Rehabilitation
- This stage is offered in hospitals or convalescent homes and lasts for seven days from the hospital release date.
Second Stage of Rehabilitation
- This stage takes place after release from the hospital or convalescent facility and it lasts approximately 9 months.
- Heart patients who are referred to a heart rehabilitation facility within the first year after a cardiac event or relevant diagnosis must start a program in the second stage of rehabilitation.
- Completion of the rehabilitation program is in accordance with the patient’s medical condition, as determined by the program’s medical director.
- For high-risk patients, the second stage of rehabilitation is of unlimited duration.
- This stage is aimed at improving risk factors and the patient’s functioning capacity and physical and mental state to the greatest extent possible, and it includes physical training in addition to advising and behavioral and pharmaceutical intervention.
- The rehabilitation services that are part of this stage are provided at heart rehabilitation facilities. The treatment staff includes a cardiologist, registered nurse and specialist in rehabilitative physical training.
Third Stage of Rehabilitation
- This stage is not included as part of the healthcare basket, but there are Ministry of Health guidelines to refer patients to continue with these types of rehabilitation frameworks.
- The stage begins after achieving the previous stage’s objectives, and it includes continuation of physical activity, as well as maintaining proper nutrition as part of a specialized program.
- Every physician treating a patient requiring heart rehabilitation must recommend these medical services.
Recovery and Rehabilitation in a Convalescent Home
- Following a myocardial infarction or coronary bypass surgery, patients are entitled to a five day stay at a convalescent home with whom their health plan has an arrangement, at no cost to the patient.
Heart Rate Monitoring and Follow-Up
- Following a myocardial infarction or coronary bypass surgery, patients are entitled to heart rate monitoring and tracking using a personal monitoring device (for up to six weeks) that can transmit the EKG reading directly to a medical service center that operates 24 hours a day.
- Health insurance policyholders are entitled to rehabilitative exercise, which is limited physical activity under the close supervision of a cardiologist; it is provided as part of the second stage of rehabilitation detailed above.
How to Claim It?
- Eligible heart patients will be referred by their attending physician.
- If a patient is referred by a hospital's cardiology, internal medicine or cardiac surgery unit, it is recommended that the referral be written in the form of a detailed recommendation as part of the hospital release paperwork.
- Rehabilitation is provided by the patient’s health plan through a heart rehabilitation facility or another rehabilitation program. Convalescence services are provided in a convalescent home that has an arrangement with the patient’s health plan.
- Patients should contact their health plan for more details regarding the rehabilitation and convalescence services offered and how to claim them:
- Patients are accepted to a rehabilitation program after their condition is assessed by a cardiologist from the rehabilitation facility who will determine the patient’s level of risk, the rehabilitation objectives, the rehabilitation plan and the medical limitations to physical activity.
- Patients who claim that they are not receiving the rehabilitation services to which they are entitled according to the National Health Insurance Law are entitled to submit a complaint to the Ministry of Health's National Health Insurance Law ombudsman.
- Patients may also submit a complaint to the health plan ombudsman.
Laws and Regulations
- Medical Administration Circular 54/2006 from 26.12.06 regarding rehabilitation of heart patients
- Medical Administration Circular 47/2002 from 10.10.02 regarding rehabilitation services for heart patients
- Medical Administration Circular 4/2003 from 2.2.03 regarding rehabilitation services for heart patients
- Medical Administration Circular 27/2011 from 11.7.2011 regarding heart rehabilitation facilities (update)