U ask: Can you describe the health system in Israel?
Norman Answers: A full answer would require a detailed lecture. However I'll try and list below the basics.
Under the National Health Insurance Law all residents of Israel are entitled to comprehensive medical care through one of the four National Health Funds (Kupot Holim) – Clalit, Maccabi, Meuchedet and Leumit.
These funds provide a range of services as designated by the Ministry of Health in what is commonly known as the "Basket of Health" (Sal Briyut). This is fixed annually by the Government.
These public health insurance services are in the areas of – family medicine, emergency treatment, elective surgery, transplants and new medications for serious illness.
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U ask: How good are these services?
Norman answers: Generally, certainly in comparison to other National Health Programs outside of Israel, the services are considered very good and relatively inexpensive. This is particularly true in the areas of family medicine and emergency care.
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U ask: What then is the Supplementary Health service
(Mushlam, Zahav, Adif) provided by the Funds and is it needed?
Norman answers: These supplementary health insurance programs offer the customer – you – a broader range of services than provided by the Government funding and thus the Funds chare an extra fee for them. Each Fund has its own range of extra services provided as described in their promotional booklets (available in English from each Fund). To summarize I'd say these extra programs offer you to receive a broader range of health insurance services by the Funds on what could be described as semi-private basis.
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U ask: Do I really need this extra service?
Norman answers: The answer depends very much on individual needs and financial circumstances. I definitely support joining these health insurance programs particularly for young families where they provide a much broader range of services in relation to pregnancy and children's special needs. Also, because the Funds are obligated to be able to provide these services to all their members, certain individuals who have existing medical issues have no other choice available to them other than this.
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U ask: Are these fixed contractual services?
Norman answers: No. The Funds can and do alter them from time to time and they can do this more-or-less at their discretion.
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U ask: What then is the need for Private Health Insurance?
Norman answers: Private Health Insurance is there to fill in the gaps on the services provided by the public Health Funds. There will always be a shortage of public monies made available for Governmental health services (certainly as long as Israel has other essential needs such as security etc.) and thus there will always be areas where the service can't be fully or easily provided.
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U ask: Can you describe these areas?
Norman answers: Broadly speaking I'd say that in the areas of general family medicine and emergency care all the Funds provide very good quality service and thus there is no need to take out extra health insurance. However, in the other 3 areas – elective surgery, transplants and new medications for serious illness – if you can afford it, a private health insurance policy is a big plus in giving you the choice, the timing and the monies needed for whatever care you may need.
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U ask: What then do Private Health Insurance Policies provide?
Norman answers: In the area of elective surgery, Private Health Insurance offers you the choice of surgeon, anaesthetist and hospital for the procedure anywhere in Israel or for that matter even worldwide. Most importantly by enabling you this choice invariably timing plays an important part of this service. In the area of transplants, unlimited funds are available to enable you to find a suitable donor and have the procedure without the requirement of Government approval. In the area of medications, there are hundreds of new and expensive medications FDA and EU approved for use coming on the market every year for the treatment of serious illnesses. The " basket of medications " provided through the Health Funds indeed is updated regularly. However there simply isn't enough public money to include all or even a major group of these medications and thus patients either need to pay for them themselves or do without them. Private Health Insurance Policies provide nowadays up to NIS 1 million per person in case of these needs.
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U ask: Who provides these Private Health Insurance policies?
Norman answers: All the major Insurance Companies provide such plans. You are advised to consult with a qualified Insurance Agent to discuss and suggest the most suitable one for your individual needs.
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U ask: Are these Private Health Insurance policies expensive?
Norman answers: Relative to the cost of Private Health Insurance abroad, such plans here are considered not expensive. Premiums nowadays are based on age, gender and previous medical history. The most expensive section is the surgery one.
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U ask: How about some figures?
Norman answers: Each Company has its own rates and there can be quite a variance between certain ages. Just for example though, a family of 5 with let's say two adults aged around 35 could get a fully comprehensive policy for under NIS 300 a month. Companies very often have special reductions and you should ask your agent about these. You can buy a particularly cheap policy to cover you just for transplants and medications for under NIS 50 a month.
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