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1. Your Branch Secretary is the Center of the Universe

If you need anything the Kupat Cholim offers and you want to know how to get it, ask the branch secretary. In practically every publication from the Kupah you are told to contact your local branch for clarifications about rights, permissions, required documents, payment authorizations, etc.
 
There are surrogates, of course. While away from home you can call the closest branch, and you can always call the Kupah’s 24 hour number. You can even directly access most of the information you need straight from the Directory of Services (Madrich Sherutim) or online. But really, learning the local secretary’s name and establishing some sort of rapport might be the most valuable investment in your wellbeing that you could make.
 
Also, remember you can just call to ask questions, or fax to transfer documents. You may get a small charge if the Kupah has to fax some document to or for you, but the hours saved in making the trip are probably worth it.
 

Finally, it’s usually not worth it to ‘sort of get’ crucial information, so if you need to, speak English. Most professionals know it, or can pass you on to someone who does. Besides, you’re about to learn the most essential vocabulary-

2. Two Words: Hafnaya and Hitchayvut

 

Always ask if you need either or both of these to get the service you need.

A Hafnaya (הפנייה) is a referral to a specialist or other medical  services, sometimes necessary for internal Kupah services, and very often necessary for services from other institutions.

A Hitchayvut (התחייבות) is a payment voucher from the Kupah, usually necessary for services, including tests and hospitalization, from other institutions. This payment voucher is also referred to as Form 17 (“Tofes Shva Esrei”), or a letter of financial obligation (“Tofes Hitchayvut”).  Click here to learn more about this important concept from a page we translated as part of our collaboration with Kol-Zchut.

3. Your Primary Doctor is the Center of your Galaxy

 
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Your primary doctor is the Kupah’s point man for your physical wellbeing. He/she should be the fount from which flows all (or most) referrals, prescriptions, and communiqués.

Got a prescription from a private specialist? Ask your doctor to reissue it as a Kupah prescription. Looking for lab results from blood work? They get sent to your doctor. Need to see a physical therapist? Ask for a referral from your doctor,  etc.

It’s true that you can find your own specialists and services in the Directory of Services, and many will not require a referral. Perhaps you don’t need to check with your primary care physician every time you want to see a dermatologist, but it’s important to keep in mind the Kupah’s point-man perspective when deciding a course of action.

You might even want to consider adopting the philosophy yourself. In many health related situations it’s important to have a professional to rely on with an eye on the big picture.

Not sure if the doctor you’ve got actually fits the bill for your ideal point-man? The Kupah won’t fuss if you change doctors after one calendar quarter. If you need a more immediate change, consult the branch secretary for advice.

Finally, keep in mind that if your doctor is not available, or you just want to see someone else for some reason, there are other options-

4. Round the Clock Service

Any time you’re in need when the Kupah is closed, or the timing is simply inconvenient, call the Kupah’s 24 hour number to check if the service can be sent to your door, or  where the closest emergency medical center is that you can walk into any time.

Despite the operating hours of local branches, the Kupot have admirably committed themselves to round the clock basic medical services like diagnosis and prescriptions, and sometimes even lab tests and imaging.
The Kupah has arrangements with emergency medical centers, like Terem, as well as house-call services, though the services offered by these institutions will vary, as well as the expected co-payment.

It’s worthwhile to know the capabilities of the closest emergency medical center for times when your need is not just a matter of convenience. In certain urgent situations you should go straight to the hospital or call an ambulance. Click here for information about coverage of ambulance costs from a page we translated as part of our collaboration with Kol-Zchut.

5. Knowing Your Insurance Plan is Totally Worth it


In the USA  “good health insurance” is so elusive (read: expensive) and coveted it’s almost mythical. Here it’s really quite cheap.

By law, the Kupot cover doctor visits, diagnostic and laboratory services, some paramedical services, medical equipment, rehabilitation, hospitalizations and many prescription medications. Still, what’s left out, and how these services are provided can sometimes feel restrictive.

Supplementary Insurance (Bituach Mashlim) plans cost an extra monthly membership fee but offer a much wider selection of medications, more opportunity for using private doctors and specialists, and more options and benefits in general. If you already have it, review your additional benefits, and remember to check with the Kupah before paying for any medical service out of pocket.

If you don’t already have a supplementary insurance plan but want to join, do it immediately. There may be a waiting period before all the extra benefits kick in, though the Kupah must accept you to their supplementary health insurance plans regardless of age or medical history. Different benefits also may have different waiting (qualification) periods. Click here for more information about supplementary health insurance on a page we translated as part of our collaboration with Kol-Zchut.

Bonus: Long term care insurance may also be worth it, though it’s a different beast all together. Worthy of a separate post found here.

18 thoughts on “5 Things To Know About Your Kupat Cholim

    • Glad you find the resources helpful, please forward and distribute to anyone else you think it might help!

  1. What about the extra tiers, for instance Macabbi Sheli- where they offer dental and other services…..how do those tiers work?

  2. Kupat Holim Clalit now has an English translation of the Power of Attorney clause from the Ministry of Health, thanks to a friend of mine. You might want to check that out.

  3. Is there an English list of medications which if a person is required to take routinely qualify or support the claim of disability for that individual?

    Thank you!

  4. I am a British citizen married to an Israeli and I need health insurance, I am in the process of applying for citizenship. Please help I need to know which health insurance cover is best for me to use, I need repeated prescriptions.

    Thankyou

    • Hi Julie, As an independent non-profit project dedicated to educating people about the healthcare system, we do not recommend specific insurance plans, though we address some of the factors to consider when choosing a kupat cholim in “Question: Changing Your Kupat Cholim?”. Your current residency status is critical to answering any question about insurance coverage, as the answer will be different if you are a resident (even if you are not yet a citizen), versus if you are on a tourist visa, for example. Check out “Who is an Israeli resident?” for more information on that. For personal counseling on this or any other aliyah/bureaucratic issues, contact our klitah counselors. Please let us know if you have any other unanswered questions or issues.

  5. How can I find out how much a private doctor is charging every time I submit a hitchaivut to her from my Macabi insurance? Will Macabi send me a bill with her fee?

    • Robin, The hitchayvut is a payment voucher from your kupah for the medical service. It implies that you will not be charged for those services because they have been approved in advance by the kupah based on your rights, or your supplemental plan agreement. The kupah may set a limit on their cost participation in certain private or optional services, based on your supplemental plan agreement, or charge you a copay, which you will see on your kupah statement, but the hitchayvut is the payment from the kupah to the doctor. As far as how much the doctor is charging the kupah, we recommend that you ask the secretary in the doctor’s office when you submit the hitchayvut. However, remember that the hitchayvut is the kupah’s voucher covering that charge, not your obligation.

  6. This is very, very helpful. For future articles, it’s always good to know what everything is called in Hebrew. For instance, here, you’ve mentioned the “Branch Secretary,” but it’s useful to be able to ask for that person by the proper title in Hebrew.
    Thanks!

  7. I have meuhedet See and have just reached the age of 70. What benefits do I have regarding buying eyeglasses, specifically “progressive” /multifocal? I was told by Halperin [by Big] that my prescription makes me ineligible as the lenses are above the number 4. Is that so.
    If one has a complaint against Meuhedet or a complaint against a vendor, to whom does one turn?
    Zeit Gezunt, Shlomo

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