The following page gives a general explanation of the most basic Israeli healthcare rights, including the National Health Insurance Law, the “Healthcare Basket” concept, and which healthcare services are provided by whom.
The Law: Why the system is what it is
In 1994, the Knesset passed the National Health Insurance Law which basically put into place the current Israeli healthcare system based on the following principles:
- Application to all residents: Every resident of Israel is entitled to health services under the National Health Insurance Law.
- Provision of service is not connected to the ability to pay: A resident pays for health insurance according to his means, and is treated according to his needs. The state is responsible for providing funding, while the health fund in which the insured is registered is responsible for providing the service.
- Choice of a fund without limitations: Every resident is entitled to be registered as a member of one health fund chosen by him, unconditionally and without any limitations due to age or state of health.
- Provision of service: The fund is responsible for providing all the services included in the healthcare basket, based on medical discretion, with reasonable quality, within a reasonable time, and within a reasonable distance.
- Maintaining dignity and privacy: Every insured individual is entitled to receive health services while maintaining his dignity, privacy and medical secrecy.
- Switching health funds: Every resident is entitled to switch from one health fund to another.
- Selection of service providers: Every insured individual is entitled to choose service providers, such as doctors, caregivers, hospitals and institutes, from a list of service providers who are affiliated with the health fund in which he is a member and according to the arrangements for selecting service providers as published by the fund from time to time.
- Complaints by the insured: Every insured individual is entitled to submit a complaint to the officer in charge of public inquiries at the medical institution that treated him, to the officer responsible for investigating members’ complaints at the health fund in which he is a member, or to the ombudsman under the National Health Insurance Law in the Ministry of Health.
- Application to the court: Every insured individual is entitled to submit a claim to the Regional Labor Court.
The Healthcare Basket: What you’re entitled to
The healthcare basket includes all the services, medications, supplies and medical equipment that the insured is entitled to receive according to the National Health Insurance Law. It was originally determined based on the health services that were provided by the Ministry of Health and the Clalit health fund as of January 1, 1994 and has been regularly updated by the Ministry of Health, on the basis of recommendations by a public committee.
The healthcare basket is provided to the insured
- based on medical discretion,
- at reasonable quality,
- within a reasonable time, and
- at a reasonable distance from his place of residence
subject to the conditions set forth in the law and its regulations.
Which services are provided by the Kupat Cholim?
The National Health Insurance Law describes the following fields of service to be included in the healthcare basket for which the health funds are responsible:
- Diagnosis, consultation and medical treatment.
- Medications according to a list, some of which are provided only for a particular indication.
- Hospitalization in a general hospital.
- Rehabilitation, including hospitalization.
- Accessories and medical supplies.
- Medical services in the work place.
Which services are provided by the Ministry of Health?
There are several health services that, as of now, have not been transferred to the health funds and remain the responsibility of the state:
- Preventive medicine – well-baby clinics and inoculations.
- Certain general rehabilitation devices, walking and other mobility devices, for which the Ministry of Health participates in the cost.
- Health services for schoolchildren.
- Nursing home stay.
This information was translated and adapted as part of a collaboration with The Society for Patients’ Rights in Israel.