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Sharap 101

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Note: This post is specifically about Hadassah Hospital’s Sharap service. Other private and non-profit hospitals in Israel offer similar services.

If you are dealing with specialists or procedures in the Jerusalem area, you should know about Sharap.

Sharap is the private health services associated with Hadassah Hospitals that enables patients to select the senior physician who will treat them, both for the outpatient clinics and for surgery and hospitalization at Hadassah. Sharap can also be arranged to obtain more timely clinic appointments or procedure scheduling as well as access to preferred laboratories, imaging equipment, and operating theaters.

According to Hadassah’s website, Sharap services also make accessible medical treatment in all medical fields, “second opinion” consulting, and legal medical opinions for use in court or for the medical committees of the National Insurance Institute, Ministry of Defense, Ministry of Health, etc.

Sharap is a private, paid service, however your Kupat Cholim’s supplemental plan may include reimbursement, sometimes as much as 90%. Speak to your kupah first to find out what the policy is for your plan.

Sharap Hadassah Ein Kerem
Location: Hospital entrance level.
Hours of operation: Sunday – Thursday, 8:00 AM to 7:00 PM
Fridays, 8:00 AM to 12:00 noon.
Telephone: 02-6778899
Fax: 02-6776600

Sharap Hadassah Mt. Scopus
Location: Hospital entrance level.
Hours of operation: Sunday – Thursday, 12:30 PM to 8:00 PM
Telephone: 02-5844044
Fax: 02-5323307

Sharap Tel Aviv – 10 Dubnov St.
Location: 10 Dubnov St., Tel Aviv.
Hours of operation: Sunday – Thursday, 12:00 noon to 8:00 PM
Fridays, 8:00 AM to 12 noon
Telephone: 03-6955333
Fax: 03-6954433

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Health Services Abroad

In principle, the obligation imposed by the law for the Kupat Cholim to provide health services to Israeli residents is limited exclusively to the territory of Israel. However, there is a defined set of cases where the insured is entitled to participation in the costs of medical treatment abroad, subject to the fulfillment of all the following conditions:

  1. The treatment is in one of the following fields: organ transplants, congenital defects, tumors, cardiovascular diseases and neurocerebral diseases.
  2. The insured is unable to receive the required treatment or an equivalent treatment in Israel (if a little experience does exist in Israel, it is considered as if the insured is able to receive the treatment in Israel).
  3. The insured is in danger of losing his life if he does not receive the specific health service.

In addition, if in the opinion of the health fund a case presents exceptional medical circumstances, it may fund the treatment abroad.
Note: If a health fund rejects the insured’s request to receive health services outside Israel, the decision may be appealed before a special appeals committee in the Ministry of Health.

For more information of Health Services Abroad click here

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Health Services: Distance, Wait, Choice and Continuity

Reasonable distance and wait time

The law requires that basket of health services be provided to the insured at a reasonable distance from his place of residence, but does not define the term “reasonable distance”. There have been conditions for which the Ministry of Health has ruled that the Kupat Cholim must reach an arrangement with an institute near the insured’s place of residence or, alternatively, it must arrange transportation for the insured to and from the institute to which he was referred. Additionally, if there is no nearby medical facility which can provide a required service within a reasonable wait time, the health plan must provide the required service at a different facility, even if it does not have an agreement or arrangements with that facility. Though, again, the law does not define what “reasonable wait time” is, so it is also open to interpretation.

 

Service in small localities

 

In localities with a population of less than 5,000 residents, not more than one health-fund clinic may operate; in localities with a population of less than 10,000 residents, not more than two health-fund clinics may operate. A health fund that operates a clinic in a locality with a population of less than 10,000 people is obligated to provide medical services, within the framework of the clinic, to members of another health fund that does not operate a clinic in the same locality, upon the same conditions at which it provides them to its own members. There is no need to receive the approval of the health fund that does not have a clinic in the locality and a member of that fund may apply directly to the clinic for services.

 

Choice of health service provider

 

A health fund provides health services through its own service providers or by arrangement with other providers. The Kupat Cholim may establish guidelines for members choosing between its service providers, and is obligated to publish its guidelines for selecting service providers and to provide them free of charge at its branches at the request of any insured individual.

However, where there is medical justification for providing the service at a specific location, the health fund must fund the treatment at that location. For example: when a disease or medical condition warrants treatment at a medical institution that possesses a special degree of knowledge and professional experience, the insured will be given the option to receive the medical service he requires in connection with that disease or medical condition at such an institution.

 

Maintaining treatment continuity

Continuity in treatment must be maintained and the insured must be allowed, when possible, to receive the entire treatment for a disease or for a defined medical condition at the same institution where the treatment was begun . Thus, even if a health fund decided to provide a certain treatment that is not included in the mandatory basket of services, once it was begun and as long as it is suitable and medically indicated, the health fund is obligated to continue providing it.

 

Prohibition on discrimination

 

A health fund is forbidden to discriminate between patients suffering from a particular disease. Thus, all members of a health fund who apply for treatment/hospitalization in a certain department/institute and meet the same conditions are entitled to receive the fund’s approval for that service.

 

This information was translated and adapted from content provided by The Society for Patients’ Rights in Israel and Kol-Zchut.

For more information on this and related topics, see Health Plan Choice of Service Provider Arrangements and the Health Plan Portal, both of which we translated as part of our collaboration with Kol-Zchut.

 

To your health ! לבריאות

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Limits and Exceptions in the Scope of Treatment from the Kupat Cholim

Indications for treatments

For some medications, the basket of health services explicitly determines “indications” – that is, provisions that limit the insured’s right to receive the medication or the medical service to specific medical conditions. A health fund is not obligated to fund the cost of a medication for indications other than those included in the basket.

 

Treatment alternatives

The choice between treatment alternatives which are included in the basket of health services, such as different medications, is subject to the discretion of the health fund, which may determine that an insured individual will receive the cheaper of two medications that have the same medical effect. Nevertheless, when there is an indication that a certain alternative is preferable for treating the insured’s problem, the health fund is obligated to provide the preferred alternative.

 

Limits on the scope of treatment

The fact that a certain service or medication is included in the basket of health services does not mean that that service or medication will be provided free of charge and without any limit. For example: physiotherapy for chronic patients may be limited to 12 treatments per year, and may require reasonable co-payment.

 

Receipt of Services Not Included in the Basket From a Health Fund

The basket of health services describes a minimum, and the health fund is authorized to provide additional medical services or medications determined by a committee that considers exceptional cases. The committee’s approval will apply to all patients who meet the criteria that were set. The committee must conduct an orderly proceeding, including the hearing of arguments, keeping of minutes, etc. and an insured is entitled to receive a copy of the minutes and any information on the hearing in his case.

 

This information was translated and adapted from content provided by The Society for Patients’ Rights in Israel.