Navigating Healthcare in Israel

Ma’arechet HaBriut מערכת הבריאות

Navigating a new country's healthcare system can be daunting, especially as an Oleh Chadash - עולה חדש - New Oleh. Israel's medical system, based on universal health care through Kupot Cholim - קופות חולים - Health Funds, offers high level care once you understand how it works.

Mandatory Enrollment in a Kupat Cholim

Israel operates under the National Health Insurance Law, ensuring that all citizens and permanent residents (including New Olim) are entitled to comprehensive health services.

Your First Step: Upon making Aliyah, you must choose one of the four public Kupot Cholim (Health Funds) with your Shaliach – שליח – Emissary

• Clalit – כללית
• Maccabi – מכבי
• Meuhedet – מאוחדת
• Leumit – לאומית

Understanding Basic Coverage: Sal HaBriut - סל הבריאות - Health Basket

The Sal HaBriut is the basic, comprehensive package of health services legally guaranteed to all members of a Kupat Cholim.

It covers a wide range of essential medical services, medications, tests, and treatments.

Check out our Guide here for more information

Health Insurance Contributions

• No direct monthly premiums are paid to your Kupat Cholim
• Instead, health insurance contributions are collected via Bituach Leumi – ביטוח לאומי – National Insurance Institute as part of your overall social security payments.
• New Olim generally receive a grace period (usually their first six months) where Bituach Leumi payments for health insurance are covered by the Misrad Haklita – משרד הקליטה – Ministry of Aliyah and Integration. There are exceptions, depending upon income and financial need.

Important Documents and Terms Explained

Before diving into how to access services, it’s crucial to understand two fundamental terms:

Hafnaya – הפניה – Referral

• The Hafnaya is an electronic or paper medical referral from your Rofeh Mishpacha – רופא משפחה – family doctor or another Kupah specialist. It authorizes you to see a specific type of specialist or undergo a specific medical test.
• Purpose: It’s the medical justification and permission for receiving a service outside your local clinic family doctor
• When you need it: For almost all specialist consultations, most imaging tests (e.g., MRI, CT, ultrasound), some specific laboratory tests beyond routine blood work, and for therapies like physiotherapy etc.
• Validity: Hafnayot typically have a limited validity period (e.g., 3-6 months).
• Cost: There is no cost to obtain a Hafnaya

Tofes 17 – טופס 17 / Hitchayvut – התחייבות – Financial Guarantee

• The above terms refer to the same thing: an official financial commitment or approval from your Kupat Cholim guaranteeing that they will cover the cost of a specific medical service, treatment, or consultation that you receive outside of your regular Kupat Cholim clinic or by an external provider.
• Purpose: It ensures you will only pay your standard Hishtatafut Atzmit – השתתפות עצמית – co-payment (if applicable) for the service, rather than the full, unsubsidized cost.
• Distinction from Hafnaya: While a Hafnaya is the medical referral (what service you need), a Tofes 17/Hitchayvut is the financial approval (who will pay for it). You need a Hafnaya first to obtain a Tofes 17.
• Cost: There is no cost to obtain a Hitchayvut

Step-by-Step Guide to Accessing Medical Services

Your Rofeh Mishpacha

Your Rofeh Mishpacha (for adults, or Rofeh Yeladim – רופא ילדים – Pediatrician for children) is your primary point of contact and acts as a gatekeeper to specialists and many services.

• How to Choose: When registering with your Kupat Cholim, you’ll select a Rofesh Mishpacha etc. from their list in your area. You can change your doctor quarterly if needed.
• Booking an Appointment:
  • Online/App: The most common and convenient method. All Kupot Cholim have sophisticated websites and mobile apps.
  • Phone: Call your Kupat Cholim’s main call center or your specific clinic directly.
  •  In-Person: Visit your local clinic during reception hours.

Seeing a Specialist

Requirement: For almost all specialist visits within the Kupat Cholim system, you will need a Hafnaya from your Rofeh Mishpacha

• How to Get a Hafnaya:
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  • Make an appointment with your Rofeh Mishpacha.
  • Explain your symptoms and why you need to see a specialist or undergo a specific test.
  • Your Rofeh will issue the Hafnaya electronically or print it for you.
• Booking the Specialist: Once you have the Hafnaya, you can book an appointment with a specialist using your Kupat Cholim’s app, website, or call center. For some specialist visits, particularly those at a hospital or external institute, you might also need a Tofes 17 / Hitchayvut after receiving the Hafnaya.

Urgent Care & Cheder Miyun - חדר מיון - Emergency Room Visits

Understanding when and where to go for urgent care can save you time and money.

Moked Refuah Dchufa – מוקד רפואה דחופה – Urgent Care Clinic

• When to go: For urgent, non-life-threatening issues that cannot wait for a regular doctor’s appointment (e.g., high fever outside clinic hours, minor injuries, acute infections). These are often open evenings, weekends, and holidays.
• Generally, no Hafnaya or Tofes 17 is needed to visit a Moked clinic within your Kupat Cholim network.
• Cost: Usually involves a small co-payment.

Cheder Miyun – חדר מיון – Emergency Room

• When to go: Only for life-threatening emergencies, severe injuries, or conditions requiring immediate hospital intervention (e.g., heart attack symptoms, severe trauma, sudden loss of consciousness).
• Please note: Car accident victims are eligible for free Cheder Miyun services provided they have a Police report confirming their involvement in the accident. For additional cases that are exempt please see the following links English Hebrew

Tofes 17 / Hitchayvut for the Cheder Miyun

• For true emergencies: Go directly to the Miyun. The hospital will contact your Kupat Cholim for the Tofes 17/Hitchayvut, and you will not be charged on the spot for life-saving care.
• For non-life-threatening conditions: If you go to a hospital Miyun for a condition that is not deemed life-threatening by the staff (even if you thought it was), you will likely be charged a significant fee unless you obtain a Tofes 17 / Hitchayvut from your Kupat Cholim before your visit. In such cases, your Kupat Cholim might direct you to a Moked instead.

Beit Cholim - בית חולים - Hospital Admissions (Planned & Emergency)

Planned Admissions:

• Your specialist or Rofeh will determine if you need to be hospitalized for a procedure or treatment.
• They will provide you with a Hafnaya for hospitalization.
• Your Kupat Cholim will then issue a Tofes 17 / Hitchayvut for the planned hospitalization. This is typically pre-arranged between your doctor’s office, the hospital, and your Kupat Cholim.

Emergency Admissions:

If you arrive at the Miyun with a condition requiring immediate hospitalization, the hospital staff will initiate the process and contact your Kupat Cholim for the Tofes 17 / Hitchayvut. You generally won’t need to worry about this aspect during an emergency.

Ambulance Services

The cost of an ambulance ride in Israel primarily depends on the service provider and whether the patient is hospitalized.

Magen David Adom – מגן דוד אדום – MDA

• They can be contacted by dialing 101
• If an MDA ambulance is called for a life-threatening emergency and the patient is transported to a hospital and subsequently hospitalized (admitted for at least one night), the cost is generally fully covered by your Kupat Cholim.
•  If an MDA ambulance is called but the patient is NOT hospitalized after being evaluated at the Miyun, you will likely be responsible for the full cost of the ambulance ride (can be several hundred to over a thousand NIS). You also pay for non-emergency or scheduled transport, unless specific medical conditions get pre-approval (Tofes 17) from your Kupat Cholim.

Ichud Hatzalah – הצלה – Volunteer First Responders

• They can be contacted by dialing 1221
• Hatzalah organizations provide free initial first aid and stabilization as volunteers.
• If transport to a hospital is needed, they will often call MDA. Any subsequent ambulance transport will then fall under MDA’s billing policies (as described above).

Important Note: For true, life-threatening emergencies, call MDA (101). For anything less severe, consider an urgent care clinic – Moked or private transport to avoid potentially high ambulance fees if hospitalization isn’t ultimately required.

Understanding Costs & Coverage Options

While basic healthcare is universal, there are co-payments and options for extended coverage.

Dmei Hishtatfut Atzmit – Co-Payments

• Doctor Visits: A small co-payment is usually charged per visit to a specialist within the Kupat Cholim while Rofeh Mishpacha visits are generally free.
• Lab Tests & Imaging: Many routine tests are covered with no or minimal co-payment. More advanced imaging (e.g., MRI, CT) or specialized lab tests may require a co-payment, even with a Hafnaya.
• Medications: Medications listed in the Sal HaBriut – סל הבריאות – Medical Basket are heavily subsidized. You will pay a co-payment (typically a few shekels) for each item.
• Annual Cap: There’s usually an annual or quarterly cap on out-of-pocket co-payments for medical services and medications.

Sherutei Briut Mashlimim – שירותי בריאות משלימים – Supplemental / Extended Coverage Plans

These are optional, paid extended insurance plans offered by each Kupat Cholim, providing benefits beyond the basic Sal HaBriut. You pay an additional monthly fee directly to your Kupat Cholim for these plans.

What they cover (examples): Check with your Kupah to get a clear understanding what services are actually included but significant discounts for services like the following are covered:

• Dental treatments
• Alternative/complementary medicine
• Eyeglasses and contact lenses
• Access to private specialists at reduced rates
• Certain elective surgeries or advanced treatments
• Psychotherapy

Important Note: These plans may have waiting periods before you can utilize certain benefits. Many Olim choose to enroll in these plans for broader coverage.

Names of Primary Supplemental Programs by Kupah

• Clalit
  Clalit Mushlam – כללית מושלם – Their main supplemental insurance, with tiers:
  Clalit Zahav – כללית זהב
  Clalit Platinum – כללית פלטינום
• Maccabi
  Maccabi Sheli – מכבי שלי
  Maccabi Zahav – מכבי זהב (often a higher tier)
• Meuhedet
  Meuhedet Adif – מאוחדת עדיף
  Meuhedet C – מאוחדת שיא (higher tier)
• Leumit
  Leumit Zahav – לאומית זהב
  Leumit Kesef – לאומית כסף (often a base tier)

Important Documents & Advice for New Olim

Always carry these documents when accessing medical services:

• Teudat Oleh – תעודת עולה – Oleh Certificate: Especially crucial in your first year.
• Teudat Zehut – תעודת זהות – ID Card: Your primary Israeli identification.
• Kupat Cholim Membership Card: You will receive this after registering.
• Hafnaya: If you are going to a specialist or for a specific test.
• Tofes 17 / Hitchayvut: If pre-arranged for a visit to the Miyun (for non-emergencies) or planned hospitalization.
• Relevant Medical History/Records: Especially for your initial Rofeh Mishpacha appointment. If possible, have key summaries translated into English or Hebrew.

Important Advice for New Olim

• Choose Your Kupat Cholim Wisely: Research each Kupat Cholim’s services, clinic locations near you, and supplemental plans before choosing.
• Learn Basic Hebrew Medical Terms: While many medical professionals speak English, knowing key terms will greatly assist you.
• Utilize Online Services/Apps: The apps and websites of the Kupot Cholim are incredibly powerful for booking appointments, viewing results, getting referrals, and communicating with doctors.
• Don’t Hesitate to Ask: If you don’t understand something, ask your doctor, the clinic secretary, or a fellow Oleh. There are many resources and people willing to help.