Thursday, 15 October 2009

Kupat Cholim in Israel

Let us take a look at the National Health Insurance, known in Israel as Kupat Cholim. Israel has four options for Kupat Cholim: Meuhedet, Maccabi, Leumit and Clalit. It used to be that there were major difference within these four Kupat Cholim, I have been told by some Israelis that their differences are no longer as clear.

I can not say that I am an expert of the Kupat Cholim but can share some information that I have experienced and then open up for other Olim to share or clarify and of course for potential Olim or Olim Chadashim to pose questions.

During the first 6 months after making Aliya, an Oleh enjoys free basic Kupat Cholim and Bituach Leumi. The Kupat Cholim provide 3 different levels: basic, Adif and C. There are certain services that are available more readily if one has Adif or C, however, I am still unclear as to what one gets by paying the extra.

In order to qualify or begin receiving your 6 months free or sponsored Health Care, an Oleh has to take a form to the Post Office on which s/he indicates which of the Four Kupat Cholim s/he is choosing. When I made Aliya, the Mercaz Klita (Absorption Centre) told me to do this within the first week. Probably you can take a little longer, I would check that out with your Aliya Counsellor and or Shaliach.

How do you decide which Kupat Cholim to choose? Some make a decision based on convenience, meaning, they find themselves to be perhaps in a certain Absorption Centre and the closest Kupat Cholim is X, therefore they go with X. Others select their Kupat Cholim as they already know a certain doctor and wish to go to that doctor. Others will use the Kupat Cholim that most of their friends or family are using.

If you can, do a little research before coming. Write out for yourself what your priorities and needs are in terms of Health Insurance. The Kupat Cholim do have websites, however, all the information is in Hebrew. If you are already fluent in Hebrew or at least read Hebrew well and can understand most of what you read, it is worth taking a look at the sites.

If you have compiled your list of your own needs in a Health Insurance, that will make it easier to ask specific questions when checking out which Kupat Cholim is best suited for you. This is a very good exercise to do prior to coming on a Pilot Tour. If you have some time, on your Pilot Tour, try to visit the different Kupat Cholim and ask your questions. Or when meeting Israelis, other Olim, organizations in Israel, you can pose your questions and gather the information prior to coming to Israel.

One feature that is important to mention is the policy of staying with a specific doctor or group of doctors for a 3 month period. The 3 month period is a set time span set out by the Kupat Cholim and not from the beginning of your first appointment with a given doctor. That means, if you need to see a specialist e.g. Opthalmologist, Neurologist, Orthopoedic Surgeon or other specialist, you pay the nominal fee of ILS 18 - 20 for that 3 month period. If you are lucky enough to go for your first appointment at the beginning of the set 3 month span, you can return however many times you need within that 3 month period and not have to pay again.

The down side is that if you go to a doctor, Family Doctor or Specialist and find they are not suitable for your needs for whatever reason, you have to wait out the 3 months period in order to change doctors. If you have a good reason to move and really need medical attention, there is a way to request permission to change from the main branch of the Kupat Cholim. From what I can work out, there is a Rofe Minhal (I hope I have transliterated that correctly), this is a doctor who acts as case manager in the main branch who can grant you permission to change doctors or advise a better or more suitable doctor for you. It is worth finding out the details of how to contact this person when signing up, just in case you ever need to go this route.

Another important piece of information is use of an ambulance. I think this information is relevant to the Adif level, but stand to be corrected. If you require going to hospital or emergency unit by ambulance, if the doctor has ordered the ambulance, your Kupat Cholim covers the fee, where as if you or a relative call the ambulance from your home, Kupat Cholim will pay half. However, you will be required to pay the full fee, send in the receipt for payment and then will be credited the half by Kupat Cholim, usually into your bank account.

I hope this has provided some information about Kupat Cholim in Israel. In another post we will try to cover some information regarding the Bituach Leumi. If you have specific questions, please do send them in and we will do our best to answer them, or to find a specialist who can assist you.

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