Kupat Cholim - Free Medical Aid in Israel

In Israel, there are currently four different Kupot (medical aids) available - Meuhedet, Klalit, Maccabi and Leumit. Every citizen of Israel is entitled to choose to be a part of any of these (and must!) It is your right - but be aware, it's not free. You'll be paying for it. As a start, your Bituach Leumi (National Insurance) is considered the start of its payment and at a current entry level amount of ₪160 per month for the unemployed and those earning less than around ₪2000 per month, it can already be a hefty amount to pay - especially if you're not actually in need of any medical treatment (a condition you should be most thankful for in any case!)

Beyond the initial Bituach Leumi amount and dealing with increasing Bituach Leumi payments depending on your monthly income / salary, you can be paying up to 40% of your earned income - ultimately for your rights to "free" medical insurance. 

What do you get for it? Basic medical services allow you to visit your GP for free (the reason everyone will say it's free!) but don't let that fool you! In addition to seeing the GP, if there is anything remotely requiring a specialist (in practically almost every case) you will be sent to a specialist usually with a Hafnayah - הפניה - a referral. Currently you must pay ₪22 for each time you see the specialist and ₪22 for each additional specialist you see during a period known as "quarterly" - or Rivon - רבעון. Be aware that any doctors or authorities indicating to you that medical treatment is free in Israel are sadly misinformed. The costs may escalate even further. 

While in many countries, a GP is entitled to perform numerous small procedures, Israel limits the activities of the GP - forcing them to refer you on to a specialist. An example would be having one's ears syringed. In the event that one's ears become filled with wax, a regular doctor will not be permitted to remove the wax, but will refer you to a specialist. In other countries, GP's are quite capable of the small procedure themselves! 

In addition, though the specialist may be knowledgeable in his area of expertise, he too is limited by Israeli law to the procedures he may perform. As an example - a dermatologist may check your skin noticing various blemishes that can be easily removed with liquid nitrogen, but his authority allows him to only diagnose; he may not correct the problem, in essence being required to refer you to a surgeon - for the relatively simple burning procedure! Ultimately one's "free" medical treatment can well lead to visiting numerous doctors and being required to pay the Kupah for each additional visit - amounts which in other countries would be avoided due to one doctor being quite capable of performing the smaller procedures himself!

Dental and Eye Costs:

Dental treatment is not covered for by the Kupah and can be rather expensive. Likewise, seeing an optometrist to have spectacles prescribed will require almost full payment with very little if any subsidy by the Kupah.

Costs of Medications:

Upon purchasing a medication under the list of "subsidized" medications, you will pay a minimum of ₪14 per medication (currently.) There are many medications that require  a higher price or full payment thereof. All the amounts listed in this post, increase each year as a general rule. 

The Free Fertility Treatment Fallacy!

For those looking into the "free" fertility treatments that are offered in Israel - be aware, that while much may be "subsidized," all tests and procedures are charged for just as the referral to a specialist or more. You will be charged for injections, drugs and other invasive procedures as well as your net loss from days off from work (no pay) and with the emotional stress added to this, the financial costs can be a lot more than ever bargained for. It is hard for anyone not in such a predicament to ever imagine anything close to the actual costs, as they still maintain that fertility treatment in Israel is absolutely free! Indeed, those not actually involved in these special treatments will again assume that all is free. (It almost sounds too good to be true - even exciting!)

Kupah Plans:

In addition to the basic "free" structured medical treatment provided in Israel, each Kupah will offer numerous "special" - must-have options which will entail paying even larger amounts to be a part of the more appropriate medical aid systems which allow for even more "free" things. 

Choosing a Doctor:

Do remember that because Israel works with a Rivon (quarter) period, the doctor you choose - whether you know them are not - will be your doctor for a period of 3 months. You will not be able to change doctors. Get advice from others who may have used a particular doctor, to know if they are the right doctor for you. Join us for our next article where we will discuss more about the practical aspects of "what can go wrong" or "what can be right!" when choosing a doctor in Israel.

Important Points to be Aware of:

• Be aware of the actual costs. 
• Don't be fooled by those indicating that medical treatment in Israel is free.
• Choose the plan that is best for you after appropriate research.
• Be aware of the doctor you choose. You will be stuck with them for a quarter period - 3 months, without the ability to change!
• Be aware of the Kupah you choose. Though you can switch Kupot, it is not easy to work out which one will serve your needs better. 
• Visiting a GP may only be the start of treatment - often requiring seeing at least two other specialists - all at an additional cost.