If one has a pre-existing medical condition, he or she must have a plan for sufficient medical insurance coverage in Israel. For those who intend to be here for a while, obtaining Bituach Leumi becomes an option after a minimum wait of 6 months plus a processing period of 1-2 additional months. However, coverage must be arranged for any time spent in Israel before qualifying for Bituach Leumi coverage, either through an international insurance plan or through a traveler’s insurance plan purchased before your trip.
Here is a guide to the steps involved in obtaining sufficient and effective medical insurance coverage.
About the Israeli National Health Insurance System
Israel’s National Insurance Institute, called Bituach Leumi, provides health insurance as part of its many benefits. Both citizens and established residents of Israel are eligible for health insurance through Bituach Leumi. This government-subsidized health insurance covers hospitalizations, doctor’s visits, surgeries, scans, procedures and more. As part of Bituach Leumi’s program, members can choose to join one of four kupot cholim (lit. “sick funds”), or healthcare networks. Each kupah has its own group of doctors and services throughout the country. Basic kupat cholim membership is covered by Bituach Leumi. There are also supplementary insurance options beyond the basic plan that can be purchased by members directly from the kupah.
Bituach Leumi health insurance is available to both citizens and established residents of Israel, with a waiting period for eligibility that varies based on circumstance. Fresh Olim are accepted immediately to Bituach Leumi (with a processing time of about 3 weeks). Israeli citizens who left Israel may be required to wait as long as 6 months for Bituach Leumi eligibility upon their return, depending on how long they were out of Israel. Potential “established residents” must wait 6 months and fulfill specific conditions (below) before they are eligible.
Once one passes the required waiting period and applies to Bituach Leumi with the required documentation, he/she will be accepted regardless of any preexisting condition. Upon acceptance, he will gain access to the kupah of his choice, and even medical complications relating to his condition will be covered.
The Waiting Period for Potential Established Residents
For non-Israeli citizens who plan to establish residency in Israel (for a minimum of about 1 year), there are two requirements for Bituach Leumi eligibility:
- The applicant must accrue 183 non-consecutive days of physical residency in Israel within the 365-day period preceding application; and
- At the time of application, the applicant must hold one of the following A-category visas: an A/1 (temporary resident) visa; an A/2 (student visa) from a Torani institution; or an A/4 (escort to a Torah student).
The processing time for acceptance to Bituach Leumi is usually two months.
Kupat Cholim During the Waiting Period
In Yerushalayim, both Meuhedet and Maccabi offer a “passport plan” for those who wish to join a kupat cholim privately and receive limited, in-network healthcare before they are eligible for Bituach Leumi. However, these kupot will generally not accept those who have preexisting medical conditions until they have become members of Bituach Leumi. Make sure that your application form is filled out fully and correctly. Hiding or minimizing the condition can ultimately be very much to your detriment.
Please note: the kupot cholim consider pregnancy a “preexisting condition” and therefore may not accept a pregnant woman as a member as of her second trimester until she is registered with Bituach Leumi. In such cases, private insurance would be advisable.
What to prepare before your trip
Being that government-subsidized health insurance will not be available to you for up to 8 months (including the 6-month wait and the 2-month processing), you do need to plan for coverage for that time. Be aware that if there is a chance that you will leave Israel during the first 6 months, you will need to make up lost time and your waiting period will be extended until you accrue 183 days in Israel out of a 365-day period.
Purchase Traveler’s Insurance
If you have private medical insurance in your country of origin, find out what it will cover while abroad.
Unless your insurance from your country of origin will cover your medical needs while abroad, it is critical that you sign up with a traveler’s insurance plan that covers emergencies for up to a year’s time. Certain traveler’s insurance plans may not cover you if you have a preexisting condition, so make sure to read the fine print and ask any relevant questions.
Allianz Insurance, which can be purchased from many countries worldover, does service those with preexisting conditions. Their plan will cover emergencies that are not related to the preexisting condition. They require that the traveler be healthy enough to travel, and the insurance plan must be purchased within 14 days after the ticket is booked.
Medical Records and Medications
Make sure to come to Israel prepared with comprehensive medical records. If you take medication or need to have medication via IV or injection, come with at least a 3 month supply to start with. Additionally, even if you bring the drug with you, save all receipts pertaining to how you obtained it.
Support from Your Institution
If you or your child will be a student in a yeshiva or seminary, you want the institution on your side. Make sure to discuss your or your child’s medical situation with a trustworthy member of the faculty before the start of the study period. You will need a reliable, informed contact in case of a flare-up. Bochurim in yeshiva and girls in seminary need to know that there is an adult who knows about their situation and can help.
What to do when you arrive
Appointment with a Specialist
When you first arrive in Israel, make an appointment with a doctor who specializes in the condition you have. After seeing the specialist once, you will have someone to touch base with here in Israel. Do not wait until the need arises to make your first contact with a doctor in the field; the doctor should be familiar with you and your situation before an urgent need arises.
Private Medical Care
Because you will likely be using private medical insurance, you will need to access everyday medical care through privately-run clinics/service providers. Here are two such providers in Yerushalayim:
- Refuit: 02-566-8888
Refuit is a clinic that provides private medical care and testing. While not all doctors are on staff at all times, special exceptions may be arranged.
- MSG: 072-222-4442
MSG is an insurance and medical service provider. MSG provides student insurance plans to many yeshivos and seminaries. Students can sign up with their insurance program and receive the full package of services. MSG can also be contacted on a need basis for private medical services, including medical advocacy, medical transport even to outside Israel, referrals, and help with medical/bureaucratic glitches.
Hospital Visits on Private Insurance
In the event that you are hospitalized or visit the emergency room before registering for Bituach Leumi, your stay will only be covered if you have a private insurance plan that covers emergencies. However, if the hospitalization is related to your preexisting condition, it is not a given that a traveler’s insurance plan will cover it at all. Clarify the plan’s details before your trip to ensure that you are properly informed.
If the hospitalization occurs during your waiting period for Bituach Leumi, i.e. while you hold a student or toshav arai visa, you may be able to apply for retroactive coverage of the incident, but again, it is not a given that the expenses will be reimbursed. Be in touch with Chaim V’Chessed if you need assistance in this or any other area.
Make sure to save all receipts and documentation of your hospital stay or visit to present to the insurance company from whom you will be requesting reimbursement.
Once You Apply to Bituach Leumi
After you are successfully registered with Bituach Leumi, your membership will automatically be updated with the kupat cholim that you chose.