Israel Survival Tips: Part 1 – Health Insurance

28 May

This is the first in a series of posts about surviving in Israel prior to and after making Aliyah. I hope that my experiences with Israeli companies and the beaurocratic system can help make a smoother adjustment for others coming to live in Israel. I’ll start by detailing health insurance for both citizens and non-citizens.

Health insurance: every Israeli citizen is entitled to health insurance. However, just saying the words “bituach leumi” (national insurance) is likely to solicit a groan (or worse) from even the most hardened Israelis. Bituach Leumi is probably Israel’s worst public institution, though I have yet to really deal with the IDF. The beaurocracy is crippling and what little service exists is horrendous. Still, if you can navigate the system, you get pretty good health insurance out of it.

Once you make Aliyah, you’re given an immigrant certificate called a “teudat oleh” and a health insurance form. Using these two documents, you can approach Bituach Leumi to request the necessary status for obtaining health insurance. To do this, visit the branch of BTL that covers your area (in Tel Aviv it’s on Yithak Sadeh, open between 8:30 and 12:00 on Sunday, Tuesday, and Thursday). Yafo has a different branch. Don’t try going there if you live in Tel Aviv – they won’t help you, as I learned.

Once there, you’ll get in line and eventually see a person who will give you some forms to fill out. These forms will ask you about your work experience and other background details. You submit this form and then BTL “processes” it. For me it took 5 weeks, with me calling them every couple days demanding that they speed up the process. Before you leave the office during this first visit, be sure to ask how long to expect it to take and get a phone number – this will save you hours of wasted time.

Eventually, BTL will send you a form which you can use to take to an HMO (“kupat holim”). This form is golden – bring it to the HMO of your choice along with the original form given to you by the MOIA and your “teudat oleh.” They’ll sign you up. Which HMO you choose is a topic for someone else – I understand that there’s relatively little differences between the HMOs, but perhaps some HMOs are better for certain types of health conditions than others. Macabbi and Clalit seem to be the most common, at least in Tel Aviv.

Next you can expect a letter in the mail from BTL detailing how much you have to pay. Even if you don’t work and have no income, you have to pay at least 140 shekels a month, which can be done directly with your bank (details forthcoming in another survival tip post on Israeli banks). If you work, it will be automatically deducted from your paycheck. If you don’t understand the invoices, don’t worry too much. Get someone to explain it to you, but by law BTL cannot cut off your health insurance if you don’t pay on time.

For those who are not citizens of Israel but still want health coverage, there exist several options. One option is to get private insurance through one of the HMOs (Macabbi, Clalit… they all have a plan). Fact is, as I was so kindly told by a Macabbi employee, that it’s a horrible deal. A 24 year old pays about 400 shekels a month and gets virtually no coverage. A better deal is to get private insurance where you pay by the day – essentially tourist insurance, but it covers everyone regardless of status – from a company called Harel (I think you can sign up through Issta, the student travel agency). It’s a bit more than a dollar a day, but the coverage is good. It works a bit like a PPO in the States – you call in and ask for a doctor that participates in the network and they give you a name and number.

For those with more complicated status questions (“halfies”, “ezrach oleh”, etc.), ask me, I may have a tip or two.

Get insured, you’re entitled.


24 Responses to “Israel Survival Tips: Part 1 – Health Insurance”

  1. lynda kaye April 8, 2007 at 9:21 pm #

    Ive just found your Website! May be YOU’LL have the answer to a question that many hoping to make Aliyah desperately need answered! We are told, before making Aliyah , to do our ‘homework’ about which Health Fund will suit us best depending on the answers to the very specific questions we are told to ask, eg: is a certain drug available free, is there out-of-hours cover in the place you’ll be living, etc etc. However it is IMPOSSIBLE to get such details from the U.K from each fund, neither from the internet nor by phone. The Websites only give general info, much of it only in Hebrew & have no phone number outside of Israel. A Website that cross-compares the four Funds in detail would be wonderful! An idea for someone with initiative & ‘net skills? Meanwhile can you or anyone suggest how/where I can get such info. so we can come to Israel knowing which health fund to join?

  2. Jon Aizen April 8, 2007 at 9:25 pm #

    Hi Lynda,

    The truth, or so I hear from everyone, is that the HMOs are all relatively the same. The choice, for most people, comes down to what is most convenient in the city you live in. In Tel Aviv Macabbi and Clalit are the most abundant. Unless you have a very specific health concern, I wouldn’t worry too much about which HMO you choose. I’ve been very satisfied with Macabbi.

  3. orna July 8, 2007 at 7:09 am #

    I read your website and I am trying to make a decision about health insurance issues and your articale helped a lot; thanks.
    I am coming to Israel for a minumum of 2 years ( who knows maybe more) as a student in an Exec MBA program. As of yet, I do not have a job lined up for me. I had looked at the “tourist insurance” but it did not seem like it really covered much g-d forbid something really happened.
    Do I understand correctly that even if I did make “aliyah” it would take some time for me to get private citizenship coverage? What is speacial about “ezrach oleh” situation b/c for some reason I was told that is how I woud be “categorized”

    Thanks you in advance, orna

  4. miryam May 28, 2008 at 2:34 pm #

    i am married and moving to israel i am already 3 months pregnant but i am not doing aliya. my husband is getting a student visa and i am getting a work permit. what do i do to get health insurance

  5. Sofya June 19, 2008 at 6:21 am #

    I’m going to Israel to have IVF (in-vitro insemination). It’s very expensive in USA, but in Israel they have quite reasonalbe prices. Can I buy health insurance which will cover at least my expences on medications? If yes, what kind of insurance?

  6. Devorie August 6, 2008 at 5:35 pm #

    I need to purchase health insurance for my daughter to see Dr. Kerem at Hadassah Hospital once a month for a year – she has Cystic Fibrosis, he treats it and she will be in Israel for at least a year. Any tips?

  7. Lillie November 30, 2008 at 2:59 pm #

    Hi Jon,

    I just had a fantastic experience at Bituach Leumi today! I think I fall into the category of “halfies” that you’re talking about. I came to Israel to stay for about a year or two and have an Israeli passport. However, I didn’t want to establish residency/make aliyah so I never got a Teudat Zehut (which everyone told me was a good idea). Now they’re telling me that not only do I not qualify for health insurance coverage (because I haven’t established residency) but I still have to “pay my dues” and have it automatically deducted from my paycheck. I do not want to establish residency. Do I have no other option besides both paying for private coverage and having them take my money every month?


  8. Jon Aizen December 1, 2008 at 7:45 am #

    Hi Lillie,

    From what I understand, everyone who works in Israel has to pay into Bituach Leumi by law. If you don’t establish residency, you are not eligible for the benefits.

    Best of luck!


  9. Cloclo March 9, 2009 at 8:57 pm #

    J’ai fait mon ALYAH en 2004 mais je ne savais pas qu’il fallait aller au BITOUAKH LEOUMI.
    Je ne me suis pas inscrit non plus à la KOUPAT HOLIM

    Au bout de 4 ans, mes voisins m’ont conseillé de faire les démarches …
    Et là je me heurte à un mur … j’ai l’impression d’être à MOSCOU ou à Téhéran

    Je ne peux pas avoir la KOUPAT HOLIM car je suis désormais considéré comme TOSCHAV HOZER
    et je dois attendre 6 mois avant de pouvoir m’inscrire à la KOUPAT HOLIM

    JE rentre en FRANCE dégouté par cette bureaucratie
    I made my Alyah in 2004 but I did not know he was going to BITOUAKH LEOUMI. I did not enter either the KOUPAT Holim

    After 4 years, my neighbors advised me to take the steps …
    And here I am up against a wall … I feel like in Moscow or Tehran

    I can not be KOUPAT Holim because I am now considered TOSCHAV Hozer
    and I must wait 6 months before they can register for the KOUPAT Holim

    I returned to France by the bureaucracy disgusted

  10. Rubi July 14, 2009 at 7:26 pm #

    I checked the Harel-Yediddim website that you recomended. Although in my case I can apply as a student or pay daily as a traveler, I have been married to an Israeli citizen for three years and am searching if his health insurance would cover. What would be the best plan for married couples, if one is not a citizen?

  11. Kate August 17, 2009 at 4:41 pm #

    I want to move to Israel for 6 months, and need to have medications every 8 weeks and possibly doctors visits during that time as well. This means I’ll need health insurance that covers me most thoroughly. Suggestions?

  12. Cassie January 22, 2010 at 9:02 pm #

    My husband and I will be moving to Israel soon and he is considered Ezrach Oleh. I am interested in the differences you mentioned in your blog. I haven’t heard of any differences. I was told we would get full coverage upon arrival (well once we ‘sign up”). Is this not the case?

  13. Avery Blumenblatt February 1, 2010 at 11:26 pm #

    My kids 20 & 23 are both studying Talmud in Jerusalem. My Cobra insurance in America is running out at the end of the month. My youngest has a pre existing condition that requires expensive meds. Is there a policy that pays for prescription meds on a pre existing condition?


  14. Yulia February 5, 2010 at 11:58 am #

    What if I have problems with the jewish Agency, cannot make Aliyah but am already here, without a health insurance and ill?

  15. Melissa February 23, 2010 at 5:21 am #

    I am moving to Israel through an educational program for a year. I plan on continuing to pay for my policy in the US for when I move back. My boyfriend and I will need coverage while we live in Jerusalem. I will need coverage for weekly physical therapy, and my boyfriend (moving not through a program) will need regular visits for post-cancer treatment check-ups and scans.

    Is there any direction you can point us in in finding the right insurance options?


  16. rafi July 22, 2010 at 12:57 am #

    i lived in israel for 3 years, and even though im not a citizen, i was able to get israeli health insurnace by saying that i plan on making aliyah (which i do someday).

    I’m in the US right now, and im wondering if i can pause my health insurance w/o going to israel. Anyone know?

  17. Shani July 31, 2010 at 9:58 pm #

    Thanks for your blog. I’m an Israeli citizen. Did the army. Was a ketina Chozeret because I lived there as a child. Wasn’t born there. Been living overseas most of the time and am now in the U.S. If I want to come to Israel to get cheaper health care, do I first need to establish residency? Or can I get it on the basis of being a citizen and having served the country? Thanks!

    • Dana June 25, 2012 at 4:19 pm #

      Shani, I don’t know if this applies to you but I am an American married to Israeli. I am a non jew so our situation is a bit mixed. He is a returning citizen and had to apply at the national health office for insurance. From my understanding as a toshav hozer he will have to pay back taxes to get into the national health program. they claim he will be refunded (when the gvt has money lol). so far it’s been a process. fortunately our kids (all children under 18) are covered automatically once you apply for the process. whether tourist, etc children are covered. So the short answer is…you may have to pay back tax (if you are over 18 obviously you are) in order to get back into the national healthcare system. double check with their office or misrad clita that deals with returning citzens. Again, not sure if the information I have applies to you but maybe it’s a start of process of elimination. 🙂 good luck!

  18. Susan January 1, 2012 at 2:16 pm #

    I have been living in Israel under a Tourist Visa for 10 months. I have applied for Aliyah, my Husband is and Israeli Citizen, he has Insurance as a Citizen. I would like to check out maternity insurance for myself. Thanks

  19. Rita Osorio May 9, 2012 at 3:34 pm #

    Have you heard about Ayalon Insurance Co. I asked some questions before enrolling my 18 year old daughter however there are no answers from them in a week.
    They send me all the forms to fill out. This is a tourist insurance.
    I would appreciate your answer.

  20. Dana June 25, 2012 at 4:14 pm #

    I live in Israel as an ex-pat, non-Jew and did not make Aliya. I am scoping out private insurances and already got the feeling to avoid the national programs. do you have any specific companies you suggest or recommend? so far I looked into Pacific Prime…awaiting a quote and details. still searching for more. Thanks!

    • GOIIsrael October 4, 2012 at 7:18 pm #

      Dana – I saw your post and I was in the same position. I went through a company called Hilit, which works with Clalit. It costs about 1 dollar a day. Harel is one of the most expensive private insurers, I think that a company called Mango is said to be the cheapest. Good luck!

  21. Nathaniel Orlowek September 2, 2012 at 10:44 pm #

    I am 54 years old, American all my life, a career Jewish educator and camp professional. I am planning on doing the following: To continue to work in the USA for about 8 months of the year where I will be able to earn enough money to go to Israel to volunteer in my profession for about 4 months of the year (3 months in the summer and one additional month in the winter). I might end up just staying permanently in Israel, but for now this is what I am planning and needing to do. I am weighing the pros and cons of becoming an Israeli citizen (I have already registered with NBN and done the interview and cleared all the hurdles with the Jewish Agency and have been fully approved by the Israeli Embassy as qualified for Aliyah). I am generally in very good health but did have a heart attack 11 years ago and am on medication to control blood pressure (as is standard for heart patients), so I have a “pre-existing condition”. Of course, I have American health insurance (from before my heart attack) that is still in effect and I will be keeping it for as long as I still would be spending most of the year in the USA. I have extensively looked into my options with Israeli private companies. I’m in a borderline situation but they indicated that they would cover me for anything that is clearly not related to my “condition” (e.g., breaking a leg) but would not for anything “directly or indirectly related to my pre-existing condition”. Evidently, if I become an Israeli citizen I would of course be covered by Israeli health insurance. However, if I would be spending most of the year outside of Israel evidently the National Insurance Institute would cancel my insurance and/or would not honor any claims if I were to need medical care while in Israel. I understand that the government of Israel doesn’t want people proclaiming Aliyah and just spending 4 months per year in Israel just to get health insurance, but the reason I would be spending 4 months in Israel per year would be to volunteer (as I did in summer, 2011) using my 34 years of experience to help ילדים בסיכון–something that is very helpful to Israeli society. Any help you could give me (so that I can help Israel!) would be greatly appreciated. I know that government ministries have to have rules and that it’s impossible for the rules to fit every situation and that it’s easier to just have the rules be inflexible, but would there be any flexibility for someone like me who would be coming to Israel to give of his talents and experience to help? Thank you very much. Nathaniel Orlowek

  22. Mike December 1, 2012 at 10:46 pm #

    I am an Israeli citizen living in the U.S. My Israeli health insurance expired. I plan to retire in Israel. How can I buy back into the system?

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