page_title: Healthcare in Israel
section_title: National Health Insurance Law
hierarchical_section_title: Healthcare in Israel / Health insurance framework / National Health Insurance Law
caption_attribution_description: English: This image indicates Israeli health care spending as a percentage of GDP. An 'OECD Health Data 2010' report is used for the information, which is available here.
context_page_description: Healthcare in Israel is universal and participation in a medical insurance plan is compulsory. All Israeli residents are entitled to basic health care as a fundamental right. The Israeli healthcare system is based on the National Health Insurance Law of 1995, which mandates all citizens resident in the country to join one of four official health insurance organizations, known as Kupat Holim which are run as not-for-profit organizations and are prohibited by law from denying any Israeli resident membership. Israelis can increase their medical coverage and improve their options by purchasing private health insurance. In a survey of 48 countries in 2013, Israel's health system was ranked fourth in the world in terms of efficiency, and in 2014 it ranked seventh out of 51. In 2015, Israel was ranked sixth-healthiest country in the world by Bloomberg rankings and ranked eighth in terms of life expectancy.
context_section_description: Under the National Health Insurance Law, membership in one of the four following health funds, or Kupot Holim (Patient Funds) is compulsory for all residents of Israel: Clalit, Maccabi, Meuhedet and Leumit. Clalit is the largest of the four, with about half of the population belonging to it. The four Kupot Holim are obligated to provide a uniform list of health services, known as the "Health Basket" (סל בריאות; Sal Briut ), for all members - a list of medical services and treatments which each Kupat Holim is required to fund for its members. The law established a system of direct oversight of the Kupot Holim by the state, and certain services are under the direct administration of the State, usually by means of the Health Ministry.
  The Health Basket covers all costs of medical diagnosis and treatment in the areas of family medicine, hospitalization (general, maternity, psychiatric and chronic), preventive medicine, surgery (including elective surgery), transplants, treatment for drug abuse and alcoholism, medical equipment and appliances, first aid and transportation to a medical facility, obstetrics and fertility treatment, medications approved under the National Health Basket (which is updated every year), treatment of chronic diseases and paramedical services such as physiotherapy and occupational therapy, and mental healthcare. Medications for serious illnesses that are part of the official "basket of medications" formulary (which is large and updated regularly, but does not include all medications) are covered, though patients must partially pay for these medications with copays: medications included in the basket are covered at rates that vary from 50% to 90%. IVF treatments for the first two children up to the age of 45 and abortions are also covered.
  A committee appointed by the health ministry reviews the contents of the health basket on a yearly basis and determines which new treatments will be added to it within the constraints of the annual budget allocated to the basket by the government.
  In general, each Kupat Holim allows members to choose a primary care physician and specialists from a list of doctors associated with the fund. Availability of services differs by location, as each of these organizations operate their own medical facilities, including private hospitals.
  While the Kupot Holim typically cover medical treatment in Israel, they can fund medical procedures abroad when the procedure in question cannot be obtained in Israel. There is a cap of $250,000 without copay to fund treatment abroad, though that limit can be waived by the Director-General of the Health Ministry.
  Members of each Kupat Holim can switch to another once a year. There are six specified dates on which people can transfer, depending on when they signed up for their previous one. In special circumstances, it is possible to petition the Ministry of Health to cancel a change or register earlier than an official date.
  The National Health Insurance Law sets out a system of public funding for health services by means of a progressive health tax, administered by Bituah Leumi, or the National Insurance Institute, Israel's social security organization, which transfers funding to the Kupot Holim according to a capitation formula based on the number of members in each fund, the age distribution of members, and a number of other indices. The Kupot Holim also receive some direct government funding. The government provides the Kupot Holim relatively wide leeway in determining how to spend this funding, with the condition that the Kupot Holim must guarantee providing the treatments set forth in the health basket as a minimum service to their members.
  For the health tax, wage-earners and the self-employed must pay 3.1% of their monthly salary up to 60% of the average prevailing market wage (appx. NIS 6,300 in 2020), and 5% of anything earned above it. Employers are legally obligated to deduct insurance contributions from their employees' salaries, while the self-employed must arrange payment on their own. Pensioners have contributions deducted fr
caption: Health care spending in Israel as a percentage of GDP
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