Israeli Healthcare Explained: From Kupat Holim to Emergency Care - A Complete Guide for 2025
Israel's healthcare system consistently ranks among the world's most advanced, earning fifth place globally in the World Health Organization's healthcare quality and innovation rankings. For residents, new immigrants, and visitors alike, understanding this sophisticated system can mean the difference between excellent care and costly confusion. Whether you're making aliyah, working in Israel temporarily, or simply visiting, this comprehensive guide will help you navigate everything from choosing a health fund to handling medical emergencies.
Bottom Line Up Front: Israel provides universal healthcare through four competing non-profit health funds (Kupat Holim), with comprehensive coverage including mental health, prescriptions, and emergency care. New immigrants get significant benefits including free coverage for up to one year. While the basic system is excellent, most Israelis (80%+) purchase supplementary insurance for enhanced services and shorter wait times.
Understanding the Foundation: Israel's National Health Insurance System
The Historical Context
Israel's 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 (קופת חולים - "Patient Funds") which are run as not-for-profit organizations and are prohibited by law from denying any Israeli resident membership.
The term "Kupat Holim" literally translates from Hebrew as "Patient Fund" and the Yishuv's health insurance and medical services organizations, known as Kupat Holim (pl. Kupot Holim) were modeled after the medical mutual-aid societies that were formed in Germany following Otto von Bismarck's social legislation of the late 19th century. The term Kupat Holim is a literal Hebrew translation of the German word Krankenkasse.
Core Principles of Israeli Healthcare
The Israeli healthcare system operates on several fundamental principles:
Universal Coverage: All Israeli residents are entitled to basic health care as a fundamental right. Every resident must be insured through one of the four health funds.
Freedom of Choice: Every resident has a right to register as a member of a Kupat Holim of his/her choice, free of any preconditions or limitations stemming from his/her age or the state of his/her health.
Comprehensive Services: Residents choose from four competing nonprofit health plans that provide a mandated benefit package, including hospital, primary, specialty, mental health, and maternity care, as well as prescription drugs and other services.
Quality Standards: Every resident has a right to receive, via the Kupat Holim of which she or he is a member, all of the services included in the medical services basket, subject to medical discretion, and at a reasonable quality level, within a reasonable period of time and at a reasonable distance from his/her home.
The Four Kupat Holim: Your Health Fund Options
Understanding the differences between Israel's four health funds is crucial for making an informed decision about your healthcare coverage.
1. Clalit Health Services (Kupat Holim Clalit)
The Largest Player: The largest health insurance fund is Clalit. It is used by half of Israel's citizens. Clalit, (Hebrew: שירותי בריאות כללית, General Health Services; previously – קופת חולים כללית, General Sick Fund), is the largest of Israel's four state-mandated health service organizations, charged with administering health care services and funding for its members.
History and Background: Widely known as Kupat Holim Clalit, it was established in 1911 as a mutual aid society. When the State of Israel was founded in 1948, Clalit was instrumental in providing medical care for the massive influx of new immigrants.
Advantages:
The best thing about Clalit is its extensive network of clinics, which are available in almost every municipality and residential area.
Most comprehensive geographic coverage nationwide
Largest hospital network including major medical centers
Disadvantages:
The main disadvantage of "Clalit" is that because of the large number of clients, the reception of narrow specialists or studies have to wait longer than in others.
Longer wait times due to high volume
Can feel impersonal due to size
Major Hospitals Include:
Soroka Medical Center (founded in 1960) in Beersheba. The largest hospital in the Clalit network, serves over half the area of the State of Israel, and a population of 1 million.
Rabin Medical Center (Beilinson and Golda campuses) in Petah Tikva
Lady Davis Hospital in Haifa
2. Maccabi Healthcare Services
The Second Largest: The second one is Maccabi, where about 1.5 million Israelis are insured.
Characteristics:
Known for shorter wait times compared to Clalit
Strong presence in central Israel
Good reputation for customer service
More personalized care due to smaller size
Target Population: Often preferred by middle-class families and professionals who prioritize shorter wait times and better service.
3. Leumit Health Fund
The Middle Option:
Moderate size with good service levels
Competitive with other funds in terms of coverage
Strong presence in certain geographic areas
4. Meuhedet Health Fund
The Innovative Player: This organization may be the smallest in terms of number of people, but it's certainly not the least important. The company was set up in 1933. Right from the start, the founders made it their mission to make sure everyone had access to medical care.
Characteristics:
Smallest but often most innovative
Along with long-term solutions such as increasing the number of medical students to train a new generation of doctors and incentivizing doctors to return to work in Israel after completing their studies abroad, we at Meuhedet have decided to take up the gauntlet with a creative solution based on advanced technology.
Often pioneers new digital health solutions
Can offer more personalized service
Disadvantage: One of the organization's disadvantages is the problematic location of the clinics, which are mostly found in large cities.
How to Choose Your Health Fund
Switching Options: 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.
Factors to Consider:
Geographic Coverage: Where do you live and where might you move?
Specialist Availability: What specialists do you need access to?
Hospital Preferences: Which hospitals do you prefer?
Wait Times: How important is quick access to specialists?
Supplementary Insurance Options: What additional coverage do you need?
English-Speaking Services: Particularly important for new immigrants
The Health Basket: What's Covered Under Basic Insurance
Comprehensive Coverage Included
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.
Primary Care Services:
Family doctor visits with no copayment
Preventive care and screenings
Vaccinations and immunizations
Basic diagnostic tests
Hospital Services:
There are no copayments for primary care visits, preventive care, cancer screenings, or hospital admissions.
Emergency room treatment
Surgical procedures
Maternity care and childbirth
Psychiatric hospitalization
Specialized Care:
Specialist consultations (with copayment)
Advanced diagnostic imaging
Physiotherapy and occupational therapy
Mental health services
Services NOT Included in Basic Coverage
Dental care for adults, optometry, and hearing aids are excluded. Additionally, the basic health basket typically doesn't cover:
Adult dental care (except emergency situations)
Cosmetic surgery
Alternative medicine treatments
Private hospital rooms
Some advanced medications not on the approved list
Cost Structure: Understanding Copayments and Fees
What You DON'T Pay For
Primary care physician visits
Emergency room visits (for serious conditions)
Hospital admissions
Preventive care and cancer screenings
Chronic disease management
What You DO Pay For
Specialist Visits: Specialists:Copays up to quarterly ceilings, from NIS 25–34 (USD 6.5–9) for healthy adults and children.
Prescription Medications: Prescription Drugs · Minimum coinsurance of NIS 17 (USD 4.5) per prescription; maximum 15% for patented drugs, 10% for generics.
Mental Health Services: Mental Health: Mental health services are included. The co-pay for a therapy session is around $10.
Physical Therapy: Physical Therapy: Included: for a patient from abroad, this costs $60 to $80 per session.
Safety Nets and Protections
Safety Nets · No cost-sharing for preventive care. Specialists: no copays for older adults receiving public income support, people with severe illness, low-income children; monthly caps for chronically ill. Prescription drugs: Holocaust survivors and people with severe illness exempt from copays; discounts on coinsurance for older adults and WWII veterans; monthly coinsurance caps for people with chronic illness.
Payment Methods
When copayments and coinsurance are owed, such as for specialist visits and pharmaceuticals, patients never pay providers directly. Instead they use their health plan membership cards to make copayments. The provider then receives the full fee from the health plans, which collect copayments electronically from enrollees' bank accounts each month.
Emergency Care: When You Need Immediate Help
Calling for Help
Emergency Numbers:
Ambulance: 101
Police: 100
Fire Department: 102
Emergency medical services in Israel are provided by the Magen David Adom (MDA) organization, and in some places by the Palestinian Red Crescent Society. The phone number to call for an ambulance is 101
Magen David Adom: Israel's Emergency Medical Service
Magen David Adom is the nationally recognized EMS organization of the State of Israel. MDA consists of approx. 22,000 volunteers and 2550 employees, Paramedics and first responders. The organization operates 166 stations with a fleet of over 1000 ambulances.
Response Times: They have succeeded at trimming the national average EMS response time to less than three minutes and in urban areas to less than 90 seconds.
Types of Ambulances:
The majority of the fleet consists of Basic Life Support (BLS) ambulances. These are supplemented by Advanced Life Support (ALS) ambulances, mobile intensive care units (MICU) and a variety of first responders.
Air ambulance services through helicopter and fixed-wing aircraft
Emergency Room Protocols
When Emergency Care is Free: Emergency rooms are for serious and life-threatening injuries. You must pay for your care there if you do not have a severe condition that qualifies for an exemption. Examples of exempt conditions include fractures, dialysis, and hemophilia. If your condition is exempt, your Kupat Holim will cover all the fees.
When You Must Pay: If you are not with a Kupat Holim, you will have to pay, too, and the costs will be high, starting at $250.
Ambulance Costs
You must pay for the ambulance service when calling an ambulance in Israel. If you have coverage through Kupat Holim, you can get full or partial coverage, depending on the conditions.
Special Provisions: At the end of 2023, citizens over 80 who get a subsistence and care allowance can get 50% back on the cost of getting to the hospital by ambulance. If you or your relative doesn't fall into this category, it'll probably be cheaper to get to a medical facility by cab.
Urgent Care vs. Emergency Care
Urgent Care Centers: If you are covered by a Kupat Cholim plan, your urgent care co-pay is usually covered with a co-pay, especially if you go to your recommended urgent care center. However, if you are not with a Kupat Cholim, you will need to pay between $90 and $150 for your visit and more for prescriptions or treatments such as an IV for dehydration.
After-Hours Care: After-hours care is available via hospital emergency departments (EDs), freestanding walk-in urgent care centers (both nonprofit and for-profit), and physician home visits provided by for-profit companies.
Supplementary Insurance: Beyond the Basics
Why Most Israelis Buy Additional Coverage
Most citizens also purchase voluntary health insurance for medications not covered by the benefit package and for faster access and greater provider choice. In fact, 85% of the sample reported possessing SHIP. (Supplemental Health Insurance Plan).
What Supplementary Insurance Covers
Voluntary health insurance plays a complementary role, covering benefits excluded from the NHI scheme (dental care for adults, certain medications, alternative medicines), as well as a supplementary role, expanding access to NHI-covered benefits, offering access to private providers, and providing improved amenities and faster access to care.
Common Supplementary Benefits:
Adult dental care
Private hospital rooms
Medications not in the basic basket
Alternative medicine treatments
Reduced wait times for specialists
Access to private specialists
Enhanced imaging services
The Reality of Supplementary Insurance Knowledge
This survey found that most of the Israeli public parched additional insurance coverage however did not show a significant knowledge about the benefits provided by the supplementary insurance, at least in the three measurements used in this study.
Important Note: Acquiring SHIP became a default option rather than an active decision. It's crucial to understand what you're buying and whether you actually need the coverage.
Types of Supplementary Plans
Each health fund offers various levels of supplementary insurance:
Basic Supplementary Plans: Cover essential extras like dental care
Premium Plans: Include private specialists and reduced wait times
Platinum Plans: Comprehensive coverage with maximum benefits
Prescription Medications: The Medication Basket
How Prescription Coverage Works
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%.
Copayment Structure
Prescribed medications are supported by government subsidies, but you may need to make a co-payment. A prescribed antibiotic costs around $6.
Standard Copayments:
Minimum copayment: Minimum coinsurance of NIS 17 (USD 4.5) per prescription
Generic medications: 10% coinsurance
Brand-name drugs: 15% coinsurance
Medication Approval Process
Basic medications are covered in the basket of health services but the Ministry of Health has their own specific conditions regarding the distribution of medications. You will find a listing of medications available under the Ministry of Health at their website.
For New Immigrants
We recommend bringing a three-month supply of your medication or whatever your present health plan allots for. In addition, we suggest bringing a medical summary to present to your new physician in Israel.
Mental Health Services: Comprehensive Coverage
Mental Health in the Basic Basket
Mental health services are fully integrated into Israel's healthcare system. Mental Health: Mental health services are included. The co-pay for a therapy session is around $10.
Available Services
The comprehensive mental health coverage includes:
Psychiatric consultations
Psychological therapy
Psychiatric medications
Inpatient psychiatric care
Crisis intervention services
Substance abuse treatment
Digital Mental Health Innovation
Improvements in mental health technology help solve problems like not having enough therapists and long wait times, making therapy and counseling more accessible. Over the last few years, there has been a rise in different online mental health platforms, making it easier for patients to get care.
Accessing Mental Health Services
Mental health services can be accessed through:
Referral from your family doctor
Direct contact with your health fund's mental health department
Emergency psychiatric services through hospitals
Community mental health centers
Special Provisions for New Immigrants and Foreign Residents
Benefits for New Olim
Free Coverage Period: New Olim, Ktinim Chozrim and Ezrachim Olim are entitled to up to one year of free health insurance for the basic level of coverage, if they are not working.
Immediate Eligibility: New immigrants who already have immigration visas are eligible for Kupat Cholim cover immediately, too.
Emergency Provisions: New immigrants who have not yet registered with a Kupat Holim and are in immediate need of healthcare can apply for coverage from the Public Ombudsman of the Ministry of Health.
Registration Process for New Immigrants
At the Airport: You can register immediately upon arrival at Ben Gurion Airport
Post Office: Register at any post office branch throughout Israel
Online: Through the National Insurance Institute website
Health Fund Branches: Direct registration at your chosen health fund
Foreign Workers and Students
However, internationals who are not Israeli residents, for example, students and researchers, are required to obtain private health insurance. They can still receive medical treatment from Kupot Holim, but they must pay for services out-of-pocket.
Special Programs: Foreigners who are in Israel for more than a short visit can sign up for a non-resident program with Kupat Holim.
Requirements for Foreign Workers
About 100,000 of them are foreign workers who entered Israel legally and have a mandatory private health insurance that is paid by their employer.
Digital Health Revolution: Telemedicine and Innovation
Israel's Digital Health Leadership
Thanks to this plan, in five years Israel became a center of health innovation, with more than 1,500 active startups, pioneering advances in predictive medicine, personalized healthcare, telehealth, big-data, artificial intelligence and more.
National Digital Health Initiative
In March 2018, Israel announced a national priority programme called Digital Health as an Engine of Growth. This is a joint collaboration of six government ministries and includes an unprecedented investment amount of almost NIS1 billion (about $250 million) until 2023.
Program Goals:
make the Israeli health system a world leader, based on telemedicine and digital health solutions; promote clinical and academic research in Israel in the field of digital health; and transform the digital healthcare industry in Israel into a national growth engine and a global innovation hub.
Telemedicine Services Available
Current Capabilities:
Video consultations with specialists
Remote patient monitoring
Digital prescription services
AI-powered diagnostic tools
Mobile health applications
Future Developments: Telehealth in 2025 will help people in rural areas get medical care by using devices that patients can wear and sensors at home to keep track of health conditions. This allows doctors to step in early if needed.
Addressing Wait Times Through Technology
Extended waiting times are one of the biggest challenges in the healthcare system and one of the most frustrating for anyone who wants to consult with a doctor but finds that the next available appointment is weeks away
Innovative Solutions: Health funds are implementing technological solutions to reduce wait times, including:
Automated appointment scheduling systems
Real-time cancellation notifications
AI-powered triage systems
Remote consultation options
Wait Times and System Navigation
Current Wait Time Challenges
Although the number of physicians per capita in Israel has risen over the past decade, it remains below the OECD (Organization for Economic Co-operation and Development) average, and this shortage is expected to worsen as many physicians retire in the coming years.
Geographic Variations
Whether it is an appointment with a gynecologist, an ear, nose, and throat doctor (ENT), an eye specialist, dermatologist, or orthopedist, the farther one is from the center of the country, the longer the waiting times, due to the shortage of medical personnel in the periphery.
Strategies for Reducing Wait Times
Consider Different Health Funds: Some have shorter wait times than others
Geographic Flexibility: Consider specialists in different cities
Use Supplementary Insurance: For faster access to private specialists
Emergency vs. Urgent: Understand when conditions qualify for immediate care
Technology Solutions: Use health fund apps for cancelled appointment notifications
Advanced Scheduling and Imaging
Appointments that use special equipment, such as an MRI, may be scheduled at any hour of the day and night. This 24/7 scheduling helps accommodate the high demand for advanced diagnostic services.
Hospital Systems: Public vs. Private
Public Hospitals
In Israel, public hospitals offer shared rooms for their patients and are frequently noisy due to medical staff's constant check on patients. Visiting hours in these public hospitals are limited to a few hours per day.
Characteristics:
Covered by your health fund
High medical standards
Can be crowded and noisy
Limited visiting hours
Shared rooms standard
Private Hospitals
In Israel, non-state organisations fund private hospitals which hire private medical staff. Although public and private hospitals provide decent medical treatments, private hospitals have better facilities and patient care.
Enhanced Amenities: Private hospitals in Israel offer patients with private rooms which resemble hotel rooms rather than ordinary hospital rooms. In addition, they provide decent TV and internet access, restaurant-quality cuisine at their cafeteria.
Cultural Perspectives on Hospitals
Israeli hospitals are crowded and noisy and considered by Israelis to be for emergencies only. This cultural perspective means that outpatient care is strongly emphasized, with hospitalization reserved for truly necessary cases.
Medical Tourism and International Standards
Israel as a Medical Tourism Destination
Israel is emerging as a popular destination for medical tourists. In 2006, 15,000 foreigners travelled to the country for medical procedures, bringing in $40 million of revenue. As of 2010, up to 30,000 foreigners come to Israel every year for treatment, mostly from Russia.
Why People Choose Israel for Medical Care
Some medical tourists come to Israel because the procedures they seek are not available in their home countries. Others, particularly from the US, choose Israel because they can receive high quality treatment, such as surgery and in-vitro fertilization at much lower cost.
Cost Comparison
As a rule of thumb, the price of medical treatment in Israel is significantly lower than in the USA or Europe.
Pricing Transparency: Rambam Hospital employs a full-transparency financial approach; a detailed invoice is provided to all patients, and payment is made directly to the hospital cashier.
Healthcare Financing and National Insurance
Funding Mechanism
Bituach Leumi is also responsible for collecting health insurance contributions under the National Health Insurance Law. These contributions are then transferred to the various Kupot Cholim (health funds).
Residency Requirements
According to Bituach Leumi, eligibility for insurance is determined according to residency in Israel and not citizenship. The definition of residency is whether or not your life is centered in Israel.
Residency Criteria Include:
Your permanent place of residence (residing in Israel for minimally 183 days a year; cumulatively)
Center of life test (both objective and subjective factors)
Financial and social ties to Israel
Payment Obligations While Abroad
If you are an Israeli resident living abroad, you must continue to pay national and health insurance contributions. A delay in payments while abroad may cancel your eligibility to receive health services for several months.
Special Populations and Circumstances
Military Personnel
All soldiers except those who were found medically unfit for service but volunteered are not covered by their Kupat Holim during their military service, but receive healthcare through the military healthcare system. Upon leaving the military, soldiers rejoin their previous Kupat Holim.
Veterans and Special Cases
Disabled veterans are covered by the Ministry of Defense. In addition, some disabled World War II veterans and victims of the Nazis are eligible for certain types of health benefits from the Ministry of Finance.
Alternative Medicine Coverage
Alternative Care: Each Kupat Cholim provides some alternative care, such as reflexology and acupuncture, often with a co-pay. These services cost $75 to $250 independently.
Practical Navigation Tips
Choosing Your Health Fund
Research Considerations:
Geographic Coverage: Where are the clinics and hospitals?
Specialist Networks: Which specialists do you need access to?
Language Services: Availability of English-speaking staff
Supplementary Options: What additional coverage is available?
Technology Services: Digital health capabilities and telemedicine options
Managing Your Healthcare
Essential Steps:
Register Immediately: Don't delay registration if you're eligible
Choose a Family Doctor: This is your gateway to the system
Understand Copayments: Know what you'll pay for different services
Consider Supplementary Insurance: Evaluate if you need additional coverage
Keep Documentation: Maintain records of all medical interactions
Language Barriers
For English speakers, consider:
Choosing health funds with strong English-speaking staff
Bringing a Hebrew-speaking friend to important appointments
Using translation apps for basic communication
Requesting English-speaking specialists when possible
Emergency Preparedness
Essential Information to Keep Handy:
Your health fund membership number
Emergency contact numbers (ambulance: 101)
Nearest hospital locations
Your family doctor's contact information
List of current medications and medical conditions
Common Challenges and Solutions
Wait Time Management
Strategies:
Book Early: Schedule routine appointments well in advance
Flexibility: Be willing to see different specialists or locations
Cancellation Lists: Ask to be notified of cancellations
Private Options: Consider private specialists for urgent needs
Telemedicine: Use digital consultations when appropriate
Insurance Complexity
Navigation Tips:
Annual Review: Reassess your health fund choice annually
Supplementary Evaluation: Regularly review supplementary insurance needs
Cost Tracking: Monitor your healthcare expenses
Benefits Education: Understand what's covered and what isn't
Quality of Care Concerns
Ensuring Good Care:
Research Providers: Ask for recommendations
Second Opinions: Don't hesitate to seek multiple perspectives
Documentation: Keep thorough medical records
Advocacy: Speak up if you're not receiving appropriate care
Future Trends and Developments
Technological Advancement
Israel's healthcare system is rapidly embracing new technologies:
Artificial Intelligence: AI will substantially change many aspects of healthcare, making it faster, smarter, and more efficient. It will help doctors create personalized treatments using tools like Dermalyser, which can quickly spot skin cancer.
Remote Monitoring: Devices that track patients' health remotely will work with AI to catch problems early, helping manage chronic illnesses like diabetes or heart disease.
Digital Twins: Digital twin technology is expected to be a groundbreaking force in healthcare, revolutionizing areas like personalized medicine, clinical trials, and predictive analytics.
System Improvements
Ongoing Challenges Being Addressed:
Physician shortage through increased training programs
Geographic disparities through telemedicine expansion
Wait time reduction through technology solutions
Enhanced patient engagement through digital platforms
Conclusion: Making the Most of Israeli Healthcare
Israel's healthcare system represents one of the world's most comprehensive and advanced medical systems, offering universal coverage with a unique blend of competition and coordination among health funds. While the system has its challenges—particularly around wait times and the complexity of supplementary insurance—it provides excellent medical care at reasonable costs.
Key Takeaways for Success:
Choose Wisely: Take time to research and select the health fund that best meets your needs
Understand Coverage: Know what's included in basic coverage and what requires supplementary insurance
Be Proactive: Register immediately, establish care relationships, and schedule routine appointments early
Embrace Technology: Take advantage of Israel's cutting-edge digital health innovations
Plan for Emergencies: Know the emergency numbers and nearest facilities
Consider Supplementary Insurance: Evaluate whether additional coverage is worth the cost for your situation
For New Immigrants: Take full advantage of your free coverage period while you learn the system, and don't hesitate to ask questions—Israel's healthcare workers are generally helpful and patient with new immigrants navigating the system.
For Visitors: Ensure you have appropriate travel health insurance, as the Israeli system primarily serves residents. However, you can receive excellent emergency care at any Israeli hospital.
For Temporary Residents: Explore the non-resident programs offered by health funds or maintain robust international health insurance.
The Israeli healthcare system's combination of universal access, high quality care, technological innovation, and comprehensive coverage makes it a model for healthcare systems worldwide. By understanding how to navigate its complexities, you can access some of the world's best medical care while in Israel.
Whether you're dealing with routine preventive care, managing chronic conditions, or facing medical emergencies, Israel's healthcare system is designed to provide the care you need. The key is understanding how to access and utilize its services effectively—and with this guide, you're well-equipped to do exactly that.
This guide provides general information about Israeli healthcare and should not be considered medical or legal advice. Always consult with healthcare professionals and official sources for specific medical needs and current regulations.