5 Things To Know About Your Kupat Cholim
1. Your Branch Secretary
If you need anything the Kupat Cholim offers and you want to know how to get it, ask the branch secretary. While all the kupot offer 24-hour mokeds (hotlines) for assistance when you need help making appointments, accessing rights and benefits, or getting a hafnaya or hitchayvut (see below), your local clinic/brand secretary is the person to go to. They can be found by calling your local clinic or going in in-person to the front desk of your doctor's office.
2. Your GP
Your primary doctor is the kupah’s point person for your physical well-being. He/she should be the first step when dealing with a medical situation, and is the person who will have an eye on the big picture.
Got a prescription from a private specialist? Ask your doctor to reissue it as a Kupah prescription. Looking for lab results from blood work? They get sent to your doctor. Need to see a physical therapist? Ask for a referral from your doctor. Everything starts and ends (remember to follow up!) with your GP.
Not sure if the doctor you’ve got actually fits the bill for your ideal point-person? You can switch up to once a quarter. We recommend you find someone who you are comfortable communicating with, is reasonably responsive and available, and who understands the big picture for your medical needs. If you need recommendations for a good, English speaking GP, ask the locals or crowdsource in our Facebook group, Navigate the Israeli Healthcare System.
3. 2 words: Hafnaya & Hitchayvot
Always ask if you need either or both of these to get the service you need.
- A Hafnaya (הפנייה) is a referral to a specialist or other medical services, and is often necessary for services both in and outside the kupah. There are some cases where a hafnaya is not needed, but that is subject to change regularly, so we recommend if you're not sure if you need one to get one. Even when they're not necessary, a hafnaya can help give a specialist background on your medical situation and why you are there.
- A Hitchayvut (התחייבות) is a payment voucher from the kupah, necessary for services, including tests and hospitalization, that are outside the kupah. If you are expecting your kupah to cover the service, and the building you're entering does not have your kupah's name on it, you probably need a hitchayvut. This payment voucher is also referred to as Form 17 ("Tofes Shva Esrei"), or a letter of financial obligation ("Tofes Hitchayvut"). You can get an hitchayvut my submitting your hafnaya (and other relevant paperwork if needed) to your branch secretary or through your kupah app.
4. 24/7 Care
Despite the operating hours of local branches, the Kupot are responsible for you 24/7. Any time you’re in need when the Kupah is closed, or the timing is simply inconvenient, call the Kupah’s 24-hour moked to check if the service can be sent to your door, or where the closest emergency medical center is that you can walk into any time.
The Kupah has arrangements with emergency medical centers, like Terem, in-house urgent care, and house-call services. The services offered by these institutions will vary, as well as the expected co-payment. If you're headed to the ER, you may need a hafanaya (referral). For more on off-hour treatment and urgent care click here.
It’s worthwhile to know the capabilities of the closest emergency medical center for times when your need is not just a matter of convenience. In certain urgent situations you should go straight to the hospital or call an ambulance. Click here for information about coverage of ambulance costs.
5. Knowing Your Rights
By law, the kupot cover doctor visits, diagnostic and laboratory services, some paramedical services, medical equipment, rehabilitation, hospitalizations and many prescription medications. Supplementary Insurance (SHABAN) plans cost an extra monthly membership fee but offer a much wider selection of medications, more opportunities for using private doctors and specialists, and more options and benefits in general. If you already have it, review your additional benefits, and remember to check with the Kupah before paying for any medical service out of pocket.
