Choosing Your Kupah's "Higher Level" Plans - Supplemental Insurance
Another one of our most frequently asked questions is: What is supplemental insurance? What are the different levels, the benefits, and should I join?
Supplemental insurance (שב״ן- שירותים בריאותיים נוספים) is the additional levels of health insurance available through the Kupot Cholim. Each Kupat Cholim offer 2 levels of supplemental insurance, and the cost varies by level and by age, and be anywhere from 10 NIS - 200 NIS per month. Supplemental insurance, like the basic healthcare plan in Israel, is regulated by The Ministry of Health, and therefore you can not be denied for pre-existing conditions. This makes supplemental insurance a very attractive option for many, as you can receive many additional healthcare benefits regardless of your medical status or conditions.
So, should I join? Probably, but know your specific needs:
Ideally, every family member can benefit from supplemental insurance, however, many of the benefits of supplemental insurance are catered to specific populations. For example, there are many added benefits for women in their reproductive years, children, and the elderly. Additionally, if someone has a comprehensive private insurance plan, some of the supplemental benefits may feel redundant. While we generally believe there are many amazing supplemental insurance benefits, and it is often worthwhile, every household needs to do their own personal cost-benefit analysis when it comes to purchasing additional insurance.
Examples of Supplemental Insurance Benefits:
Remember: this list is not comprehensive or universal, and you should always check directly with you kupah for the complete and most up-to-date list of supplemental insurance benefits.
More personal choices of advanced medical care:
- Additional private diagnostic consultations (second opinions) with medical specialists in Israel and abroad.
- Partial reimbursement for some specialist consultations.
- Partial reimbursement or coverage of some surgeons.
- See Sharap 101 for more information.
Services in fields not covered by the basic Health Basket:
- Dental Care for those over 18 and under 73.
- Kupah complementary medicine clinics.
- Orthopedic devices.
- Vaccinations when traveling abroad.
- Some cosmetic treatments.
Expanded Treatment/Benefits for fields covered by the basic Health Basket:
- Additional child development treatments in physical therapy, occupational therapy, speech therapy, psychotherapy.
- Extensive Genetic Testing.
- Additional educational or ADHD assessments.
- More expanded fertility treatments/benefits.
- Additional testing or reimbursement for pregnancy related purchases.
- Discounts on hundreds of medications not included in the Sal's "drug list".
- (Note: this benefit is commonly used by people particular about their medications and/or options in treatment, and it has the potential to cover the cost of a premium plan in savings to the consumer)
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Additional Benefits:
- Laboratory services at home (like blood tests).
- Discounted prescription glasses (varies by kupah).
- Fitness and nutrition benefits.
- ....and more!
Some Important Caveats
- Most benefits offered still have associated costs, like requiring partial payment by the member, partial reimbursement for private services after the member pays in full, and/or enumerated limits to how much the kupah will pay. These co-payments are often nominal, but in certain situations can still be costly.
- Private services offered may depend on a specific agreement with specific providers, not any provider that you choose.
- There are rules and regulations that you will have to fulfill for entitlement to many benefits, so claiming them may take further effort.
- Besides variation in benefits offered by each kupah, within the kupah there are multiple "levels" with distinct offerings.
- When a person first joins a supplemental plan, the specified benefits can have various waiting periods before they are available to them. Qualification periods can range up to 2 years from sign-up, but typically average around 6 months. If you join within 90 days of Aliyah, the wait times will be waived.
Ultimately, as mentioned above, everyone has to do their own personal cost-benefit analysis as to whether or not supplemental insurance is "worth it" for you. Typically though, we are hard pressed to find another insurance package that offers as much as it does, at this low of a cost, with no consideration for pre-existing conditions.
