Private health insurance in Israel is one of the more important decisions a family makes — and one of the more confusing. The name sounds similar to Shaban, but it is a completely different product: a policy with an insurance company, with terms, exclusions and deductibles. This guide walks through what to check before joining, what not to do without review, and why the name of a cover is not enough to know what is actually there.
What private health insurance is — and what it isn't
Private health insurance is a policy with an insurance company (for example Harel, Migdal, Clal, Menora, Phoenix, Ayalon). It does not replace the HMO and does not replace Shaban. It is an additional layer designed to cover some of the gaps in those two — private surgeries, medications outside the public basket and certain treatments.
The difference from the public health basket is clear: the basket is a statutory right of every Israeli resident, with no enrollment and no underwriting. The difference from Shaban is more subtle: Shaban is an additional service of the HMO — usually without medical underwriting — while a private health policy is taken out with an insurance company with a health declaration and may carry underwriting, exclusions or extra premium related to a pre-existing condition.
What usually appears in a policy — and should be checked
- Medications outside the basket — coverage ceiling, approval terms, exclusions, reimbursement or indemnity mechanism.
- Surgeries in Israel and abroad — which procedures are included, which require a medical-committee approval.
- Transplants and special services — included in some policies only; read the definition.
- Consultations and tests — varies by policy; some include, some don't.
- Critical illness — usually a separate product or a dedicated rider, not automatically part of the basic policy.
Medical underwriting and exclusions
In most private policies the insurer underwrites based on a health declaration. The outcome can be acceptance, exclusion of a pre-existing condition, an extra premium or refusal — subject to the policy terms. The declaration must always be completed honestly and in full; material non-disclosure can ground a claim rejection years later.
Why not to cancel an old policy without a review
Many people who receive an offer for a new policy are tempted to cancel the old one immediately. That is a common mistake. Old policies sometimes enjoy terms from the time they were signed — the medical situation declared then, the joining age, coverages that are no longer being sold. Cancelling before you have understood the differences can cost more than it saves, especially if your medical situation has changed since you originally joined.
Common mistakes before buying
- Relying on the cover name instead of reading the definition and the exclusions.
- Cancelling an old policy before understanding its terms and before the new policy is in force.
- Hiding a pre-existing condition on the health declaration — a possible ground for claim rejection.
- Assuming the policy covers surgeries abroad without reading the list of countries and procedures.
- Buying a policy without checking what Shaban and the basket already provide.
Questions to ask the agent
- What is the coverage ceiling for medications outside the basket, and under what conditions?
- What is the reimbursement track for surgeries abroad and what is the deductible?
- What waiting period applies to each section of the policy?
- Which exclusions apply for a pre-existing condition, if underwriting raised any?
- What does the claim process look like and what are the expected processing times?
- What future premium changes are expected as I age?
An objective comparison before deciding
An insurance portfolio review compares your existing policy with new offers, checks what is already included in Shaban and the basket and surfaces gaps — no cost, no obligation.
Open the private health insurance hubFrequently Asked Questions
Does private health insurance replace the HMO?
No. The public health basket through the HMO is the foundation for every Israeli resident under the National Health Insurance Law, and that foundation cannot be replaced. Private insurance is an additional layer on top of the basket and Shaban, subject to the policy terms.
What should I check before switching from an old policy to a new one?
Read both policies, compare ceilings, exclusions and waiting periods, and check whether the change in your medical situation since you first joined could affect the underwriting of the new policy. Never cancel an old policy before the new one is in force.
What is cover for medications outside the basket?
This is a cover for medications that are not included in the public health basket in a given year. It is subject to the policy terms — coverage ceiling, required approvals, exclusions and a reimbursement or indemnity mechanism. A separate guide on the site walks through what to check in a specific policy for medications outside the basket.
Is critical illness part of the basic policy?
Usually not. Critical illness insurance is normally a separate product or a dedicated rider. It pays a one-off cash benefit if a condition listed in the policy is diagnosed, and is not ongoing medical-expense reimbursement. The two products can work together.
Can I join with a pre-existing condition?
Subject to the insurer's underwriting. The outcome can be acceptance, exclusion, an extra premium or refusal. Always complete the health declaration honestly and in full; material non-disclosure can damage your rights at claim time.
What is the difference between Shaban and private health insurance?
Shaban is an additional HMO service — usually no medical underwriting, a relatively low premium, focused on specialists and surgeries in Israel. A private policy is with an insurance company, with underwriting, exclusions, higher coverage ceilings and sometimes cover for surgeries abroad. A separate guide on the site compares Shaban with private health insurance in detail.
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