If you already have Shaban through your HMO, it does not mean there is nothing to check on a private policy — but it also does not mean you must buy another one. The first step is to see what you actually have, what's missing and what might be duplicated. This guide explains how the two products differ, which layer each one sits in, and how to think about the decision calmly based on the family situation.
What Shaban actually is
Shaban ("שירותי בריאות נוספים" — additional health services) is a supplementary service offered by your HMO — Clalit, Maccabi, Meuhedet or Leumit — and not a private insurance policy with an insurance company. You join through the HMO, the monthly payment is collected through the HMO (usually from your salary or bank account), and the services are delivered through the HMO under the Shaban regulations.
Each HMO offers one or more Shaban plans (for example Mushlam, Magen Zahav, Adif, Zahav/Kesef) with different scopes and prices. The exact scope of each plan is set by the HMO and published on the HMO's website.
Worth remembering: Shaban is an HMO service, not a policy. Joining usually does not require medical underwriting, subject to waiting periods and to the specific regulations.
What private health insurance is
Private health insurance is a policy with an insurance company (for example Harel, Migdal, Clal, Menora, Phoenix, Ayalon). The policy has terms, ceilings, exclusions, deductibles, waiting periods and a premium that usually grows with age. Joining is typically conditional on a health declaration and medical underwriting, and may carry an exclusion of a pre-existing condition or an extra premium.
The main practical differences
- Who provides the service: Shaban is given by the HMO; a private policy is given by an insurance company.
- Underwriting: Shaban usually has no medical underwriting; private insurance usually does, sometimes with exclusions or extra premium.
- Payment framework: Shaban is a monthly HMO fee by age and plan; private is a premium to the insurer that can change with age and plan.
- Waiting periods: exist in both, subject to the regulations / the policy.
- Claim process: with Shaban, through the HMO; with private, through the insurer, under an indemnity or lump-sum mechanism per the policy.
A common pitfall: overlap between Shaban and a private policy
Many families end up with some overlap between Shaban benefits and items inside a private policy — for example private surgery in Israel or specialist consultations. Duplicate cover is not always waste: sometimes the ceilings, deductibles or claim ease differ. But before deciding to add or cancel, look at the full picture.
Worried about duplicate cover?
A structured review of what Shaban includes and what your private policy adds helps decide what complements, what duplicates and what is not critical — before paying more or cancelling the wrong thing.
Read about duplicate insuranceWhen does it make sense to consider adding a private policy?
There is no single answer. Below are situations where many people seriously consider a private policy — but the final decision always depends on the plan regulations, the policy terms and the family situation.
- Wanting broader cover for medications not in the basket, beyond what Shaban covers.
- Wanting cover for a surgery or treatment that is not performed in Israel.
- A family medical history that justifies a deeper review of the cover.
- A life transition (birth, divorce, going self-employed) that changes the insurance need.
- Wanting to lock in policy terms at a young age and in good health.
Where to start — mapping what you already have
Before comparing new policies, see what you actually have today: which Shaban plan you are on, what it includes and what it excludes, and which private policies are already registered under your name. The Shaban plans appear on your HMO's website or by calling their service centre. All the private policies registered under your name appear on Har HaBituach, run by the Capital Market Authority.
Once you have the full picture, you can decide what's missing, what's duplicated and what's worth adding — and that is much more useful than buying a policy just because it was offered.
Not sure what you already have and what is missing?
I'd be happy to go over Shaban and your existing policies with you — no prior promise, no pressure.
Send a WhatsApp messageFrequently Asked Questions
Can I switch between Shaban tiers?
Yes. You can upgrade or downgrade your Shaban plan within the HMO, subject to the HMO's terms and to waiting periods on certain services when upgrading. Downgrades usually take effect sooner. The details appear in the plan's regulations on the HMO's website.
Does a private policy stay with me if I change jobs?
A personal private policy bought directly from an insurer is not tied to an employer and continues to operate when you change jobs, subject to premium payment. A group health policy through an employer, on the other hand, is usually a collective policy: when you leave that workplace the group cover can end, and sometimes there is a continuity option on separate terms. Check who actually insures you before any transition.
What happens if I have both Shaban and a private policy and I need surgery?
The answer depends on the Shaban regulations and the policy terms. The service may be delivered through a Shaban track with a deductible, and certain items may be reimbursed under the private policy subject to its terms. Indemnity policies (reimbursement of actual expenses) typically include rules that prevent reimbursement beyond expenses that were already covered; lump-sum policies operate under different rules. There is no single rule — every case has to be checked against the specific documents.
Should I cancel Shaban if I have a good private policy?
Not automatically. Shaban and a private policy operate under different frameworks, and Shaban often provides accessible, efficient delivery for everyday services that are not covered the same way in the private policy. Before cancelling, compare cost, services, waiting periods, current medical situation and whether any clauses would be excluded or ended at cancellation.
Does Shaban require medical underwriting like a private policy?
In most cases Shaban does not require a health declaration and enrolment is automatic for HMO members, subject to waiting periods. Private health insurance is usually medically underwritten and may carry exclusions, an extra premium or refusal for a pre-existing condition — subject to the Shaban regulations and the specific policy terms.
Where do I start if I want to see what I already have?
You can log in to your HMO website and see which Shaban plan you're on and what it covers. You can see your private policies on Har HaBituach, run by the Capital Market Authority. Once you have the full picture, you can decide what's missing, what's duplicated and what is worth adding.
Summary
Shaban and private health insurance are two separate products with different coverages — not substitutes for one another. Shaban is provided by the HMO and usually focuses on specialist care and everyday treatment tracks in Israel; a private policy is provided by an insurance company and may add a layer for medications outside the basket, private surgeries in Israel and abroad, and certain other coverages. The right choice is not about "the best" — it is about what actually fits the family's situation, health and budget.
“I always tell clients: before buying a new policy or cancelling an existing one — let's first understand what you have today, in Shaban and in the policies already registered under your name. A calm decision starts with mapping, not with a promise.”
— Edi Efraimov
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