Private Health Insurance

No. Every Israeli resident is entitled to the state health basket through one of the four HMOs (Clalit, Maccabi, Meuhedet, Leumit) under the National Health Insurance Law — this is the foundation that cannot be replaced. Private health insurance is an additional layer on top of the basket, intended to cover well-known gaps such as private surgeries in Israel and abroad, medications outside the basket and serious illnesses. In practice the private policy complements the HMO rather than replacing it, and the actual scope is always subject to the specific policy terms.

Shaban (supplementary health services, offered as of 2026 by all four HMOs — Clalit Mushlam, Maccabi Magen Zahav/Shli, Meuhedet Adif/Si, Leumit Zahav/Kesef) is sold by the HMO itself, has no medical underwriting, and carries a relatively low monthly premium that focuses on specialists, surgeries in Israel and complementary medicine. Private health insurance is bought from an insurance company, requires a health declaration, may apply underwriting and tends to become more expensive with age, but typically offers much higher coverage limits, surgeries abroad and treatment of complex conditions. For most families both products work together rather than as substitutes.

The Israeli health basket is updated each year by the Ministry of Health's Basket Committee, but many advanced medications — particularly oncological, biological and gene therapies — are not approved into the basket in the year they receive marketing authorization, and sometimes not for several years afterwards. Coverage for medications outside the basket in a private policy is designed to fund medications not financed by the HMO, subject to the policy terms and to the coverage ceiling defined in the policy. This is one of the coverages that meaningfully changes the financial picture of a family in a serious medical situation, which is why it should be reviewed carefully before being dropped.

In most private policies the insurer underwrites based on a health declaration and may accept the applicant, exclude coverage related to the existing condition, or decline part of the coverage. Group policies, children's policies and newborn enrollment windows sometimes apply more lenient terms. The health declaration must always be completed honestly and in full — material non-disclosure can be grounds to reject a claim even years after enrollment.

It is worth reviewing the policy every one to two years, and at every meaningful life event — childbirth, marriage, divorce, moving into self-employment, a new medical diagnosis in the family, or an HMO/Shaban update. The review covers the private policy benefits, how they relate to the HMO and Shaban layer, the actual monthly premium and any duplicate coverage. Har HaBituach, run by the Capital Market Authority, provides a single dashboard of all policies registered under the client's ID.

Some policies may cover private surgery abroad, subject to the policy terms — the type of surgery, the insurer's medical committee, the coverage ceiling, the deductible and exclusions. Two policies with the same name can behave very differently in practice, so read the policy wording before relying on it.

Critical illness insurance is usually a policy that pays a one-off cash benefit if a condition listed in the policy is diagnosed (for example certain cancers, stroke, severe heart attack). It is not ongoing medical-expense reimbursement and does not replace private health insurance. The two products can work together, subject to each policy's terms.

The decision is personal and depends on the child's health, family history and the cover already provided by the HMO and Shaban. At a young age and in good health the premium is relatively low and there are no exclusions, which is why many parents consider cover early. The review should be based on the policy terms, not a general promise.