Articles

Supplementary Health Insurance in Israel: Shaban vs Private Policies

A health fund must accept you into its supplementary plan whatever your medical history. A private insurer is allowed to say no.

Three weeks after his flight landed, Daniel sits in the waiting area of his new health fund clinic in Modiin, an orthopedic referral folded in his hand. At the front desk the clerk asks whether he wants to add the fund’s supplementary plan. That evening a colleague forwards him a quote for a private health policy with one line: “The kupa won’t cover what matters. Take this.”

Daniel wants to know which layer pays for what, so he does not pay twice for the same surgery or leave the expensive treatments uncovered.

Health cover in Israel has three layers. Your health fund’s supplementary plan, shaban, must accept you whatever your medical history. A private insurer can refuse you or exclude a condition, but it can cover the drugs shaban is barred from.

Contents

1. Three Layers of Health Cover in Israel
2. What Shaban (Supplementary Health Insurance) Covers
3. Joining Shaban: No Health Questions, but Waiting Periods
4. What a Private Policy Adds
5. Where Shaban and a Private Policy Overlap
6. How to Decide What You Need
7. Frequently Asked Questions

Three Layers of Health Cover in Israel

The first layer is the health basket. The National Health Insurance Law entitles every citizen and permanent resident to health services through one of four health funds, the kupot cholim: Clalit, Maccabi, Meuhedet and Leumit. Every resident aged 18 or over must register with a fund of their choice, and Bituach Leumi (the National Insurance Institute) collects the health tax and passes it on.

The second layer is shaban, short for sherutei briut nosafim: the health funds’ own supplementary health insurance, sold only to their members. The third layer is a private health policy, bought from an insurance company directly or through an agent and supervised by the Capital Market, Insurance and Savings Authority. English-language sites use “supplementary” for both, so in this article it means shaban only. The terms you will hear:

• Shaban, or bituach mashlim: your health fund’s supplementary plan
• Bituach briut prati: a private health policy from an insurance company
• Mashlim shaban (“complementary to shaban”): a private surgery policy that pays only what shaban does not. Not the same as bituach mashlim
• Mehashekel harishon (“from the first shekel”): a private surgery policy you claim from directly
• Chitum: underwriting, the insurer’s check of your health before it accepts you

What Shaban (Supplementary Health Insurance) Covers

The law lets each fund offer a plan for services outside its basket, and the plan and every change to it need the Minister of Health’s approval. Plans differ by fund and tier. Leumit, for example, lists these among its plan benefits:

• Surgery in private hospitals, with a choice of surgeon and hospital and priority scheduling
• Second-opinion consultations with specialists
• Dental treatment in private clinics at reduced prices
• Extra child development treatment, such as physical, occupational and speech therapy
• Discounts on over 600 medications that are not in the basket
• Complementary medicine such as acupuncture and reflexology

Most services carry a co-payment, because each shaban plan has to fund itself. The law bars shaban from life-saving and life-extending drugs outside the basket, and plans pay in treatment or refunds rather than cash compensation.

Each fund sells its plan in tiers. Kol Zchut, a Hebrew-language guide to rights in Israel, lists Mushlam Zahav and Mushlam Platinum at Clalit, Maccabi Sheli, Zahav and Kesef at Maccabi, Adif and Si at Meuhedet, and Silver and Gold at Leumit. Leumit describes Silver as its basic plan and Gold as its most comprehensive.

Joining Shaban: No Health Questions, but Waiting Periods

A health fund must accept every member who asks to join its supplementary health insurance plan, regardless of age or health, and it runs no medical check first. The price is the same for everyone in the same age group and plan, regardless of seniority or health.

The fund can set a waiting period before each service becomes available. The law only requires the periods to be reasonable, and according to Kol Zchut they never exceed 24 months. At Maccabi, private surgeries carry a 12-month wait and certain drugs outside the basket a 24-month wait.

Switching funds without starting over

If you move to another health fund and join its shaban within 90 days of registering with it, the law credits the time you spent in your previous plan against the new waiting periods. Moving up from a lower tier to a higher one restarts the full waiting period of the higher tier.

If you have just made aliyah

1. At the airport: register with a health fund at the Ministry of Aliyah and Integration desk.
2. From your aliyah date, for 6 months: no health tax if you have no income, or an income below NIS 688 (as of January 2026), as Bituach Leumi explains for new olim.
3. Within 90 days of arrival, or 12 months at Maccabi: join shaban with no waiting periods. The 90 days come from olim guides such as Nefesh B’Nefesh and the 12 months from Maccabi’s own site, so confirm your fund’s window.
4. After 90 days from aliyah: fund registration is possible only at a Bituach Leumi branch.

Our insurance tips for olim also suggest comparing the funds in your new town before you arrive.

What a Private Policy Adds

A private policy works the other way around. You go through underwriting (chitum): you fill in a health declaration, and the insurer uses it to decide whether to cover you and on what terms. It may refuse you or ask for a higher premium. Each family member is underwritten separately, and you choose which coverages to buy; our page on private health insurance lists what a typical plan includes.

Earlier conditions are handled through exclusions. A general exclusion for a pre-existing condition is valid for up to a year from joining, or half a year if you joined after age 65, while a specific exclusion written into your policy can last for life.

Alongside shaban, these are the coverages that matter most:

• Drugs: the life-saving and life-extending drugs outside the basket that shaban is barred from.
• Transplants and special treatment abroad: an insurer must cover at least lung, heart, kidney, pancreas and liver transplants.
• Surgery: in Israel or abroad, in one of two policy types.
• How you are paid: the insurer either reimburses what was spent or pays a one-time sum regardless of the cost.

Two kinds of surgery policy

Since February 2016 every insurer must offer surgery insurance on the same standard terms. Health policies sold since then renew automatically every two years for life and are updated in line with developments in the field, so the terms are not frozen. A first-shekel policy lets you claim directly from the insurer without using your shaban first. A complementary-to-shaban policy pays only the difference between your costs and your fund’s refund, and its premium is lower.

Since June 2024, anyone with an individual first-shekel surgery policy who is also a shaban member is moved to a complementary policy. You can refuse the move, and if you were moved you can ask to switch back within a year.

Where Shaban and a Private Policy Overlap

Shaban vs private health insurance is rarely an either-or choice. In a Myers-JDC-Brookdale survey (in Hebrew) of adults aged 22 and over, conducted between October 2021 and March 2022, 81% had shaban, 49% had private (commercial) health insurance, 44% had both and 14% had neither.

A reimbursement policy will not pay you twice for the same expense, and surgery is where the two layers overlap most: Kol Zchut warns that people end up paying for both covers and collecting from only one. Drug coverage overlaps far less than surgery cover, because of the legal bar on shaban. Transplants sit in between: the funds offer funding for transplants abroad through shaban once basket rights are used up, and private policies cover them too.

Before you buy anything, check which policies are already in your name on Har HaBituach, the Ministry of Finance’s insurance lookup site.

How to Decide What You Need

Five questions decide it:

• If you have a medical condition, join shaban within your window first: it must accept you, while a private insurer can exclude that condition, possibly for life.
• If you are older, shaban still accepts you at its age-group price, while a private insurer may refuse a person because of age.
• If your main worry is a life-saving drug outside the basket, only a private policy can cover it.
• If you already have shaban and want surgery cover, a complementary-to-shaban policy costs less, and a first-shekel policy lets you skip shaban.
• If you have shaban and a first-shekel surgery policy, you pay for two surgery covers but can collect only once for the same operation, so check whether yours was moved to a complementary policy in 2024.

For Daniel, three weeks in, joining shaban inside his fund’s window comes first: it cannot turn him away over the condition he was referred for, while a private insurer may exclude it. Whether a private layer is worth adding depends on what worries him most.

If you want your shaban tier and any private policy compared side by side, the English-speaking team at Goldfus meets clients at its offices in Jerusalem, Modiin and Beit Shemesh or online, and you can book a time through the contact page.

Frequently Asked Questions