Quick Answer: To legally bring a foreign caregiver to Israel, the patient's family applies to the Manpower Administration (part of the Employment Service) for an employment permit (*rishyon ishur asaka*), then to the Population and Immigration Authority (PIBA) for a B/1 caregiver visa. The patient must meet a medical eligibility threshold set by the Ministry of Labor. The caregiver earns at least the statutory minimum wage (NIS 5,571.75/month as of 2026), and the employer pays full National Insurance contributions. Total processing time is typically three to five months. Hiring a foreign caregiver outside this framework exposes both the family and the worker to serious legal and financial consequences.

Israel has roughly 65,000–70,000 foreign caregivers working legally in private homes at any given time, making it one of the largest categories of foreign workers in the country. The majority come from the Philippines, Nepal, India, and Sri Lanka — countries with which Israel has bilateral caregiver placement agreements. For diaspora families in North America, Europe, and Australia with elderly parents in Israel, arranging proper care from a distance is both urgent and complicated. Many families discover too late that the process involves two separate government agencies, a medical eligibility assessment, strict employment law obligations, and a paper chain that can take five months to complete.

The mistakes that land families in trouble are almost always the same: letting the health insurance lapse, paying wages in cash instead of by bank transfer, and failing to notify the National Insurance Institute (NII) when the arrangement ends. This guide walks through each stage — eligibility, the permit process, wages, NII, and termination — so you know what you are taking on before the caregiver arrives.

1. Who Qualifies to Hire a Foreign Caregiver in Israel?

Not every Israeli household can bring in a foreign caregiver. The Foreign Workers Law 5751-1991 and the Ministry of Labor's caregiver regulations impose a medical eligibility requirement: the person receiving care (the *ne'ezar*, or dependant) must genuinely need full-time personal assistance due to age, disability, or illness.

The Manpower Administration evaluates each case using a dependency scoring system. To qualify, the patient generally must meet one of the following criteria:

  • Be assessed as dependent in at least three basic daily activities (bathing, dressing, eating, mobility, continence, and transfers) as evaluated by a licensed social worker or physician
  • Have a recognized diagnosis of moderate-to-severe dementia that requires constant supervision
  • Be under a Ministry of Health hospice care designation
  • Have a high-level care designation (*derug gimla*) from the National Insurance Institute under the Long-Term Care Insurance Law 5748-1988

Families whose relative already receives an NII long-term care benefit (gimla) at a sufficient level have a significantly smoother eligibility process. The NII care-level assessment is accepted directly by the Manpower Administration, reducing the documentation burden.

In Practice — Eligibility Assessment: The Manpower Administration's assessment is conducted by a licensed social worker employed by the government. The appointment is typically arranged at the family home or the patient's care facility. Families can request the assessment by submitting Form Aleph-1 to the regional Manpower Administration office (there are offices in Tel Aviv, Jerusalem, Haifa, Beer Sheva, and Rishon LeZion). The social worker's report goes back to the Manpower Administration within 10–14 working days. If the patient is hospitalized, the assessment can still proceed based on hospital records. Families managing this from abroad should engage a local representative via notarized power of attorney to attend the assessment and receive correspondence.

2. Two Permit Tracks: Private Agency vs. Government-to-Government

Once eligibility is confirmed, families choose between two tracks for sourcing the caregiver:

Track 1: Private Placement Agency (Most Common)

The family works with a licensed Israeli placement agency (*sochnut koach adam*) that matches them with a caregiver and handles much of the paperwork. The agency recruits from its own pool of candidates in source countries. Under the Employment Service Law 5719-1959, placement agencies must hold a valid license from the Ministry of Labor.

Three things to know before signing with any agency. First, placement fees are capped: as of 2026 no agency may charge the employer more than NIS 2,500 as a one-time placement fee, with regulated monthly service fees on top. Second, an agency may not collect any fee from the caregiver — doing so is a criminal offence under the Foreign Workers Law, and a worker who "paid a recruitment fee abroad" is a warning sign for labour trafficking. Third, the agency is not the employer. The patient's family is the legal employer from day one, regardless of who handled the paperwork.

Track 2: Government-to-Government (G2G) Bilateral Agreements

Israel has bilateral government-to-government caregiver placement agreements with the Philippines, Nepal, Sri Lanka, and India. Under this track, the foreign government's labour authority screens and places the caregiver directly, bypassing private agencies. The G2G track is intended to eliminate exploitation and recruitment fees entirely.

In Practice — G2G Track: The G2G process is administered on the Israeli side by the Manpower Administration (Agaf Koach Adam) within the Ministry of Labor, located at HaArba'a 30, Tel Aviv. Under the Philippines bilateral agreement (the most heavily used), applications go through the Philippine Overseas Labour Office (POLO) in Tel Aviv. Processing under G2G typically takes 5–7 months — longer than the private agency track — but the caregiver arrives without having paid recruitment fees, reducing the risk of debt bondage. Annual quotas apply to each source country; the Philippines quota is the largest, and slots fill up quickly in the first quarter of each calendar year. Families should apply early if using this track.

3. The Application Process Step by Step

Regardless of which track you use, the formal permit application follows the same two-stage government process:

Stage One: Employment Permit from the Manpower Administration

  1. Obtain the medical eligibility assessment (described above) — the social worker's report confirming the patient qualifies for a foreign caregiver.
  2. Submit the employment permit application to the Manpower Administration regional office, including: the social worker's eligibility report, the patient's Israeli ID and health records, a draft employment contract (or template), proof of the family's Israeli address, and (for diaspora employers) an apostilled power of attorney authorizing a local representative to act.
  3. The Manpower Administration issues an employment permit (*rishyon ishur asaka*) authorizing the hire of one named caregiver for one named patient. Processing takes four to six weeks once the file is complete.

Stage Two: B/1 Caregiver Visa from PIBA

  1. Once the employment permit is in hand, the Israeli employer (or their representative) submits a B/1 visa application to PIBA (Population and Immigration Authority, *Rashut HaHagira V'HaKnisa L'Yisrael*). The caregiver can also apply at the Israeli embassy in their home country simultaneously.
  2. PIBA requires: the employment permit, the caregiver's passport and criminal background clearance from their home country, a medical fitness certificate, a signed employment contract, and proof the caregiver has arranged (or the employer has arranged) comprehensive health insurance.
  3. PIBA issues the B/1 caregiver visa. Processing currently takes four to eight weeks. The visa is typically valid for one year and is renewable up to a total of five years (extendable to 63 months in exceptional medical cases).
In Practice — PIBA Processing Fees and Timelines: The employment permit application fee at the Manpower Administration is NIS 1,270 (2026 rate, updated annually). PIBA charges a separate visa processing fee of NIS 450 for the initial B/1 visa and NIS 260 for annual renewals. Expedited processing (*tahalich mahir*) is available in documented medical emergencies at an additional fee of NIS 750 and can reduce PIBA processing to 10–14 working days. All fees are paid via the government's *Tashlum Online* portal and are non-refundable. Total out-of-pocket government fees for the initial permit and visa are approximately NIS 1,720 (excluding agency fees and legal representation).

4. Employer Obligations Under Israeli Law

When you hire a foreign caregiver in Israel, you become a full employer under the Foreign Workers Law 5751-1991 and the broader Israeli labor law framework. The obligations are mandatory and cannot be waived by contract.

Written Employment Contract

The employment contract must be in a language the caregiver understands and must specify: job duties, working hours, salary (at least minimum wage), overtime rate, rest days, annual leave entitlement, sick leave, the accommodation arrangement, and notice period for termination. PIBA will check that the contract exists and that its terms meet statutory minimums; a contract below these thresholds will cause the visa application to fail.

Accommodation

Live-in caregivers must be provided with a private room that meets minimum standards set by the Foreign Workers Regulations: the room must lock, have adequate natural light and ventilation, and not be shared with the patient or family members. The caregiver is entitled to privacy. If the employer deducts a room charge from wages, the deduction is capped at NIS 1,200 per month (2026 rate) and must appear in the contract.

Health Insurance

The employer must provide the caregiver with comprehensive health insurance from a licensed insurer from the caregiver's first day in Israel. PIBA will not issue or renew a visa without proof of valid coverage. The policy must cover hospitalization, specialist care, medication, and emergency repatriation. Typical annual premiums for an employer-procured caregiver health policy run NIS 2,800–3,500 in 2026. The employer bears this cost — it cannot be passed on to the caregiver.

In Practice — Health Insurance Enforcement: PIBA conducts periodic compliance checks, particularly at visa renewal. Families managing care from abroad sometimes allow the health insurance to lapse between renewal cycles. PIBA will refuse visa renewal if the policy has lapsed, even for a single day. Insurers typically send renewal notices to the Israeli address on the policy — diaspora families should ensure these notices are forwarded or that a local representative monitors the policy status. The insurer's name, policy number, and coverage dates must appear on the visa renewal application.

5. Wages, Working Hours, and Leave

Foreign caregivers are entitled to the same statutory employment rights as Israeli workers. There is no carve-out in the Minimum Wage Law or the Annual Leave Law for foreign nationals.

Minimum Wage

As of January 2026, the statutory minimum wage in Israel is NIS 32.30 per hour, or NIS 5,571.75 per month for a full-time (182-hour) position. Live-in caregivers often work irregular hours; in practice, wages are usually set monthly rather than hourly.

Overtime

Under the Work and Rest Hours Law 5711-1951, the standard working day is 8 hours (or 9 hours for a 5-day week). Hours beyond the daily norm attract overtime pay: the first two overtime hours are paid at 125% of the regular rate, and any further overtime at 150%. For live-in caregivers, calculating overtime is genuinely complicated. Set clear working-hour boundaries in the contract before the caregiver arrives, not after a dispute starts.

Rest Days and Annual Leave

  • Weekly rest of at least 36 continuous hours, including one full day off (usually Saturday under Israeli law, or Sunday by agreement if the caregiver is Christian)
  • Annual leave: 10 days in the first year, rising with seniority under the Annual Leave Law 5711-1951
  • Sick leave: 1.5 days per month of employment (accruing up to 90 days), with the employer paying from the second sick day
  • Public holidays: caregivers who are not Jewish are entitled to the public holidays of their own religion, but the family may arrange substitute leave
In Practice — Live-in Caregivers and Working Hours: The Ministry of Labor's position, confirmed in several Labour Court rulings, is that a live-in caregiver is not "on duty" for every hour they spend in the patient's home. Typically, a live-in arrangement is treated as covering up to 10 active hours per day (with the remaining hours classified as rest or standby). Families should document the daily schedule in the employment contract to avoid post-termination claims for unpaid overtime. The National Labour Court held in Belenky v. Pindak that an undocumented standby arrangement leads to courts calculating unpaid overtime in favor of the worker. If the caregiver genuinely works more than 10 hours per day, overtime supplements must be paid.

6. National Insurance Contributions and Income Tax

Bituach Leumi (National Insurance Institute — NII)

The employer must register the caregiver with the National Insurance Institute (NII / Bituach Leumi) no later than the first day of employment. Registration is done online via the NII employer portal. Both the employer and the caregiver make monthly contributions.

As of 2026, the employer pays approximately 3.55% of the caregiver's gross wages and the caregiver pays approximately 3.50% — withheld from salary by the employer. These are the reduced rates that apply below the NII income floor (*rashmat bituach leumi*). Both portions are due together by the 15th of the following month. Late payment costs 0.5% per month plus an indexation adjustment.

In Practice — NII Employer Registration: The employer-family registers with the NII as an maasik beyit (household employer) using Form Aleph-1 at any NII branch or online. The NII issues an employer number linked to the patient's Israeli ID. Families managing care from abroad must also assign a local power-of-attorney holder to handle ongoing NII filings, since the monthly contributions and the annual reconciliation (Form 126) must be filed in Israel. Failure to register exposes the family employer to NII back-assessments covering the full employment period, interest, and in serious cases personal liability proceedings.

Income Tax Withholding

The employer must also withhold income tax from the caregiver's wages and remit it to the Israel Tax Authority (ITA). Most foreign caregivers earn below the tax-exempt threshold — personal credit points shelter roughly NIS 7,600 per month for most individuals — so in practice many caregivers owe nothing. The employer is still legally required to register with the ITA as a withholding employer and either deduct the correct amount or obtain a zero-rate withholding certificate (*tofes 3101*). Skipping registration carries fines under the Income Tax Ordinance.

7. Caregiver Rights You Must Respect

Foreign caregivers have the same statutory employment rights as Israeli workers, enforced by the Ministry of Labor's inspectorate. Three rules trip up families most often.

Passport Retention is a Criminal Offence

Under Section 1C of the Foreign Workers Law 5751-1991, it is a criminal offence to hold or confiscate a foreign worker's passport. Any family or agency that takes a caregiver's passport "for safekeeping" is committing a crime. Penalties include fines and up to one year's imprisonment for individuals.

Termination Notice and Severance

The Notice to Employee and Candidate Law 5762-2002 requires written notice of termination: one day per month of employment in the first six months, then 6 days for months 7–9, then one month's notice thereafter. A caregiver employed for one year or more is entitled to severance pay (*pitzuei piturin*) equal to one month's salary per year worked, under the Severance Pay Law 5723-1963. If the patient dies, this triggers the termination right, and severance becomes payable unless the caregiver was enrolled in an integrated pension arrangement under Section 14 of the Severance Pay Law — in which case the pension fund covers the severance component.

No Deductions Without Written Consent

The employer may only deduct wages for items expressly agreed in the employment contract (room, board, advances) and for statutory deductions (NII, tax). Unauthorised deductions violate the Wage Protection Law 5718-1958 and expose the employer to a civil claim for the deducted amounts plus compensation of up to NIS 5,000 per violation.

In Practice — Ministry of Labor Inspections: The Ministry of Labor's Mankal Avodat Zar (Foreign Worker Labor Inspector) division conducts unannounced compliance inspections of households employing foreign caregivers. Inspectors check: that the caregiver has a valid work permit and visa, that wages are being paid by bank transfer (not cash only — required since 2014 for household employers), that NII is current, that the employment contract exists and is signed, and that the accommodation meets standards. Families found non-compliant face fines starting at NIS 10,000 per violation. Repeat violations or systematic abuse can result in prosecution and a ban on future employment permits.

8. Renewal, Transfer, and What Happens at the End

Annual Visa Renewal

The B/1 caregiver visa is initially issued for one year and must be renewed annually. The renewal application goes to PIBA and requires: updated health insurance proof, a declaration that employment conditions are unchanged, a medical update on the patient's condition, and payment of the NIS 260 renewal fee. Renewal should be filed at least 60 days before expiry — PIBA's processing queue for renewals currently runs four to six weeks. A caregiver whose visa expires before renewal is processed falls into unauthorized status, exposing both worker and employer to penalties.

Maximum Cumulative Stay

Foreign caregivers may remain in Israel for a cumulative maximum of five years (63 months in exceptional medical need cases) under the current PIBA policy. Once this limit is reached, the caregiver must leave Israel and cannot return on a caregiver visa for at least one year. This limit applies even if the worker changes patients. Diaspora families should factor this timeline into their care planning — particularly if the patient has a long-term degenerative condition.

Transferring the Caregiver to a New Patient

If the original patient dies or enters a care facility, it is sometimes possible to transfer the caregiver's work permit to a new patient within the same family. This requires a new employment permit application (the old permit lapses automatically) but the caregiver does not need to leave Israel if the transfer is managed quickly. The new patient must meet the medical eligibility criteria. PIBA allows transfers within the caregiver's existing visa period; the new employer pays a reduced permit fee of NIS 635 for a mid-period transfer.

When the Arrangement Ends

Whether the caregiver is dismissed, resigns, or the patient dies, the employer must notify both the Manpower Administration and the NII within five working days. Failure to do so can result in continued NII liability for contributions even after the caregiver is gone. The caregiver must also formally notify PIBA of the change in status. All outstanding wages, vacation pay, and severance (if applicable) are due at the time of termination. Under the Wage Protection Law, final wages must be paid within nine days of termination.

In Practice — End-of-Employment Checklist: When a caregiver arrangement ends, the family should: (1) pay all outstanding wages and severance by bank transfer within nine days; (2) issue a Form 106 (annual wage certificate) for the year of termination; (3) notify NII using the employer portal; (4) notify the Manpower Administration by submitting a termination form to the regional office; (5) confirm with the placement agency (if used) that the worker has been formally released from the placement roster. Non-compliance with the notification requirements costs NIS 730 per day under the Foreign Workers Regulations for each day the report is late.

Frequently Asked Questions

The full process — from submitting the employment permit application to the caregiver's arrival — typically takes three to five months. The Manpower Administration takes four to six weeks to issue the employment permit once a vacancy is approved. PIBA then takes a further four to eight weeks to process the B/1 caregiver visa. Delays are common if the employer's medical documentation is incomplete or the caregiver's background clearance is slow. Starting the process at least four months before care is needed is advisable. In a documented medical emergency, PIBA's expedited track can reduce the PIBA stage to 10–14 working days.

Under the G2G government bilateral track (Philippines, Nepal, Sri Lanka, India), caregivers are placed through government channels, bypassing private agencies entirely. Under the standard track, Israeli law does not require a licensed placement agency, but in practice most families use one. If you hire independently, you remain fully responsible for the employment permit application, the work contract, insurance, and all labor law obligations. The same rules apply regardless of how the worker was found.

Foreign caregivers are entitled to the Israeli statutory minimum wage — NIS 32.30 per hour as of January 2026 (or a monthly minimum of NIS 5,571.75 for a full-time position). Live-in caregivers may have a room-and-board deduction, but this is capped at NIS 1,200 per month for accommodation and NIS 600 per month for meals in 2026. Any deduction agreement must appear in the written employment contract. The deduction cannot reduce take-home pay below the minimum wage floor.

Yes. Both the employer and the caregiver must contribute to the National Insurance Institute (NII). The employer's contribution is approximately 3.55% of the caregiver's wage; the caregiver contributes approximately 3.50%. The caregiver is entitled to work-injury compensation, maternity benefits (if applicable), and long-term care benefits as a result. Failure to register with the NII exposes the employer to back-payments, penalties, and personal liability proceedings.

The caregiver's B/1 visa is tied to the specific employer-patient. If the patient dies, the basis for the visa disappears and the caregiver is technically in breach of stay conditions after a short grace period — PIBA typically allows 30 days to leave or arrange a transfer. Families sometimes arrange a transfer to another patient through a placement agency, which requires a new employment permit application (reduced fee of NIS 635 for a mid-period transfer). The caregiver is entitled to all outstanding wages, severance (if employed for over one year), and any accrued unused vacation — these obligations do not end with the patient's death.

Related Guides