Quick Answer: Every new immigrant (Oleh) who receives Israeli permanent residency must enroll in one of Israel's four licensed health funds — known as Kupot Holim — within three months of obtaining their Israeli ID card. Health coverage is funded through a mandatory health tax component paid through the National Insurance Institute (Bituach Leumi), not through separate monthly premiums. New Olim have no waiting period and gain access to Israel's comprehensive basic health basket from day one of membership.

Israel has genuine universal healthcare — not in the aspirational sense, but in the statutory sense. Every permanent resident is legally required to belong to one of four licensed health funds, and every health fund is legally required to accept them. The system runs on the National Health Insurance Law 5754-1994 (*Chok Bituach Briut Ha-mamlachti*), which establishes both the right to healthcare and the obligation to participate in it.

For new immigrants, enrollment is not complicated, but it has a deadline. Miss the three-month window and you may face waiting periods for certain treatments. This guide covers which fund to choose, how the health tax is calculated, what the basic basket actually pays for, and when private supplementary insurance is worth adding.

1. Israel's National Health Insurance System

Israel's healthcare system is built on a social insurance model. Rather than purchasing health insurance from a private company, residents pay a mandatory health tax as part of their Bituach Leumi (National Insurance Institute) contributions. The NII then transfers those funds to the health funds, which provide services.

There are four licensed health funds (*Kupot Holim*) that every resident can choose between:

  • Clalit (*Kupat Holim Clalit*) — the largest, serving roughly 4.4 million members across Israel. Clalit owns and operates its own clinics and many hospitals, giving it the widest geographic footprint. Particularly strong in peripheral areas and smaller towns.
  • Maccabi (*Maccabi Healthcare Services*) — the second largest, with approximately 2.7 million members. Generally preferred by English-speaking Olim in Tel Aviv and the center of the country. Maccabi's app and online systems have strong English-language support.
  • Meuhedet (*Kupat Holim Meuhedet*) — approximately 1.3 million members, with a reputation for shorter specialist waiting times in certain areas. Strong presence in Jerusalem and the north.
  • Leumit (*Kupat Holim Leumit*) — the smallest fund, around 800,000 members. Often competitive on specialist access and can be a practical choice in cities where the larger funds face capacity pressure.

All four funds are legally required to offer the identical basic health basket (*sal ha-bri'ut*) to all members regardless of age, pre-existing conditions, or income. They cannot refuse membership, charge different premiums based on health status, or deny any service that appears in the basket. Where funds actually differ is on supplementary insurance products, specialist wait times, service quality, and how well their apps work in English.

2. Who Must Enroll — and Who Is Excluded

The National Health Insurance Law applies to *yoshvei keva* — permanent residents of Israel. This category includes:

  • New immigrants (Olim) who hold an Aliyah visa (A/1) and have received their Israeli ID card (*Teudat Zehut*)
  • Returning residents (*Toshavim Hozrim*) who have re-established their Israeli center of life
  • Holders of permanent residency status (A/5) who are classified as permanent residents by the Ministry of Interior
  • Israeli citizens living in Israel, regardless of whether they also hold foreign citizenship

The following groups are generally not entitled to join the national health system:

  • Tourist visa holders (B/2) — must rely on private travel health insurance
  • Holders of temporary work visas (B/1) who have not achieved permanent residency status
  • Student visa holders (A/2)
  • Foreign diplomats and UN agency personnel covered by international agreements
  • Undocumented foreign nationals (though emergency care must be provided to anyone under Israeli law)

Foreign workers who are employed legally in Israel and whose employers have enrolled them in a special group health insurance scheme under the Foreign Workers Law 5751-1991 operate under a parallel system — they receive employer-provided health coverage rather than accessing the standard Kupat Holim route, at least for the duration of their work visa.

If your status is uncertain — for example, you have A/5 temporary residency but are not sure whether you qualify as a permanent resident for health insurance purposes — the Ministry of Interior (*Misrad Ha-Pnim*) Population and Immigration Authority can confirm your classification in writing before you attempt to enroll.

3. Choosing your Kupat Holim

Every new immigrant must choose one of the four funds when enrolling. You can switch once a year during November's transfer window (*chazara*), but mid-year changes are not possible outside unusual circumstances. A poor initial choice can mean months of inconvenience, so it is worth spending a few minutes on this before you walk in.

The practical factors most relevant to new immigrants:

  • Geographic coverage — if you live outside the Tel Aviv metropolitan area or Jerusalem, check which fund has clinics and contracted specialists near your home before enrolling. Clalit generally has the widest rural and peripheral coverage.
  • English-language services — Maccabi has invested in English-language phone support and digital services, which is meaningful in the first year when your Hebrew is limited. Clalit has been expanding its English services as well.
  • Specialist wait times — for planned procedures or ongoing treatment of a specific condition, ask recent immigrants in your area which fund delivered faster specialist appointments. This varies by region and specialty.
  • Children's services — if you are immigrating with children, Tipat Halav (mother and child health clinics for routine pediatric care) is run by local municipalities rather than the Kupot Holim, so that does not vary by fund choice. However, pediatric specialist access does differ.
  • Supplementary insurance — each fund offers its own supplementary insurance packages ("mushlam" or "shimushi"). If there is a particular specialist or private hospital you want access to, check which fund's supplement plan covers it before choosing your fund.
In Practice: Under Section 6(a) of the National Health Insurance Law 5754-1994, new immigrants (Olim) must register with a Kupat Holim within 3 months of receiving their Israeli ID card. Enrollment is done in person at any branch of your chosen fund — you present your Teudat Zehut and Teudat Oleh. Clalit, the largest fund, processes Olim enrollments at over 1,400 branch locations nationwide and typically issues a membership card (*karta*) within 3 business days at no enrollment fee. Maccabi offers online pre-registration at maccabi4u.co.il with in-branch confirmation in most major cities within 48 hours.

4. The Enrollment Process: What to Bring and What to Expect

Enrolling in a Kupat Holim is among the simpler bureaucratic tasks new immigrants face. Bring your Israeli ID card (*Teudat Zehut*), your Teudat Oleh (*Certificate of Immigration*) issued by the Jewish Agency or Ministry of Aliyah and Integration, and — if you are enrolling family members — proof of relationship such as a marriage certificate or birth certificates.

Walk into any branch of your chosen fund. You do not need to enroll at a branch near your home address, though it simplifies future visits. Some funds also offer online pre-enrollment for Olim through the Ministry of Aliyah and Integration's digital portal, with final identity verification at the branch.

Children under 18 must be enrolled in the same Kupat Holim as one of their parents. They are covered under the same health basket as adults, including pediatric specialist referrals, vaccinations, and dental coverage up to age 18. Children do not pay a separate health tax; their coverage runs within the parent's contribution.

If your initial choice turns out to be wrong, you must wait until the November annual transfer window. Submit a switch request through the Bituach Leumi website or any NII branch between November 1 and 30. The switch takes effect on January 1 the following year. Mid-year switches are only permitted when you relocate to an area your current fund does not adequately serve.

5. Monthly costs: how the health tax works

Many new immigrants expect to receive a monthly bill from their Kupat Holim. That is not how it works. You do not pay your health fund directly at all. The entire funding mechanism runs through the National Insurance Institute.

Every resident pays a mas bri'ut (health tax component) as part of their regular Bituach Leumi contributions. The NII distributes those funds to the Kupot Holim using a capitation formula adjusted for age and risk. Your Kupat Holim charges you nothing for basic health basket services beyond small co-payments (*hashtatfut avirit*) on certain items like medications, which are set by law and capped.

The health tax rates (2026) under the National Health Insurance Law Regulations are:

  • 3.1% of monthly income up to NIS 6,331
  • 5.0% of monthly income above NIS 6,331

For an employee, this is deducted from salary alongside Bituach Leumi contributions — you never need to write a separate check. Self-employed individuals pay through quarterly advance payments (*mekdamot*) to the NII, filed through their annual tax return process.

New Olim receive an important benefit: the Ministry of Aliyah and Integration pays the NII health tax component on the Oleh's behalf for the first 6 months after Aliyah. This means new immigrants receive full Kupat Holim coverage at no direct health-tax cost during their initial absorption period.

In Practice: Under the National Health Insurance Law Regulations (as updated for 2026), a new immigrant earning NIS 14,000 per month pays a health tax of NIS 196 on the first NIS 6,331 (at 3.1%) plus NIS 383 on the remaining NIS 7,669 (at 5.0%) — a total of NIS 579 per month. This is collected automatically by the National Insurance Institute (Bituach Leumi) together with the employee's social security contributions, deducted at source from payroll. However, for the first 6 months after Aliyah, the Ministry of Aliyah and Integration covers this amount on the Oleh's behalf, so no net health tax is deducted from salary during that absorption period. After 6 months, the standard deduction kicks in automatically — no paperwork required by the employee.

6. The health basket (sal ha-bri'ut): what is covered

The sal ha-bri'ut is the standardized list of services, medications, and procedures every Kupat Holim must provide to every member. A government committee updates it annually. It covers most routine and specialist needs — the gaps are narrower than people expect before they arrive.

The basic basket includes:

  • General practitioner (*rofe mishpacha*) consultations — unlimited, no co-payment
  • Specialist consultations with a referral from your GP
  • Hospitalization (emergency, planned, and maternity) in public hospitals at standard ward rates
  • Diagnostic imaging: X-ray, ultrasound, CT, MRI (with specialist referral and Kupat Holim pre-approval for advanced imaging)
  • Laboratory tests
  • Medications listed in the national drug formulary (*reshimat ha-tavshirim*) — co-payments apply, capped per medication at a few NIS for generics, more for brand-name drugs
  • Mental health services (following the 2015 mental health reform): up to 18 sessions per year with a psychologist or social worker without specialist referral, plus psychiatry with referral
  • Dental care for children up to age 18
  • Maternity and obstetric care, including prenatal monitoring and birth
  • Vaccinations on the national immunization schedule
  • Physiotherapy with referral (limited sessions)

What the basic basket does not cover:

  • Dental care for adults (beyond emergency extractions)
  • Optical care beyond basic lens prescriptions for children
  • Private hospital accommodation (the standard ward is covered; a private room requires supplementary insurance)
  • Treatment abroad not pre-approved under the basket's international care provisions
  • Cosmetic procedures
  • Medications not listed in the national formulary
  • Long-term care and nursing home costs (covered separately through Bituach Leumi long-term care insurance)

Co-payments (*demi hashtatfut*) apply to some basket services. For example, an outpatient specialist visit co-payment is currently around NIS 35–45 depending on the fund and visit type. Medications have a co-payment of between NIS 3 and NIS 30 per prescription, depending on whether a generic or brand-name drug is dispensed. Low-income residents, recipients of income support, and Holocaust survivors are exempt from co-payments under Section 4(a) of the National Health Insurance Law.

7. Supplementary insurance options

Every Kupat Holim sells one or two tiers of supplementary (*mashlim*) insurance, sometimes called *shaban*. These are optional add-ons purchased directly from your fund — not part of the basic basket.

Supplementary plans typically cover access to private specialists and surgeons (with partial reimbursement, so you skip public waiting lists), private hospital rooms, adult dental care at subsidized rates, extended optical benefits, additional physiotherapy sessions, fertility treatments beyond the basket's IVF allowance, and off-formulary medications including some expensive biologics.

Premiums are age-dependent. A person in their 30s might pay NIS 80–150 per month for a mid-tier plan; someone in their 60s could pay NIS 300–500 for comparable coverage. Because premiums rise with age and waiting periods for pre-existing conditions apply at enrollment, joining supplementary insurance early after Aliyah is usually cheaper than waiting.

Private insurance companies such as Harel, Phoenix, and Menorah-Mivtachim also sell commercial health policies (*bituach briut mishvari*) that can cover treatment abroad, very expensive drugs, and private nursing care. For immigrants used to buying comprehensive private health cover in the US or UK, these feel familiar. They complement Kupat Holim membership; they do not replace it.

A practical note: many people arrive and rush toward supplementary plans before their basic enrollment is finalized. Get your Kupat Holim membership card first. Supplementary insurance cannot be activated without it, and some plans carry a 30–90 day waiting period before benefits start.