Quick Answer: Every Israeli resident must enroll with one of four state-recognized health funds (Kupat Holim) under the National Health Insurance Law 5754-1994. New immigrants (Olim) qualify for immediate enrollment on arrival day with no waiting period, and can register at Ben Gurion Airport, any Israel Post branch, or online. Monthly health contributions are collected by Bituach Leumi (NII) at approximately 3.1–5% of income:not paid directly to the fund. The four funds (Clalit, Maccabi, Meuhedet, Leumit) all provide the same mandatory basic health basket; they differ in clinic networks, wait times, and supplemental plan quality.

Registering with a Kupat Holim (Israel's health maintenance organization) is one of the first things to sort out after landing. Without it, you cannot see a GP, fill a prescription, or get a specialist referral through the public health system. Most Olim arrive not knowing which of the four funds to choose, how enrollment actually works, or why contributions are billed through Bituach Leumi rather than the health fund itself:which feels counterintuitive until someone explains why.

The sections below cover the four fund options, enrollment steps, mandatory basket, supplemental coverage, costs for Olim, and switching rules. Any NIS figures reflect mid-2026 thresholds; the National Insurance Institute updates them each year, so verify current rates at bituach-leumi.gov.il or any NII branch before making financial decisions.

1. Israel's National Health Insurance System

Israel introduced universal health coverage through the National Health Insurance Law (Chok Bituach Briut Mamlakhti) 5754-1994, which came into force on January 1, 1995. The law replaced the old system where coverage was tied to Histadrut labor federation employment. Every Israeli resident now has a statutory right to a defined basket of services (Sal HaBriut) regardless of age, income, or medical history.

Four nonprofit health funds provide services under the law. Each must accept any eligible resident who applies; no fund can refuse enrollment or charge higher premiums based on medical history. The Ministry of Health (Misrad HaBriut) supervises the funds and sets the annual basket. Bituach Leumi (NII) collects health contributions from residents and distributes the revenue to the funds using a risk-adjusted capitation formula.

In Practice:Legal Entitlement for Olim: Under Section 3 of the National Health Insurance Law 5754-1994, the right to register with a health fund vests as soon as an individual becomes a recognized Israeli resident. For Olim, residency status is established on the day the Ministry of Aliyah and Integration (Misrad HaKlita) issues the Teudat Oleh (immigrant certificate):which in practice means health fund entitlement begins on the day of arrival. Present your Teudat Oleh and passport at any enrollment point; you do not need to wait for your Israeli identity card (teudat zehut) to be issued, which typically takes several business days after arrival.

2. The Four Health Funds Compared

All four funds provide identical coverage under the mandatory Sal HaBriut. Choosing between them comes down to clinic geography, appointment wait times, digital services, and the quality and cost of their optional supplemental plans.

  • Clalit Briut: The largest fund, covering roughly 54% of the Israeli population. Clalit owns most of its clinics, diagnostic labs, and hospitals, including Rabin Medical Center (Tel Aviv area), Soroka (Be'er Sheva), and Carmel (Haifa). Its footprint is the widest, especially in peripheral cities and smaller communities. That works well for families with complex medical needs, though wait times in major cities can be longer. Supplemental plan: Clalit Mushlam.
  • Maccabi Healthcare Services: The second-largest, covering roughly 25% of residents. Maccabi contracts with private specialists rather than owning facilities, which generally means shorter waits in Tel Aviv, Jerusalem, and central Israel. Good app, solid digital services, popular with working-age professionals in urban areas. Supplemental plan: Maccabi Zahav (several tiers).
  • Meuhedet: Third-largest at roughly 14% of residents. Meuhedet owns its clinics and is particularly strong in Jerusalem and the north. Known for attentive service and reasonable wait times. Supplemental plan: Meuhedet Tal. A practical choice for immigrants settling in Jerusalem or northern cities.
  • Leumit Health Fund: The smallest, at roughly 7% of residents. Has historical ties to the Histadrut labor federation and strong coverage in development towns in the south and periphery. Supplemental plan: Leumit Or. Worth considering if you settle where Leumit has dense local coverage.

All funds maintain English-speaking staff at major urban branches and all publish materials in Russian, Arabic, and English in addition to Hebrew:an important practical consideration for new immigrants not yet proficient in Hebrew.

3. Who Must Register and When

Under Section 3 of the National Health Insurance Law, all Israeli residents are both entitled and required to register with a health fund. "Resident" follows Bituach Leumi's definition:a person whose center of life is in Israel, as determined by the Population Registry maintained by the Ministry of Interior (Misrad HaPanim).

Different categories of residents face different waiting periods before their Kupat Holim entitlement begins:

  • Olim (immigrants under the Law of Return 5710-1950): No waiting period. Entitlement starts on arrival day.
  • Toshav Hozer (returning Israeli residents): Generally no waiting period if the continuous absence was fewer than five years; a 6-month wait may apply if the absence exceeded five years without maintaining Israeli residency.
  • Spouses and children of Olim who are not themselves Jewish: Entitled under Section 4A of the Law of Return; same immediate entitlement applies.
  • Non-Jewish foreign nationals who gain Israeli permanent residency through the Ministry of Interior: A 6-month waiting period typically applies from the date the Ministry of Interior registers the change to permanent residency status in the Population Registry.
  • B1 (work visa) and B2 (tourist visa) holders, and other temporary residents: Not entitled to Kupat Holim. Must maintain private health insurance for the duration of their stay.
In Practice:The 6-Month Wait Dispute: The 6-month waiting period for non-Olim new residents is governed by Section 58 of the National Health Insurance Law Regulations (Takanot Bituach Briut Mamlakhti). During that window, the classification on your Population Registry record:maintained by the Ministry of Interior at 125 Menachem Begin Road, Tel Aviv, or any regional Population Authority (Rasham HaUchlosin) branch:determines your eligibility date. If Bituach Leumi's eligibility desk questions your start date, escalate in writing to the NII branch's eligibility supervisor; NII is required to issue a written determination within 30 days. Disputes unresolved at branch level can be appealed to the NII's internal appeals committee and thereafter to the Regional Labor Court, which handles all National Insurance Act disputes.

4. Step-by-Step Enrollment

Kupat Holim enrollment is deliberately straightforward; you can register through multiple channels depending on where you are and when you arrive:

  1. At Ben Gurion Airport on arrival: Nefesh B'Nefesh, the largest Aliyah assistance organization, operates a help desk in the Ben Gurion arrivals hall for major Aliyah charter flights. Ministry of Aliyah representatives at the airport can initiate registration on the spot. This service is not available for individual Olim arriving on commercial flights outside organized Aliyah dates:confirm with Nefesh B'Nefesh before relying on airport enrollment.
  2. At any Israel Post (Doar Yisrael) branch: Israel Post is the official registration agent for all four health funds across the country. Bring your teudat zehut (or, on arrival day, your Teudat Oleh and passport), complete a registration form, and staff will process enrollment immediately. This is the most accessible option for most new immigrants. Israel Post has over 700 branches nationwide.
  3. Online: Clalit and Maccabi both accept online registration. Upload your identity documents through the fund's secure portal and submit the form. Coverage still begins on the 1st of the following month, but online registration is convenient if you want to enroll before physically arriving in Israel.
  4. At a Bituach Leumi (NII) branch: Any NII office can process health fund enrollment. This is particularly useful when you need to open your NII file (for social security purposes) at the same time as enrolling in a health fund:both can be handled in a single visit.
  5. Directly at the health fund's branch: All four funds have dedicated new-member departments in major cities. If you have already selected a fund, enrolling directly there allows you to simultaneously sign up for a supplemental plan and schedule your first clinic visit.
In Practice:Effective Date and Backdating: Health fund coverage takes effect on the 1st of the calendar month following the month of enrollment, not on the day you complete the form. A new immigrant enrolling on August 14 will have coverage starting September 1. For Olim who enroll at Ben Gurion Airport through the Ministry of Aliyah desk, the Ministry can issue a letter backdating coverage to the day of arrival:request this letter explicitly when you register. Bring at minimum two copies of your Teudat Oleh and your passport. If your teudat zehut has not yet been issued, the Teudat Oleh plus passport together are sufficient for enrollment; you update NII's records when the teudat zehut arrives by mail from the Ministry of Interior.

5. The Basic Health Basket (Sal HaBriut)

The Sal HaBriut is the government-mandated package of services that every health fund must provide to every enrolled member without discrimination. It is reviewed and updated annually by a ministerial committee. As of 2026, the basket includes:

  • GP visits with no co-payment. Every enrolled member has a designated GP at the fund's clinic nearest their registered address.
  • Specialist referrals with a co-payment:approximately NIS 30–40 per specialist consultation (adjusted annually).
  • Prescription medications listed on the national drug formulary (Sal HaTrufot); co-payments apply at pharmacies.
  • Emergency room care at any recognized hospital, with no pre-authorization required.
  • Mental health services:GP, psychologist, and psychiatrist visits within the fund's network, included in the basket since the 2015 mental health reform.
  • Laboratory tests and imaging ordered by a treating physician within the fund's network.
  • Maternity care:prenatal checkups, ultrasounds, delivery at a recognized hospital.
  • Pediatric care and vaccinations:well-baby checkups and the national vaccination schedule are fully covered with no co-payment.
  • Chronic disease management programs for conditions including diabetes, hypertension, and asthma.
In Practice:Drug Formulary Appeals: The national drug formulary (Sal HaTrufot) is updated each January by ministerial order under Section 7B of the National Health Insurance Law. As of 2026, the basket covers approximately 700 medications. If the drug you need is not listed, your treating physician may apply for a compassionate use exemption (taarich havana) through the fund's internal medical committee (Va'adat Hariga); the committee must respond within 30 days of receiving a complete application. If the committee denies the request, you may appeal to the fund's patient appeals committee within 30 days of the denial, and thereafter to the Ministry of Health's patient rights ombudsman (Apotropos HaBriut) within 60 days of the fund's final decision. Appeals that succeed at the ombudsman level typically result in the fund covering the medication under a compassionate use authorization within two weeks of the ruling.
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6. Supplemental Insurance (Mashlim):Optional Upgrade

Each fund offers tiered supplemental plans (Bituach Mashlim or Bituach Shlimut) that layer additional benefits on top of the mandatory basket. These are optional but widely held:roughly 75% of Israeli residents carry some level of supplemental coverage.

Typical supplemental plan benefits include:

  • Access to private hospitals (Assuta Tel Aviv, Assuta Ashdod, Herzliya Medical Center, Shaare Zedek private wing) for elective procedures, including choice of surgeon
  • Shorter appointment wait times with contracted private specialists outside the standard referral queue
  • Coverage for medications and treatments not included in the state formulary
  • Adult dental care:the basic basket covers dental only for children under 18; adults require supplemental coverage for most dental work
  • Extended mental health sessions beyond the basic basket quota
  • Physiotherapy and alternative therapy sessions
  • Fertility treatments beyond the basic basket coverage (Israel covers several IVF cycles under the state basket, but supplemental plans extend eligibility)

Monthly premiums for supplemental plans typically range from NIS 60–250 per person depending on age, fund, and tier. Funds may increase premiums annually, but must give at least 30 days' notice before any rate change takes effect.

In Practice:Pre-Existing Condition Exclusions in Supplemental Plans: Unlike the basic basket (which cannot exclude pre-existing conditions), supplemental plans can refuse to cover specific conditions that existed before enrollment, typically for a period of up to 12 months from the date of joining the supplemental plan. Under Ministry of Health circular 13/2018, however, a fund that already covers a condition under the basic basket may not retroactively exclude the same condition from a supplemental plan claim simply because it was pre-existing. Review the exclusion list in writing before signing; if a fund's sales representative gives a verbal assurance that your condition will be covered under the supplemental plan, request that assurance in writing on the fund's letterhead. Verbal commitments from enrollment staff are not contractually binding. Complaints about improper supplemental denials should be filed with the fund's internal ombudsman first, and thereafter with the Commissioner of Insurance and Financial Markets (Hamefakah al HaBituach) within 90 days of the final internal decision.

7. Health Fund Costs for New Immigrants

Most new immigrants assume they will pay the health fund a monthly membership fee. They do not. Contributions go to Bituach Leumi (NII), which collects them as a health tax alongside social security payments, then distributes the revenue to the funds based on enrolled membership and a risk-adjusted formula the Ministry of Health sets annually.

The health contribution rates as of mid-2026 (subject to annual NII revision) are:

  • Up to 60% of the national average wage (approximately NIS 7,522/month as of mid-2026): health tax rate of 3.1% of income
  • Above 60% of the average wage: health tax rate of 5% on the excess portion
  • Income from non-employment sources (rental income, dividends, pension): similar rates apply to the relevant income after any applicable deductions
  • Those with no income: a minimum monthly health contribution of approximately NIS 107–130 per month (updated annually); this minimum applies even to individuals not working
In Practice:Sal Klita and Bituach Leumi Contributions for Olim: New Olim receive the Sal Klita (absorption basket):a financial support package from the Ministry of Aliyah and Integration that is paid in monthly installments over roughly the first six to twelve months following Aliyah, depending on family composition. The Sal Klita is intended partly to offset living costs including NII contributions. To confirm what subsidy applies to your household, present your Teudat Oleh at the local Bituach Leumi branch (nearest-branch locator is on the NII website, bituach-leumi.gov.il). Bring your Israeli bank account details:NII debits contributions directly and credits any Sal Klita payments to the same account. Olim whose only Israeli income during the first year is the Sal Klita payment itself typically pay health contributions only at the minimum rate. Consult the NII international desk or a licensed Israeli attorney if you have pre-existing foreign income (rental income, pension, dividends from abroad), as that income is assessable in Israel from your first day of residency.

8. Switching Health Funds

Under Section 14 of the National Health Insurance Law, a registered member may transfer from one health fund to another once per calendar year, during a designated switching window that the Ministry of Health sets annually. In most recent years, including 2026, this window has run during January:typically January 1–31. Outside the switching window, transfers are not permitted except in the rare case that a fund loses its Ministry of Health license.

The switching process:

  1. Enroll with the new fund at any Israel Post branch or directly at the new fund's enrollment office during the January switching window.
  2. The new fund notifies your existing fund automatically through the NII system; you do not need to formally resign from the old fund.
  3. Coverage with the new fund begins on the 1st of February (the month following the January switch).
  4. Your existing supplemental plan with the old fund ends automatically when you transfer; you must separately apply for a supplemental plan with the new fund, which may impose new exclusion periods for pre-existing conditions.
In Practice:Switching with a Chronic Condition: The Ministry of Health publishes the January switching window dates each October or November through a formal announcement. If you have a chronic or serious medical condition and are considering switching funds, take these steps before committing: (1) Request a written statement from the prospective new fund's medical director confirming that your condition will be covered without a new exclusion period under the supplemental plan, not just under the basic basket. (2) Confirm that a specialist you currently see (who may be contracted with your current fund) is also contracted with the new fund:if not, you will need to transfer care. (3) Request your full medical records from your current GP before switching; the new fund's GP cannot access your records from the old fund's system. Verbal assurances from fund enrollment agents about continuity of supplemental coverage for existing conditions carry no legal weight:get everything in writing before signing.