Everything you wanted to know about health insurance – general

Thinking about health insurance? Well, insurance is important. But before signing the policy that will protect you during sick periods there are a few things to understand. This article will deal with the basic definitions of the change that this insurance has undergone in recent years and will also provide some tips that may prevent a crisis from becoming a crisis and may also save a few shekels along the way.

health insurance It is insurance that allows financing for health services and medicines that are not included in the health basket. This is a relatively cheap insurance, when compared to other insurances. Private health insurance seeks to cover medical care payments during an illness. Like any other service you pay for what you want to get. That is, the more cases the insurance umbrella covers you, the more it will cost. There are a large amount of policies that each offer a different insurance umbrella like inpatient insurance or health insurance, dental insurance.

But not only is there a variety of health insurance policies, there are also a variety of services. In the State of Israel, there is a great difference in services and coverage in health insurance, both through the extensions of the health funds that constitute supplementary health insurance and through insurance companies that provide commercial insurance policies.

Health policies are complex policies and the multiplicity of information and differences in the components of the insurance companies’ policies and the lack of uniformity make it difficult for the public to examine the degree of overlap between the various insurances. This situation causes double insurance (i.e. you are insured under two different policies because of a hand fracture, while in accident controls you will get the money once).

This situation led to a reform in 2016, which was designed to strengthen the power of the insured by making insurance products simple, clear and comparable. The uniformity between the policies should increase competition and lead to a decrease in their price. A survey by the Supervisory Authority in 2018 showed that about 20% of private insurance holders hold a new insurance policy.

In the current state of the policy, it is not yet in its final format. The insurance companies were supposed to present a wording to the insurance commissioner – but have refrained from doing so so far. Of course, current insurance buyers will not fall between the cracks and their insurance will in the future also be adapted to the format that will be adopted at the end of the reform.

What is Shaban?
It is impossible to talk about health insurance without mentioning the ISA. This threatening word is the professional word for the supplementary insurance you receive at the health funds. When you choose to extend the coverage for an additional payment. That is, anyone who was not satisfied with the most basic coverage (close to 80% according to Statistics) is in the Shaban program.

The ISA does not include services provided under the health basket, and does not include various services, including: long-term care insurance or coverage for life-saving or life-prolonging drugs. The costs vary from program to program and from fund to fund. Their real problem is the double insurance they create with the private insurance policy.

The role of the insurance agent
An insurance agent should check for double insurance and must alert him. In addition, Insurance Mountain provides information that helps avoid this situation of double payment. In a footnote, the State Comptroller and the Capital Market Authority found that about half of the agents sell health insurance policies of only one insurance company, while about 70% of the agents sell health insurance policies of at most two insurance companies, with a significant proportion of those selling insurance policies of two companies Over 90% of the insurance policies of only one company are sold and in practice almost as agents who sell a policy of only one insurance company operate. so You should ask your insurance agent how many companies he works with.

Surgery insurance in Israel and abroad compared to critical illness insurance
Because of the difference in the old health insurance (from before 2016) there are a number of important extensions to the policy that an additional payment will give the patient for an additional payment. The most prominent of these is a critical illness insurance policy purchased under private health insurance. This policy provides the insured with a pre-determined amount of money in the event that a serious illness is discovered in the patient. It is important to note that the payment determined and given does not depend on the amount of expenses that will be incurred by the insured as a result of the illness or its severity.

An insured can purchase separate coverages for various serious illnesses. It is customary to refer to this extension as an extension similar to surgery financing insurance in Israel and abroad. This policy constitutes insurance coverage as an addition to the insurance coverage. In insurance for financing surgery in Israel and abroad, the insurance company pays the surgery expenses and related expenses In an arrangement with the insurance company or in the hands of the insured subject to the production of receipts if the surgeon is not in an arrangement with the insurance company.

The difference is that in long-term sickness insurance the compensation will be given based on the results of the patient’s condition (a situation that often leads to a conflict of interest between the insurance company and the patient when the latter wants to present his illness as severe while the insurance company will try to prove otherwise). In critical illness insurance the situation is “0” or “1”, meaning that his condition as sick or healthy will determine the receipt of compensation. Finally, before signing this insurance, find out what diseases the policy covers, as these are updated every few years.

Collective insurance
Collective insurance is arranged for a group of people with common characteristics that justify the creation of a comprehensive agreement for the same group and the provision of discounted payments as a result. Most Israeli citizens will encounter a proposal for collective insurance in their workplace. Engagement in an organized framework gives the insurer the advantage of mass marketing insurance or seniority in customer engagement (the business) to the company.

The insurance is intended for a group of at least 50 insured persons, who belong to a certain group, but can be given in a smaller group under certain conditions. Of course, group insurance also has extensions and is optional. In addition to the price advantage, another advantage of group health insurance is the possibility of entering the route without having to go underwriting, which means that the company must accept the applicant, or at most make an abbreviated underwriting.

Which company to take out insurance with?
In terms of the size of the revenues of the insurance companies in the health industry, the largest is Harel with revenues of almost NIS 5 billion in 2020. It is followed by Phoenix with revenue of NIS 3.25 billion and in third place is Migdal with NIS 1.6 billion. Menora Mivtachim and Ayalon are also active in the field. It is important to know which company provides the insurance, but it is more important to know how to tailor the insurance to your needs and this is done while making an informed choice of insurance agent alongside a personal understanding of what your needs are.