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Insurance Coverage for Medications Outside the National Health Basket – An Important Addition to Your Health Insurance
Coverage for medications that are not included in Israel’s National Health Basket is an optional benefit that can be added to your private health insurance policy. Good to Know
From time to time, public debate around the National Health Basket resurfaces. Each time the National Health Basket is updated, including the medications it covers, the issue makes headlines and receives significant public attention, until the next update cycle.
It is evidently clear that not all medical needs, and certainly not all medications, can be covered under the National Health Insurance framework. Even the supplementary health services offered by Israel's Health Funds (HMOs) are unable to provide solutions for rare or high-cost medications that are not included in the National Health Basket.
The only way to ensure a funding source for a life-saving medication that is not included in the National Health Basket is through a private health insurance policy that includes coverage for medications outside the basket.
What Is an Insurance Coverage for Medications Outside the Health Basket?
Insurance coverage for medications not included in the National Health Basket is a low-cost insurance benefit that can be purchased as part of a private health insurance policy.
Adding this coverage gives the insured access to a wide range of life-saving and life-extending medications, which in most cases are rare and extremely expensive. These are typically innovative medications.
This means that insurance coverage for medications outside the basket is a practical form of insurance, which, if needed (hopefully never), often proves to be a worthwhile investment.
Source: Information from the 'Kol Zchut' website
Which medications are covered?
Coverage for medications outside the National Health Basket, under a private health insurance policy, generally applies to three categories of medications:
- Medications that are not included in the health basket, but are approved in one of the recognized countries
- Medications included in the health basket, but intended for a medical condition different from that of the Insured
- Oncological and hemato-oncological medications intended for a medical condition different from that of the Insured
Source: Ministry of Health website – National Drug Registry
How Are the Medications Obtained?
If, God forbid, the policyholder requires a medication that is outside the National Health Basket, he/she may submit a claim under their policy, provided the medication meets the applicable eligibility criteria and the request is supported by appropriate medical documentation.
Coverage for medications outside the National Health Basket is one of the most important components of a comprehensive family protection plan.
Contact us today for detailed information and professional guidance, to review your existing coverage and to arrange the policy best suited to your needs.
