The Israeli Healthcare System: Health Funds, Basket of Services and Access for a French Citizen

The National Health Insurance Law, in force since January 1995, sets the state’s responsibility for the health services of all residents, excluding tourists (Israeli Ministry of Foreign Affairs). Every resident aged 18 or over contributes through the National Insurance Institute (Bituach Leumi), with two exceptions: married women with no activity outside the home are exempt from contributing, and people who immigrate after age 62 pay only the health contribution. Funding combines residents’ progressive contributions, levies on employers and the self-employed, funds from the institute, the Ministry of Health budget and patient co-payments.

Resident status rests on the “centre of life”: home, family, children’s schooling, work or study. It can be recognised for holders of a type A visa, whereas type B visas (tourist, foreign worker) remain excluded from this recognition (Bituach Leumi). In its 2025 overview, the OECD states that the whole population is covered for a basic basket of services, with spending of 7.6% of GDP against 9.3% on average in the OECD, or USD 4,352 per inhabitant in purchasing power parity against 5,967. The Central Bureau of Statistics puts 2024 spending at 7.3% of GDP.

The four health funds (kupot holim) are approved bodies that provide the basket of services under the supervision of the Ministry of Health (CLEISS, the French centre for international social security liaison). The law gives them equal status and prohibits them from refusing a member because of age or health. Each insured person freely chooses their fund; spouses can register with two different funds and children under 18 follow the fund of the parent who receives the family allowances.

Registration conditions access to care. New immigrants register at Ben Gurion airport; if forgotten, the procedure is done in person at a post office, and becomes possible online on the Bituach Leumi site three weeks after aliyah. Changing fund goes through the same site or a post office. The choice depends on place of residence, the doctor you want and the supplements offered.

The basket covers in particular general practice and specialist consultations, medicines on the ministry’s list (with an out-of-pocket share of up to 15% according to the CLEISS), laboratory tests, hospitalisation (general, maternity, psychiatric, long-term), surgery and transplants, preventive dental care for children, first aid and medical transport, medical devices, obstetrics, fertility treatment and paramedical care. If a treatment does not exist in Israel, care abroad is provided for (Israeli Ministry of Foreign Affairs).

The basket changes every year: on 16 November 2025 the government appointed the 2026 committee, with a budget of ₪650 million, to review hundreds of medicines and technologies (Ministry of Health). A patient co-payment exists for specialist consultations and outpatient centres, with a quarterly ceiling per family; new immigrants get a 50% reduction on this ceiling for one year. The Ministry of Health’s Kol HaBriout portal centralises information on co-payments and discounts.

Each fund may offer supplementary insurance, the Shaban, which covers services outside the basket. The premium is the same for all members of a given fund, except for long-term nursing care where it may vary with age (Israeli Ministry of Foreign Affairs). The Ministry of Aliyah and Integration reminds readers that a resident can take out a fund supplement, private insurance, or both, to obtain additional services.

According to the OECD, 62% of health spending is covered by compulsory prepayment, against 75% on average: the rest falls to households and voluntary insurance, which explains the value of supplements for adult dental care, optical care or services not included in the basket. French citizens who are not eligible for a fund will find pointers for comparing in the guide to expat health insurance and in the one on the CFE.

In an emergency, four national numbers apply: 100 for the police, 101 for Magen David Adom (medical rescue), 102 for the fire service and 104 for the Home Front Command (gov.il). The network includes hospitals, clinics and mother and child health centres (Israeli Ministry of Foreign Affairs).

On resources, the OECD notes in 2025: 3.0 hospital beds per 1,000 inhabitants (4.2 on average), 3.5 doctors (3.9) and 5.6 nurses (9.2) per 1,000, as well as 17 CT scanners, MRI and PET machines per million inhabitants (51 on average). Clinical outcomes are above average: 30-day mortality of 4.5% after a heart attack (6.5%) and 4.4% after a stroke (7.7%), breast cancer screening for 71% of women aged 50 to 69 (55%). The Central Bureau of Statistics counts 1.7 general care beds per 1,000 inhabitants in 2024. Life expectancy reaches 83.8 years according to the OECD, or 2.7 years more than the average.

A new immigrant registers with a fund during the airport welcome. Contributions are suspended automatically: up to 12 months for national insurance and up to 6 months for health insurance (12 months with the income support allowance), for people with no activity or on a low income (Ministry of Aliyah and Integration). After that, the employer deducts contributions from pay, whereas a self-employed or unemployed person pays Bituach Leumi directly.

Immigrants under the Law of Return are exempt from the waiting period described below (Bituach Leumi), and the 50% reduction on the quarterly co-payment ceiling applies for one year. People who arrived after age 62 pay only the health contribution. The page on healthcare reimbursement in Israel sums up each situation.

A waiting period applies to people who lived abroad for at least 18 consecutive months without contributing to health insurance for at least 12 months, or who lost their resident status. It reaches one month per year of absence (a year being 12 months of which at least 182 days abroad), with a minimum of 2 months and a maximum of 6 months. One month of waiting equals 25 consecutive days of presence in Israel, and contributions remain due during the period (Bituach Leumi).

Exempt are: immigrants under the Law of Return, minors and “returning minors” recognised by the Ministry of Aliyah, soldiers discharged less than 24 months ago and holders of an A/1 visa recognised as new immigrants. The period can be bought out by a payment of ₪16,860 since 1 January 2026, in one go or in six monthly instalments, possible from abroad before returning; it is refunded only if the return does not take place or if resident status is refused, and must be paid in full before access to care in Israel (excluding care abroad and fertility treatment).

Tourists and B visa holders remain outside the public scheme. For these profiles, cover comes through the CFE (voluntary membership of the French scheme), through insurance provided by the employer or through international health insurance. The 1965 France-Israel social security agreement coordinates maternity, old age, work accidents and family benefits; health insurance is a matter for each country (CLEISS).

The expat insurance in Israel country guide details the requirements by visa, and the guide to healthcare systems abroad helps you compare national models. Expavy sets these options side by side through the diagnostic.