The government of Israel recently introduced a health insurance reform establishing a comprehensive Private Medical Insurance (PMI) framework that creates a uniform structure for basic health policy. The new circular is expected to come into effect on 1 May 2023.


Most residents in Israel must remit contributions to the National Health Insurance (NHI) for coverage under 1 of 4 health funds with a standardized basket of medical services (including hospitalization, pharmaceuticals, generalist and specialist medical care, and laboratory services). A majority of employees supplement the national basic medical cover with Private Medical Insurance (PMI) which is intended to provide prompt access to treatment and cover medical conditions that are not included in the standard basket of medical services administered by the Health Funds. 

Key details

The reform aims at helping consumers find optimal health coverage by simplifying the process of understanding and comparing various PMI products and costs.

The new legislation applies to all individual and group PMI policies that are concluded or renewed on or after 1 May 2023.

The new legislation enables insurance companies to offer PMI only according to the following 5 distinct tiers:

  • Tier 1 – Insurance companies are required to offer their new clients a basic PMI package comprised of three uniform policies (1) transplants and special treatments abroad, (2) pharmaceuticals not included under the NHI requirements, and (3) surgical procedures and non-surgical alternative treatments abroad.  
  • Tier 2 – Comprises a uniform of three surgical options within Israel.
  • Tier 3 – Comprises an extension policy that would include additions to the insurance plan for Tier 1, 2 or 5.
  • Tier 4 – Comprises ambulatory insurance which may include consultation, medical diagnosis, and examinations; home hospitalization; treatments with advanced technologies and medical devices; medical accompaniment and treatments following a significant medical event such as surgery, hospitalization, or serious illness; any insurance appendix approved by the Commissioner in advance and in writing.
  • Tier 5 – Comprises a serious illness insurance plan.

Insurance companies would be allowed to sell additional PMI coverages only after the initial basic PMI (Tier 1) has been purchased by the client, from the same company or another company. In addition, discounts on the premiums may be given by insurance companies to the insured. Should a discount be given, it must be at a fixed rate for a period of at least ten years. 

Next steps

Employers should review the new changes and ensure compliance with the timeline. Employers may want to amend their Human Resource policies and practices, employment agreements, and health insurance-related benefits and policies as needed.