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Leumit

Summary description of the policy

What is Long-Term Care Insurance?

Long-Term Care insurance is insurance provided for cases where a person becomes dependent on long-term care and can no longer manage the activities of daily living without assistance (in accordance with the definitions specified in the policy). In such cases, the insured person is entitled to monthly insurance payments from the insurance company. If the insured person is living at home, payments are made as a fixed monthly benefit. If the insured person is living in a nursing institution, payments are made as contributions to expenses (indemnity against invoices / receipts), in accordance with the policy

A person is considered a long-term care patient when her or his health and ability to function prevent her or him from performing at least 3 of the following 6 actions (at least 50% of each action):

Get up and lie down
Continence
Dressed & Undressed
Mobilty
Eat & Drink
Shower & Bathe

To clarify, the full and binding insurance definition is the definition specified in the terms of the policy, and subject to the instructions of the Commissioner of Capital Market, Insurance and Savings Authority at the Ministry of Finance.

Why is it important to acquire Long-Term Care Insurance?

Life expectancy in the Western world is continuously rising and this affects the length of long-term care required by patients. Nursing expenses can reach thousands of Shekels each month, and the benefits provided by the state to long-term care patients are not enough. In many cases, long-term care patients become a heavy financial burden to their families, sometimes for many years. Leumit Long-Term Care, the long-term care insurance policy offered through Menora Mivtachim Ltd., provides coverage that lets you concentrate on the patient’s welfare and rehabilitation. Acceptance to Long-Term Care Insurance requires providing a health statement. In addition, the amounts of the insurance payments depend on the age of joining the policy. It is therefore recommended to join at an early age, when the health of all family members is good. The Long-Term Care Insurance policy does not cover only long-term care at old age; long-term care may be required at any age.

A guide to purchasing Long-Term Care Insurance

Is there a difference between the Long-Term Care policies offered by different health care providers?

The terms of insurance coverage at Leumit are the established terms dictated by the Capital Market, Insurance and Savings Authority at the Ministry of Finance. These terms are therefore identical to the insurance coverage offered by other health care providers (regarding eligibility for insurance payments and payments period).

Who can join?

Leumit customers at any age may ask to join our Long-Term Care Insurance. Acceptance requires providing a health statement, medical underwriting and authorization from the insurer – Menora Mivtachim.

Infants are automatically joined at birth.
Children up to the age of 19 are insured at no cost.
To join through the Leumit Long-Term Care Call Center at Menora call: 5565*.
You may also join using a digital form or fill out a paper form and fax it to 072-2238112 or mail it to Leumit-kmm@menora.co.il

What are the monthly insurance payments?

תגמולי הביטוח* למקרה ביטוח שארע לפני 01/01/2024:

גיל ההצטרפות לראשונה לביטוח סיעודי קבוצתי לחברי קופות חולים			מקום השהייה של המבוטח
60 ומעלה	50 עד 59	עד 49	מקום השהייה של המבוטח
3,500 ₪	4,500 ₪	5,500 ₪	תגמול ביטוח חודשי למבוטח השוהה בבית (פיצוי)
4,500 ₪	6,500 ₪	10,000 ₪	תגמול ביטוח חודשי למבוטח השוהה במוסד (שיפוי)

תגמולי הביטוח* למקרה ביטוח שארע אחרי 01/01/2024:

גיל ההצטרפות לראשונה לביטוח סיעודי קבוצתי לחברי קופות חולים			מקום השהייה של המבוטח
60 ומעלה	50 עד 59	עד 49	מקום השהייה של המבוטח
3,200 ₪	4,100 ₪	5,000 ₪	תגמול ביטוח חודשי למבוטח השוהה בבית (פיצוי)
4,500 ₪	6,500 ₪	10,000 ₪	תגמול ביטוח חודשי למבוטח השוהה במוסד (שיפוי)

** תגמולי הביטוח צמודים למדד חודש נובמבר 2023 שפורסם ביום 15 בדצמבר 2023

Age on joining Group Long-Term Care Insurance for customers of health care providers

Up to age 49 Level A
Monthly insurance payment for insured persons staying at home (compensation)

5,500 NIS
Monthly insurance payment for insured persons staying at an institution (indemnity) at a rate of 80% and up to-

10,000 NIS

Age on joining Group Long-Term Care Insurance for customers of health care providers

Age 50 to 59 Level B
Monthly insurance payment for insured persons staying at home (compensation)

4,500 NIS
Monthly insurance payment for insured persons staying at an institution (indemnity) at a rate of 80% and up to-

6,500 NIS

Age on joining Group Long-Term Care Insurance for customers of health care providers

Age 60 and above Level C
Monthly insurance payment for insured persons staying at home (compensation)

3,500 NIS
Monthly insurance payment for insured persons staying at an institution (indemnity) at a rate of 80% and up to-

4,500 NIS

* Insurance payments are linked to the index of May 2016, published on 15 June 2016.

A statute exists regarding different age groups according to the age of joining by health care provider.

* Notwithstanding the above, for the types of existing insured persons specified below, who joined before 30 June 2016, instead of “Age on joining Group Long-Term Care Insurance for customers of health care providers”, as specified in the table above, their age shall be considered as follows

Age groups:

Persons insured by long-term care insurance for members of Leumit who joined Leumit Long-Term Care Insurance at age 60 to 64 – 59;
Persons insured by group long-term care insurance for members of Klalit Health Services “Siudi Mushlam Plus”, who joined the insurance at age 60 to 64 – 59;
Persons insured by group long-term care insurance for members of Maccabi Health Services:
If they joined “Siudi Zahav” insurance from age 50 – 49;
If they joined “Siudi Kesef” insurance from age 60 – 59;
Persons insured by long-term care insurance for members of Meuchedet:
If they joined “Meuchedet Zahav” insurance at age 50 to 65 – 49;

Notwithstanding the above, insured persons whose age was considered to be 66 in accordance with their insurance before 1/7/2016 – 50.

How much does the insurance cost?

Age of the insured at the time of premium payment	Monthly premium in NIS
Age of the insured at the time of premium payment	From 1/4/19 to 30/6/20	From 1/7/20 to 30/6/21	From 1/7/21 to 30/6/22	From 1/7/22 to 30/6/23	From 1/7/23 to 31/3/24
0-18	0	0	0	0	0
19-25	8.63	8.63	8.63	8.63	8.63
19-25	8.63	8.63	8.63	8.63	8.63
26-30	10.43	10.73	11.23	12.24	13.24
26-30	10.43	10.73	11.23	12.24	13.24
31-35	27.77	28.05	28.32	28.61	28.89
36-40	38.67	40.11	41.56	43.00	44.45
41-45	45.65	47.77	49.91	52.08	54.26
46-50	81.05	84.23	87.47	90.76	94.10
51-55	101.10	106.84	112.77	118.36	124.14
56-60	117.87	125.45	133.29	140.38	147.75
61-65	139.95	147.57	156.50	164.75	172.33
66-70	166.80	175.09	183.78	192.91	202.48
71-75	187.04	195.94	205.27	215.03	225.26
76-80	198.54	208.09	218.09	228.59	239.58
81+	198.54	208.09	218.09	228.59	239.58

Choose Age:

Monthly premium in NIS

From 1/4/19 to 30/6/20

From 1/7/20 to 30/6/21

From 1/7/21 to 30/6/22

From 1/7/22 to 30/6/23

From 1/7/23 to 31/3/24

Monthly premium in NIS

From 1/4/19 to 30/6/20 8.63

From 1/7/20 to 30/6/21 8.63

From 1/7/21 to 30/6/22 8.63

From 1/7/22 to 30/6/23 8.63

From 1/7/23 to 31/3/24 8.63

Monthly premium in NIS

From 1/4/19 to 30/6/20 10.43

From 1/7/20 to 30/6/21 10.73

From 1/7/21 to 30/6/22 11.23

From 1/7/22 to 30/6/23 12.24

From 1/7/23 to 31/3/24 13.24

Monthly premium in NIS

From 1/4/19 to 30/6/20 27.77

From 1/7/20 to 30/6/21 28.05

From 1/7/21 to 30/6/22 28.32

From 1/7/22 to 30/6/23 28.61

From 1/7/23 to 31/3/24 28.89

Monthly premium in NIS

From 1/4/19 to 30/6/20 38.67

From 1/7/20 to 30/6/21 40.11

From 1/7/21 to 30/6/22 41.56

From 1/7/22 to 30/6/23 43.00

From 1/7/23 to 31/3/24 44.45

Monthly premium in NIS

From 1/4/19 to 30/6/20 45.65

From 1/7/20 to 30/6/21 47.77

From 1/7/21 to 30/6/22 49.91

From 1/7/22 to 30/6/23 52.08

From 1/7/23 to 31/3/24 54.26

Monthly premium in NIS

From 1/4/19 to 30/6/20 81.05

From 1/7/20 to 30/6/21 84.23

From 1/7/21 to 30/6/22 87.47

From 1/7/22 to 30/6/23 90.76

From 1/7/23 to 31/3/24 94.10

Monthly premium in NIS

From 1/4/19 to 30/6/20 101.10

From 1/7/20 to 30/6/21 106.84

From 1/7/21 to 30/6/22 112.77

From 1/7/22 to 30/6/23 118.36

From 1/7/23 to 31/3/24 124.14

Monthly premium in NIS

From 1/4/19 to 30/6/20 117.87

From 1/7/20 to 30/6/21 125.45

From 1/7/21 to 30/6/22 133.29

From 1/7/22 to 30/6/23 140.38

From 1/7/23 to 31/3/24 147.75

Monthly premium in NIS

From 1/4/19 to 30/6/20 139.95

From 1/7/20 to 30/6/21 147.57

From 1/7/21 to 30/6/22 156.50

From 1/7/22 to 30/6/23 164.75

From 1/7/23 to 31/3/24 172.33

Monthly premium in NIS

From 1/4/19 to 30/6/20 166.80

From 1/7/20 to 30/6/21 175.09

From 1/7/21 to 30/6/22 183.78

From 1/7/22 to 30/6/23 192.91

From 1/7/23 to 31/3/24 202.48

Monthly premium in NIS

From 1/4/19 to 30/6/20 187.04

From 1/7/20 to 30/6/21 195.94

From 1/7/21 to 30/6/22 205.27

From 1/7/22 to 30/6/23 215.03

From 1/7/23 to 31/3/24 225.26

Monthly premium in NIS

From 1/4/19 to 30/6/20 198.54

From 1/7/20 to 30/6/21 208.09

From 1/7/21 to 30/6/22 218.09

From 1/7/22 to 30/6/23 228.59

From 1/7/23 to 31/3/24 239.58

Monthly premium in NIS

From 1/4/19 to 30/6/20 198.54

From 1/7/20 to 30/6/21 208.09

From 1/7/21 to 30/6/22 218.09

From 1/7/22 to 30/6/23 228.59

From 1/7/23 to 31/3/24 239.58

* The Premium is linked to the index of May 2017, published on 15/6/2017.

Does an insured person who is defined as a long-term care patient continues to pay a monthly premium?

Insured persons who are recognized as long-term care patients are exempt from payment of insurance premium while entitled to insurance payments.

I transferred to Leumit, how do I maintain insurance continuity (original date of starting the insurance)?

New members of Leumit who were insured by a long-term care insurance at another health care provider and transferred to Leumit, can maintain their continuity of rights in the long-term care insurance, if they provide a confirmation to the existence of the previous long-term care insurance. Such confirmation should be submitted within 180 days from the date of transferring
to Leumit. After this period, the member shall be considered to be newly insured for all intents and purposes.

* the abovementioned confirmation shall be provided by the insurer of long-term care insurance at the previous health care provider.

Confirmations should be submitted to Menora by e-mail to leumit-kmm@menora.co.il or by fax to 072-2238112.

To complete this process, call our Sales Call Center at *5565.

Who is considered an insured long-term care patient?

An insured person who submitted a claim to receive insurance payments in accordance with the terms of the policy and whose functional condition was found to match one of the following definitions:

an insured person who, due to reduced health and function as a result of a disease, accident or health deficiency, is unable to carry out the essential part (at least 50%) of at lease 3 out of 6 of the following actions: get up and lie down; get dressed and undressed; eat and drink; continence; mobility;

an insured person in a state of “mental fatigue” as established by a specialist doctor;

“Mental fatigue” is a condition that affects a person’s cognitive activity and reduces intellectual capability, including impairment of insight and judgement, reduced short- or long-term memory, and temporal and special disorientation, requiring care throughout the day, in accordance with the decision of a specialist doctor;

in accordance with the terms specified in the full policy booklet.

How is entitlement to a long-term care benefit determined?

After receiving the claim papers, the insurance company examines the insurance coverage according to the terms of the policy. A functionality assessment may be required, to be conducted by a doctor, a nurse or a specialist on out behalf. This examination shall be scheduled in advance and conducted at the residence of the insured person or at the nursing institution where he or she resides.

In cases where further clarifications are required, the insurance company may ask you to provide additional material. In some cases, the insurance company may ask for the insured person’s medical file directly from health institutions. After receiving the results of the examination and any required documents, the insured person will be notified in writing about our decision regarding the claim for insurance payments in accordance with the terms of the policy.

How to submit a claim?

In order to allow us to handle your claim quickly and effectively, we ask that you fill the claim form and attach any relevant documents, as specified (link).

The claim form and required documents should be submitted in one of the following ways:

By e-mail to leumit-claims@menora.co.il;
By fax to 03-7608032;
By mail to POB 927, Tel Aviv 6100802.

Note: the reception of a claim form by the insurer does not constitute any agreement and/or undertaking and/or approval by the insurer regarding the submitted claim.

Information regarding the submittal of appeals

Appeals committee regarding insurance claims – if your claim is rejected or if you wish to contest the determined date of entitlement to benefits.
Appeals committee regarding the joining of Long-Term Care Insurance – if your request to be insured by the Long-Term Care Insurance is rejected.

Appeals may be submitted within 60 days from the date of the rejection notice regarding joining Long-Term Care insurance or the exercising of eligibility for insurance payments.

Appeals may be submitted in one of the following ways:

Through your personal zone here;
By fax to 03-7608032;
By mail to POB 927, Tel Aviv 6100802.

Furthermore, in order to exercise your rights, you may appeal the company’s decision by contacting the company’s ombudsman at POB 927, Tel Aviv 6100802, by e-mail at pniyou-zibur@menora.co.il or by fax to 03-7604032; and/or by contacting the Commissioner of Capital Market, Insurance and Savings Authority at the Ministry of Finance; and/or by taking legal action.

Forms and information (update links):