meuhedet-eng

Summary description of the policy

What is Nursing Care Insurance?

Long-term nursing care insurance provides financial compensation for a period of up to 60 months to a person who requires long-term nursing care (during the period when the individual involved paid insurance premiums) and does not function independently in his or her daily life.
The payment can be made in two ways: If the long-term care insured party resides at home – said party would receive monthly compensation.
If the insured party resides in an institution – said party receives reimbursement of payments made to the institution.

When is a Person Considered to Require Nursing Care?

When the party’s health and functioning prevent doing three (at least) of the following six (at least 50% of the activity): standing up and lying down, urinary or fecal incontinence, wearing and taking off clothing, mobility, bathing, eating and drinking.

When a state of mental fatigue is determined by a medical specialist in the field: impairment of cognitive and intellectual activity, including impairment of insight and judgment, decreased long-term or short-term memory, lack of orientation at a place and time requiring supervision by a caregiver during most hours of the day.

Why is it Important to Buy Nursing Care Insurance?

Life expectancy in the Western world and advanced medicine also affect, inter alia, the longevity of a nursing care patient.
That is, inter alia, that a nursing patient’s costs can total thousands of Shekels a month and for many months. The coverage provided by state institutions is insufficient, and the financial burden falling on the family is significant.
“Meuhedet Nursing,” the Meuhedet Health Maintenance Organization’s nursing care policy, offered through Menorah Mivtachim is the help that will enable the members of the patient’s family, to focus on the patient’s well-being and rehabilitation options, without financial hassles.

Why Sign Up for a Nursing Care Policy Now?

The amount of insurance benefits is contingent upon the age when initially signing up, so it is advisable to sign up at an early age when all family members are still healthy.
A nursing care policy does not cover nursing status only at old age. Nursing care cases can also occur early on at younger ages.

Is There a Difference Between Nursing Care Policies Offered by the Health Maintenance Organizations?

The insurance coverage terminology in the Meuhedet policy, cannot be amended and is regulated by the Capital Markets, Savings and Insurance Authority of the Ministry of Finance. That is, the wording is the same and uniform for insurance coverage that is also offered by other health maintenance organization’s insurance funds (provided that the party involved is eligible for insurance benefits and the insurance benefits payment period). Moreover, as of now, there is no retail product except for that offered by the insurance companies.

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.

Meuhedet members, of all ages, including compulsory service soldiers. Policy admission involves completing a health declaration, a medical underwriting procedure, and approval by Menora Mivtachim Insurance Company Ltd.
Joining is possible through the Meuhedet Nursing Care telephone call center at Menorah Mivtachim or through any of the following ways:

Meuhedit Nursing Care telephone call center: 1-700-72-22-33
Fax: 072-223-8112
Email: meuhedet-mmt@menoramivt.co.il

Insurance Benefits

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 Upon Initial Admission to a Collective Nursing Care Insurance Policy for Members of the Health Maintenance Organization

Age Up to 49
Monthly insurance benefits paid to the insured party, who remains at home (compensation)

5,500 NIS
Monthly benefits paid out to the insured party who is institutionalized (indemnification)

10,000 NIS

Age Upon Initial Admission to a Collective Nursing Care Insurance Policy for Members of the Health Maintenance Organization

Age 50 to 59
Monthly benefits paid out to the insured party who is institutionalized (indemnification)

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 Upon Initial Admission to a Collective Nursing Care Insurance Policy for Members of the Health Maintenance Organization

Age 60 and Up
Monthly insurance benefits paid to the insured party, who remains at home (compensation)

3,500 NIS
Monthly benefits paid out to the insured party who is institutionalized (indemnification)

4,500 NIS

Amounts in the table above are linked to the Consumer Price Index, as published on 15.06.2016.

The age of first joining will be as prescribed by the regulations, including the 2019 amendment.

How Much Does Nursing Care Insurance Cost?

Premiums chart

Does the insured party who is deemed a nursing care recipient, and who receives insurance benefits continue to pay the monthly premium?

No. The insured party is exempt from paying insurance premiums during the period when receiving the insurance benefits.

I Moved to Meuhedet, How do I Maintain the Continuity of my Insurance Coverage From the Previous Period?

Insured parties who move to Meuhedet and who had nursing care insurance with their previous health maintenance organization, may move with the insurance continuity built up from the date they first registered for nursing care insurance.

Insured parties who flagged, when requesting a health maintenance organization move at a postal branch or on the National Insurance Institute website, that they authorize the “Capital Market, Insurance and Savings Authority” to pass on information on their nursing care insurance rights to the new health maintenance organization’s insurance company, will automatically be added to its nursing care insurance policy, if the insured party did indeed have nursing care insurance immediately before moving to Meuhedet.
If insured parties, of minor age, also move, with the lead insured party, to a new health maintenance organization, their information will also be provided. The admission is automatic to the Meuhedit Collective Nursing Care Insurance Policy at Menorah Mivtachim, and the payment of the premium for the nursing care insurance is made from the actual date of move.

Insured parties who flagged, when requesting a move at a postal branch or on the National Insurance Institute’s website, that they do not authorize the “Capital Market, Insurance and Savings Authority” to pass on information on their nursing care insurance rights to the new health maintenance organization’s insurance company, will not automatically be added to its nursing care insurance policy. If the insured party did indeed have nursing care insurance from the health maintenance organization and would like to maintain the insurance continuity, contact the Meuhedet Nursing Care Center at Menorah Mivtachim, at 1-700-72-22-33 for guidance on joining.

How is Eligibility for a Nursing Care Benefit Determined?

After receiving the claim documents, the insurance company will check the terms of the insurance coverage according to policy terms. It is possible that the insured party may be asked to undergo a functional evaluation with a physician, nurse, or specialist in the field that we have appointed. The examination will be coordinated in advance and will be conducted at the insured party’s home, or at the nursing care home where the insured party currently resides.

When a clarification is required, the insurance company will contact the insured party with a request to provide additional material. In some cases, the insurance company will request the insured party’s medical file directly from the health institutions. Upon receipt of the results and all required documentation, we will notify you of our decision in writing of your claim for insurance benefits in accordance with the policy terms

How to File a Claim?

So that we can attend to the claim in an orderly and prompt manner, we will ask you to complete the claim form and to attach all relevant documentation as detailed in the claim submission guidelines

The claim form and documentation can be submitted in any one of the following ways:

Email to: meuhedet-siud@madanes.com

Fax: 03-638-0011

By mail: PO Box 927, Tel Aviv 6100802.

Through the website: www.menoramivt.co.il

Information on Submitting an Appeal:

There are two appeal committees that convene, as required:

Claims Appeal Committee – in case your claim is denied or if you want to dispute the date of determining your eligibility for payment.

Appeal Committee on Nursing Care Insurance Enrollment – should your application for nursing care insurance coverage be denied.

The decision may be appealed for any of the above issues, within 60 days of the rejection notice regarding joining the insurance or eligibility for payment.

Filing an Appeal:

Email: Meuhedet-siud@madanes.com

Fax: 03-638-0011

Mail: PO Box 927, Tel Aviv 6100802.

Submit an Appeal on Joining:

Through Meuhedet Nursing Care Center: 1-700-72-22-33

Fax: 072-223-8112

Email: Meuhedet@menora.co.il

Our Service Centers are at Your Service

Meuhedet Nursing Care Insurance Center at Menorah Mivtachim

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.

Phone: 1-700-72-22-33 Fax: 072-223-8112 Email: Meuhedet-siud@madanes.com Hours of operation: Sunday to Thursday 8 AM to 4 PM

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