The Benefits of Supplementary Health Insurance Program of "Meuhedet Adif"
The Benefits of Supplementary Health Insurance Program of "Meuhedet Adif"
The Benefits of Supplementary Health Insurance Program of "Meuhedet Adif"
Dear policyholders
With the welfare of its members in mind, Meuhedet operates the complementary insurance program Meuhedet Adif. This program, which offers an array of medical services not included in the national health insurance laws basic healthcare basket, has been recently expanded and received numerous improvements. Among other improvements, the list of medical services offered under Haddasah has been expanded, and the rate of the deductible for Meuhedet Adif policyholders has been significantly decreased. The program includes medical services in various areas, thus providing the policyholders with extensive medical coverage, supplementing the services included in the healthcare basket. Meuhedet Adif policyholders have easy access to advanced high quality medical services. Meuhedet cooperates with various medical centers in Israel and abroad, thus granting Meuhedet Adif policyholders access to numerous healthcare services, while assisting and accompanying the patients throughout the entire process, following Meuhedets outstanding traditions. Any member of Meuhedet may join the Meuhedet Adif program, with no limitation related to age or medical condition. This leaflet presents a brief summary of the medical services covered by the Meuhedet Adif program. The complete list of services, as well as the terms and conditions, is provided in the set of regulations of Meuhedet Adif. The Set of regulations brochure is available at Meuhedets branches and on Meuhedets website: www.meuhedet.co.il
Service
Family planning
Genetic testing Diagnosis and treatment of male and female fertility disorders Biochemical screening during the first trimester of pregnancy Follow-up of high risk pregnancies Recovery from labor and delivery Early detection of fetal congenital defects: Amniocentesis or chorionic villi sampling (CVS) Early detection of fetal congenital defects: Fetal organ screening
Service available for Meuhedet Adif policyholders Improved service available for Meuhedet See policyholders Service available for Meuhedet See policyholders only
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Service
Fetal Nuchal Translucency Screening Cesarean section Cord blood collection Children and adolescents Private pediatrician visit Speech therapy Child development Food substitute products not included in the healthcare basket Treatment of night-time urinary incontinence Hydrotherapy treatments (beyond those included in the healthcare basket by law) Art therapy Music therapy Diagnostics of attention and concentration disorders Dental and periodontal care Dental examinations and treatments Preventive medicine Vaccinations Vaccinations and drugs for travelers Preventive tests Emergency care Urgent ambulance transport Subscription to cardiologic monitoring and transmission service and emergency medical care for cardiac patients
Service available for Meuhedet Adif policyholders Improved service available for Meuhedet See policyholders Service available for Meuhedet See policyholders only
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Service
Recovery and rehabilitation Private nurse service Complex nursing hospitalization Recovery from complex surgery Rehabilitative exercise following myocardial infarction Rehabilitation after sport injuries Life style Psychological counseling and treatment Sport medicine Aesthetic medicine Laser treatment of myopia Optometric services Diet counseling Alternative medicine Workshops and courses Tests and services Sample collection for laboratory tests at policyholders home Physician home visit services Oncogenetic tests Periodic screening tests Treatments Anti-ageing treatments for slowing the ageing processes Shockwave treatment Management of hemorrhoids and fissures Management of sexual dysfunction Management of snoring and blocked nose problems
Service available for Meuhedet Adif policyholders Improved service available for Meuhedet See policyholders Service available for Meuhedet See policyholders only
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Family planning Genetic testing Eligibility for genetic tests aimed at detection of carriership of genetic diseases choosing from an extensive list of approved tests. Diagnostics and treatment of male and female fertility disorders Eligibility for fertilization treatments for members eligible to receive the fertility treatments according to the national health insurance law, in a private hospital contracted with Meuhedet. These include: Diagnostic tests aimed at discovering the reason for fertility disorders. Supply of drugs for treatment of infertility. In-vitro fertilization (IVF) beginning with third child. Freezing of genetic material freezing of fertilized ova and their subsequent implantation to the policyholder. Fertility treatments using ovum donation performed abroad. Biochemical screening test during the first trimester of pregnancy Eligibility for biochemical screening test during the first trimester of pregnancy for pregnant policyholders with a single fetus. Early detection of fetal congenital defects Amniocentesis - eligibility for amniocentesis or chorionic villi sampling (CVS), according to the policyholders choice. Fetal organ screening eligibility for early fetal organ screening or extensive fetal organ screening instead of the basic screening (approved for all the HMO members, according to the national health insurance law) performed during the second trimester of pregnancy (weeks 20-25).
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Management of high risk pregnancies Eligibility for pregnant women at high risk to receive a home monitor for continuous pregnancy follow-up. Recovery from labor and delivery Eligibility for the woman (having three or more children) to get a 3-day recovery leave in an institution specialized in recovery from labor and delivery. Children Private pediatrician visit Eligibility for reimbursement of expenses related to a private visit to a pediatrician, who is not contracted with Meuhedet by agreement. Child development Eligibility for treatment related to child development - up to 36 sessions per year, beyond the sessions to which the child is entitled according to the national health insurance law. Speech therapy Eligibility for reimbursement of expenses by Meuhedet for one course of speech therapy (treatment of stuttering) or one course of learning disability treatment due to organic speech disorder (by a speech therapist), beyond the sessions to which the child is entitled according to the national health insurance law. Dental and periodontal care Eligibility for receiving various dental care services in dental clinics of Meuhedet, including: Free dental examination once a year, emergency and first aid treatments. Special prices for dental calculus removal and oral hygiene education. Discounts on the prices of dental treatments in Meuhedets pricelist. Supply of pharmaceutical products required for dental treatments. Preventive medicine Vaccinations Vaccinations eligibility for vaccinations according to the policyholders request: hepatitis A and B vaccines, influenza vaccine and pneumococcal vaccine. Vaccinations and drugs for travelers to sites where special vaccinations are required, according to the Ministry of Health instructions. Preventive tests Eligibility for preventive tests, as specified below: Fecal occult blood test Cervical exam (Pap smear) Mammography and bone density tests beyond those covered by the national health insurance law.
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Emergency medicine Urgent ambulance transport Eligibility for partial reimbursement by Meuhedet of expenses associated with ambulance hospital transport without subsequent hospitalization. Subscription to cardiologic monitoring and transmission service and emergency medical service to cardiac patients Eligibility for compensation for a subscription to cardiologic monitoring and transmission service and emergency medical service to cardiac patients. Rehabilitative exercise following myocardial infarction Eligibility for partial reimbursement by Meuhedet of expenses for controlled rehabilitative exercise following acute myocardial infarction. Recovery and rehabilitation Private nurse Eligibility for compensation for expenses associated with purchase of private nurse services following surgery requiring continuous monitoring and follow up. Recovery from complex surgery Eligibility for compensation for expenses associated with recovery in a specialized institution, for policyholders undergoing brain surgery, abdominal surgery, organ transplantation, or other surgery (except for aesthetic plastic surgery and obstetric surgery) requiring continuous hospitalization for more than 10 days. Complex nursing hospitalization Eligibility for compensation for hospitalization expenses, in case of a policyholder defined as a patient requiring complex nursing care.
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A healthy mind in a healthy body Psychological counseling and treatment Eligibility for psychological counseling and treatment given by psychologists contracted with Meuhedet by agreement. Sport medicine Eligibility for discounts on the rates charged by Meuhedet for treatments and exams performed in Meuhedets sport clinic. Alternative medicine Eligibility for discounts on the rates charged for treatments performed in the alternative medicine clinics of Meuhedet. Diet counseling Eligibility for diet counseling by dieticians contracted with Meuhedet by agreement.
Aesthetic medicine Eligibility for discounts on the rates charged by Meuhedet for cosmetic varicose treatments. Laser treatment of myopia Eligibility for laser treatment of myopia. Optometric services Eligibility for discounts on purchase of optical glasses and sun glasses from suppliers contracted with Meuhedet by agreement.
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GENERAL INFORMATION
1. Insurance Rates
Detailed according to the policyholders age
Age group 0-24 24-30 30-55 Single over 55 Family Family (when head of the family is over 55)
Correct to April 1, 2010 Monthly Rate
Notes: a. The insurance rates listed above were calculated to include a 5% discount granted to those paying via regular money transfer from their bank accounts (horaat keva). The bank accounts of Meuhedet Adif policyholders will be charged accordingly, once a month. b. Policyholders using payment vouchers may pay at any postoffice branch (Bank hadoar) in the country or in Meuhedets offices. c. Regular transfer of insurance payments ensures all the rights to which policyholders of supplementary health insurance programs are entitled, as stated in the set of regulations. d. Delays in insurance payments may harm policyholders rights, up to cancellation of their membership in the Meuhedet Adif program. Updating Insurance Rates Insurance rates of the Meuhedet Adif program are updated according to the consumer price index published by the Central Bureau of Statistics, or the health cost index, whichever is higher. In addition, insurance rates are updated according to the changes in the service basket composition and the real cost of the variety of medical services included, based on actuarial calculation performed periodically, as approved by the Ministry of Health.
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The contents of this leaflet provide general information only. Effective terms and conditions of the supplementary health insurance program are specified in the set of regulations of Meuhedet Adif. Prior to purchasing any medical service, policyholders have to inquire about their rights to coverage.
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