Kupat holim: how Israel's four health funds work and how to pick one
Every Israeli resident must belong to one of four health funds. The basic care is identical by law, so the choice comes down to clinics near you, English-speaking staff and the extras.
The short version
- The four funds are Clalit, Maccabi, Meuhedet and Leumit. All must provide the same state basket of care [3][8].
- Residents pay a health tax through Bituach Leumi: 3.23% of earnings up to ILS 7,703 a month (about £1,785) and 5.17% above, from January 2026 [2].
- New immigrants with no income are exempt from the health tax for their first six months, and up to 12 months if they get the living allowance from the Ministry of Aliyah and Integration [9].
- Supplementary plans (known as shaban) add extras for a monthly fee. They're optional, but most people take one [6][7].
- You can switch funds up to twice in 12 months, with moves taking effect on six fixed dates a year [5].
Pound conversions use the Bank of England spot rate of 5 November 2026 (£1 = ILS 4.3162).
How the system works
The NHS hands you one system and a GP. Israel gives you a choice of four, each a bit like a giant GP practice, clinic chain and pharmacy rolled together. Health insurance is compulsory for every resident, and Bituach Leumi (the National Insurance Institute) collects the contributions and passes them to the fund you've joined [3].
Whichever fund you pick, it must provide the government's health basket [3][8]. That covers family doctors, specialists, hospital care, tests and medicines on the approved list, with some co-payments along the way. What differs between the funds is:
- where their clinics and pharmacies are,
- how easy they are to deal with in English,
- their apps and out-of-hours services,
- and their supplementary plans.
Who's in the system depends on status, not passport. New immigrants and returning Israeli citizens join a fund. The FCDO confirms that if you hold Israeli citizenship you're eligible for a fund [1]. If you're on a work visa, you're usually outside the national scheme; our guide to healthcare in Tel Aviv covers private options for you.
Joining as a new immigrant
Most people making aliyah sign up within hours of landing. Here's the usual order:
- At Ben Gurion. After passport control there's a health fund desk where you can register and get a temporary card [9].
- Or in your first days. Visit a branch of your chosen fund with your passport, teudat oleh (immigrant certificate) and teudat zehut (ID card). The permanent card arrives by post [9].
- Changed your mind already? Within 14 days of your aliyah date you can change your first choice at a post office [9].
- Set up the app. All four funds run apps for appointments, prescriptions and test results. Do it early, before you need it.
The AACI, the long-running association for English speakers in Israel, notes that many newcomers sign up hastily at the airport just to make sure they're covered, and suggests weighing clinic locations, English-speaking staff and your own medical needs first [8]. Since you can switch later, signing up at the airport is a reasonable choice. You won't be stuck with it for good.
What you pay in the first year
| Situation | Health tax |
|---|---|
| New immigrant, no income, months 1 to 6 | Exempt [9] |
| New immigrant on the Ministry of Aliyah living allowance, months 7 to 12 | Exempt, month by month [9] |
| Employee | 3.23% up to ILS 7,703 a month, then 5.17% up to ILS 51,910 (about £12,000) [2] |
| Resident with no income | Minimum of ILS 123 a month (about £28) [2] |
Self-employed people pay on their own rates through Bituach Leumi. Foreign income counts towards contributions too [3], which surprises some Brits living off UK rent or pensions. Our guide to Israeli taxes for Brits covers the tax side.
Israelis coming home after years in Britain
Returning Israeli citizens can face a waiting period of up to six months before cover restarts. You can cancel it by paying ILS 16,860 (about £3,900) at the 2026 rate [4]. Israeli citizens born abroad and returning minors are exempt [4].
Choosing between the four
There's no league table that settles it, so think about how you'll actually use the fund.
| Question | Why it matters |
|---|---|
| Where's the nearest clinic and pharmacy? | You'll be there with a feverish child at 8am. Check branches near your flat. |
| Can you get an English-speaking family doctor? | Ask before you join. Leumit, for example, offers personal service in English by phone, email or video [6]. |
| How good is the app? | Appointments, sick notes and prescription renewals mostly happen online. |
| Out-of-hours care? | Maccabi runs urgent care centres with specialists, lab tests and X-rays out of hours [7]. Leumit lists its own out-of-hours services [6]. |
| What's in the supplementary plan? | This is where the real differences lie. |
| Special needs? | Paediatrics, pregnancy, fertility, a chronic condition: ask how each fund handles it. |
The Ministry of Health runs an online comparison of the funds and their plans, which the AACI points newcomers to [8]. Ask other Brits in your neighbourhood, too: the same fund can feel very different from one branch to the next.
Supplementary plans (shaban)
On top of the basket, each fund sells its own supplementary insurance, usually in two tiers. It's optional and priced by age.
- Maccabi offers Maccabi Sheli and Maccabi Zahav [7].
- Leumit offers Leumit Silver and Leumit Gold. Both include private surgery with a choice of surgeon and hospital, second opinions, discounted private dental care and cheaper night and weekend doctor visits. Gold adds extras such as maternity payments of up to ILS 2,366 per pregnancy (about £548) [6].
- Clalit and Meuhedet sell their own tiered plans; check their sites for current names and prices.
For a feel of the cost, Maccabi publishes the rates its Wellcome members paid if they joined by the end of 2025: Maccabi Zahav at ILS 65.26 a month (about £15) and Maccabi Sheli at ILS 125.90 (about £29) for ages 30 to 45 [7]. Rates for ordinary members are set by the fund and can differ, so treat those as a guide.
Two practical points:
- Waiting periods. Supplementary plans can have waiting periods for some treatments. Yad L'Olim's guide (from 2022) says olim who join soon after aliyah can have them waived [10]; ask your fund about the current deadline when you sign up.
- Limits. The AACI warns that supplementary plans may not cover very expensive treatments or medicines [8]. That's where private insurance comes in.
Private insurance on top
The third layer is commercial health insurance from Israeli insurers, often sold as a "transplants and medicines" or private surgery policy, and sometimes through employers. It's worth considering if you have a long-term condition or want cover for drugs outside the basket. Long-term care insurance is a separate product again, sold by some funds as well [6].
If you're keeping an international policy from your old job, check whether you still need it once you're in a fund, and whether it covers you in Israel at all.
Switching funds
If you're not happy, you can move. The rules [5]:
- You can switch up to twice in any 12 months.
- Apply at any post office branch with your teudat zehut, or online through Bituach Leumi with a credit card in your name.
- The move takes effect on one of six dates a year. Apply between 16 September and 15 November to move on 1 January, between 16 November and 15 January for 1 March, and so on every two months.
- You stay with your old fund until the move takes effect.
- Your old supplementary plan ends when you leave. The new fund can't block you from joining its plan, and you may avoid its waiting periods if you bring a seniority letter from your old fund.
Swapped funds and want to tell other Brits how it went? Pull up a chair in our community group for Brits in Israel.
Sources
- GOV.UK (FCDO): Living in Israel and Palestine (last updated 14 November 2024)
- Bituach Leumi: Insurance contributions for salaried employees and for non-working people (rates from 1 January 2026)
- Nefesh B'Nefesh: Bituach Leumi and health insurance (modified May 2026)
- Nefesh B'Nefesh: Health insurance for returning citizens (updated January 2026)
- Leumit: Transferring between health funds
- Leumit: Leumit Silver and Gold and Leumit for new olim
- Maccabi: English home page and Wellcome rates (updated November 2026)
- AACI: Choosing your health fund (modified February 2026)
- Easy Aliyah: Registering for health insurance in Israel (updated February 2026)
- Yad L'Olim: Choosing a kupat cholim (updated August 2022)