309,435 nursed elderly people in Israel receive a long-term care benefit, about 55,000 of whom are in a serious nursing situation.
Acting General Director of the National Insurance, Yarona Shalom said: "Today, there is almost no long-term care insurance in the private sector that will ensure a dignified livelihood of the elderly, in parallel with the fact that old-age pensions have not risen significantly over the years, and thus the long-term care reform has led to a significant change in our ability as a society to provide assistance to the needs of senior citizens in Israel."
In November 2018, the long-term care reform came into effect, after years of reviewing the difficult at-home examinations carried out on nursed people, the
care for nursed senior citizens, and the split between various bodies and the lack in take-up of rights.
The 2017 State Comptroller's report accelerated the implementation of the reform by noting that the average life expectancy in the State of Israel is among the highest in
OECD countries, so that by 2050, for the first time in history, there will be more people aged 60 than children.
While prior to the reform, there were 3 levels of long-term care benefits, the reform brought in 6 levels and the possibility of assistance for minor long-term care situations to prevent deterioration, and the number of weekly units was expanded.
In the four years since the reform was introduced, a growth of about 131.4 thousand nursed people was observed, which showed an increase in the rights received y beneficiaries. As mentioned above, the care provided by a single body, the high life expectancy in the State of Israel, the change in regulations that removed the fear of applying for a benefit and the reliance on medical documents that brought about the long-awaited change before the reform.
While between 2016 and 2017 about 90 thousand new claims were submitted to the National Insurance Institute, between 2021 and 2022 there were about 125.6 thousand claims. It should be noted that in recent years there have been changes in the dependence assessments that relate to medical conditions and their consequences upon functioning condition, as well as to the risk of falls, based on a decision and policy of providing tools and assistance before the health condition deteriorates.
According to National Insurance Institute data regarding benefit levels (1-6 with level 6 indicating the most serious medical condition), it was found:
that by age 69 the average level of benefit is 2.5, from age 70-74 – 2.8, from age 75-79 – level 3, then the level rises gradually, reaching level 5.3. at age 95-99.
| Up to 69 | 2.5 | 2.6 | 2.5 | 2.5 |
| 74-70 | 2.8 | 2.9 | 2.8 | 2.8 |
| 79-75 | 3.0 | 3.1 | 3.1 | 3.0 |
| 84-80 | 3.2 | 3.3 | 3.3 | 3.4 |
| 89-85 | 3.6 | 3.9 | 3.9 | 4.0 |
| 94-90 | 4.2 | 4.5 | 4.6 | 4.6 |
| 99-95 | 4.7 | 4.9 | 5.0 | 5.1 |
| +100 | 4.9 | 5.1 | 5.2 | 5.3 |
| All eligible people | 3.4 | 3.5 | 3.4 | 3.4 |
According to the distribution of eligible people, there are about 41.4 thousand nursed citizens at level 1, about 61.5 thousand at level 2, about 48 thousand at level 3, about 48 thousand at level 4, about 34 thousand at level 5 and about 54.7 thousand at level 6. Since the introduction of the reform, the share of level-1 beneficiaries, the most basic level, has declined considerably.
According to the National Insurance Institute's Research Administration, it is clearly seen that during the Coronavirus period, upon recognizing that senior citizens were in a major risk group alongside state actions imposing lockdowns and movement restrictions, the National Insurance Institute immediately responded to the concerns of beneficiaries and their families about strangers stepping into their home and enabled those who did not use up care hours to receive a cash benefit, which was automatically deposited into the bank accounts of those entitled. Thus, in April and May 2020, the number of cash benefit recipients surged. Today, about 14.5% receive a cash benefit, 57% receive a hybrid benefit (money + care hours) and about 28.5% receive a benefit in kind (service in the form of long-term care)
At the lower nursing levels, senior citizens have a preference for a benefit in money and testify that they use the benefit for basic and medical needs such as: the purchase of absorbent products, the purchase of medicines, private doctors, hearing aids, dentistry, household care, payment of bills and personal needs: food, clothing, transportation, etc. The responses of senior citizens and their families indicate that money serves them for their own basic life needs and can improve their situation allowing them to purchase things that they would not have been able to without the benefit.
On levels 2-6 there are few cash-only benefit recipients and the nursed elderly ask for more long-term care such as: home nursing care , visits to day centers, ancillary products, panic buttons and more.
Satisfaction surveys conducted by the National Insurance Institute show that nursed elderly and their families tend to state that they receive all the nursing care they need, as the benefit level increases and also involves actual treatments and not just a benefit in money. The highest rate of respondents in the satisfaction survey, 77.9% - was among those receiving level-6 benefit in kind.
It should be noted that the reform brought along the possibility of changing the treatment mix at any time and in accordance with the medical condition of the senior citizen. At lower levels, the respondents claimed that they need additional financial assistance to help them in purchasing health services and/or medication.
The National Insurance Institute believes there is a correlation between the fact that old-age pensions did not significantly increase in recent years and the long-term care benefits allowing to receive a cash benefit used for basic and daily needs.
Regarding the rate of satisfaction in nursing care, at levels 3 and 4, the share of positive response exceeded 80%, and at other levels it ranged from 70% to 80%. The rate of respondents approached 90% among in-kind benefit recipients at levels 3-4 and between 60% and 70% responded positively at level 1.
From the results, it appears that benefit level is correlated to satisfaction, and that the larger the included component of services in the benefit, the greater the satisfaction.
| Level 1 | 25.9% | 5.7% | 52.7% | 28.9% | 6.8% |
| Level 2 | 7.7% | 2.8% | 62.0% | 23.9% | 8.8% |
| Level 3 | 8.9% | 6.2% | 65.4% | 21.6% | 9.8% |
| Level 4 | 12.8% | 10.2% | 63.8% | 17.9% | 9.2% |
| Level 5 | 13.1% | 12.3% | 59.0% | 14.8% | 10.7% |
| Level 6 | 22.8% | 14.6% | 60.8% | 16.5% | 6.3% |
| Cash benefit | 25.9% | 5.7% | 52.7% | 28.9% | 6.8% |
Acting General Director of the National Insurance Institute, Yarona Shalom: "Happily, the reform has led to a decrease in bureaucracy, an appropriate response has been given to the various needs of senior citizens and they have been given choice options according to their medical and economic situation. Today, there is almost no long-term care insurance in the private sector that will ensure a dignified living of the elderly, alongside the fact that old-age pensions have not risen significantly over the years, and thus the long-term care reform has led to a significant change in our ability as a society to provide assistance to the needs of senior citizens in Israel."