A person recognized by the National Insurance Institute as a work injured person is entitled to medical care for purpose of therapy, if this medical care is required in connection with his injury as recognized by the National Insurance and the Medical Board.
The medical care of the work injured is extensive: it includes all kinds of treatments whether or not they are included in the health basket.
A treatment listed in the health basket is provided according to the Public Health Law.
Whereas a treatment not included in the health basket is provided under the agreements between the National Insurance and health maintenance organizations (HMOs).
Treatments included in the health basket
Medication - exemption from payment of drugs, or entitlement to reimbursement according to the pricing of the HMO.
Medical examinations - exemption from payment for doctor visits, tests, commitment forms, x-rays and clinic treatments, or entitlement to refund according to the pricing of the HMO.
Medical equipment - exemption from payment for medical equipment, or entitlement to refund according to the pricing of the HMO.
Hospitalization - hospitalization, including long-term care hospitalization or long-term care at the vitctim's home.
Travels refund - entitlement to reimbursement of travel expenses for purposes of receiving medical care, in accordance with the standard rates of public transportation, and after a HMO's doctor determines that the work injured health condition does not allow the use of public transportation - he will be entitled to refund use other means of transportation (taxi or ambulance).
If the HMO's doctor determines that you need orthopedic shoes, you are entitled to buy such shoes once a year.
Treatments not included in the health basket
The work-injured is entitled to receive the following treatments even though they are not included within the health basket:
Quality of medical treatment
HMOs are obligated to provide medical services to the work injured according to the best professional knowledge, services and equipment available in the public health system in Israel, at a reasonable quality and according to the medical necessity.
Funding of medical care will correspond to tariffs of the HMO and according to its price list.
Whether the costs of recommended services or devices exceed HMO's tariffs / the work injured can submit a request for review of HMO's decision to the National Insurance, and its request will be examined by a physician of the National Insurance based on its medical condition resulting from the work injury.