FAQ – Medical Insurance for Israelis Abroad

Israelis who relocate to a new country for a long period of time have many decisions to make – employment, residence, education, etc. Choosing a family medical insurance abroad is one of the most important decisions you will face.

As Israelis, we’re used to the national health insurance policies and regulations, with services through our HMO. The conditions abroad are quite different. While surveying the market, many questions arise regarding the medical services and insurance coverage in various countries.

DavidShield’s insurance experts have compiled a selection of commons questions asked at the company’s call and service centers.

Reading through these questions might answer your own queries and help you understand the subject better.

If you’re interested in more information or if you haven’t found the answer to your question – please call 972-9-8920-950, call toll-free according to the list below or find us on Facebook 24/7.

Why do I need medical insurance abroad?

Israel’s national insurance law, which provides Israeli citizens with wide coverage locally, does not cover medical expenses while staying abroad. Without proper medical insurance, expenses for hospitalization, surgery or any other medical problems could potentially accumulate to hundreds of thousands of dollars. Medical insurance is your safety net for any medical event that might transpire outside of Israel – or even upon your return if you’ve lost your national healthcare rights while abroad in accordance with Israeli governmental regulations.


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Could I lose my rights to public medical services under the Israeli State Insurance Law?

Yes! Many Israelis lose their rights for public (national) medical services because they didn’t pay the National Insurance before leaving Israel or because they have relocated to a different country. When your medical insurance rights are banned, you must pay in full for any medical treatment within the public health system in Israel (as if you were a foreign tourist).

If you’ve lost your medical rights, the law stipulates that once you returned to Israel for good you must wait between two to six months (depending on your stay abroad) to reinstate services. Among other entitlements, DavidShield’s clients receive medical coverage while visiting in Israel and while waiting for their rights to be renewed after their return to Israel.

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What are the advantages of Israeli insurance over local insurance?

The DavidShield policy was uniquely designed especially for the needs of Israelis living abroad for extended periods – as reflected in its international coverage (beyond the new country of residence), service provision, suitability for visits in Israel, language of service and continuity after return to Israel. The policy is supervised by the Israeli Insurance Commissioner. DavidShield clients benefit from years of experience in service to tens of thousands of Israelis worldwide.

Local insurance programs, on the other hand, are usually limited in scope and fitted to the needs of the local population. For instance, many plans merely extend services beyond the public medical system local citizens are entitled to. Local programs do not usually enable coverage outside of the country of residence or the freedom to choose medical suppliers.

The DavidShield sales representatives can help your compare the different insurance programs and their offers.


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Can I settle for travel insurance?

 

Travel insurance provides coverage for emergency events that cannot be postponed until your return to Israel. The coverage is time-restricted and the insurance company can demand your return to Israel for treatment. Travel insurance is much cheaper than medical insurance, but is suitable only for short trips that are often already over once a disease contracted abroad or other true medical emergency arises. Travel insurance is ill-suited for those who are relocating for extended periods and require full and extensive medical coverage. In such cases, the travel insurance’s requirement to return to Israel to receive medical services will probably be highly inconvenient. Moreover:

  • Travel insurance does not qualify as medical insurance for the purposes of visas or studies abroad.
  • Only Israelis entitled Israeli public health insurance qualify for Israeli travel insurance (see the second question above).
  • Joining travel insurance programs is only possible before you leave Israel.
  • Travel insurance is time-restricted.


 


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Does DavidShield coverage apply immediately after joining

Generally – Yes!

However: please note that all health insurance policies include a waiting period for several reasons. A waiting period is a pre-allocated period of time in which the policy does not cover a specific issue. DavidShield policies only require a year-long waiting period from the beginning of the insurance for covering medical expenses related to pregnancy and childbirth and to mental health.
 


 


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Will I need to participate in any co-payment for medical services received abroad ?

Yes. The level of member cost sharing depends on the plan you choose and your country of destination. Deductibles are calculated on an annual calendar year basis.
 


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What member co-payments exist for services in Israel?

For medical services received in Israel through the Clalit Health Services, member cost sharing will be limited to the standard nominal co-payments collected by the clinic at the time of service. For other medical services received in Israel (not through Clalit Health Services), DavidShield will cover 80% of the Usual and Customary Rate (UCR).

There may be additional co-payments required for dental services received in Israel, please see the details in the insurance terms.

Member co-payments paid in Israel will not be credited towards the general annual deductible in your plan for services received abroad.


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Can member co-payments be cancelled in the policy?

For an additional fee, you can cancel self-participation fees. However: co-payments for services in Israel cannot be canceled under any policy and policies made for coverage in the USA cannot be supplemented with co-payment cancellation.
 


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I had purchased a policy that will give me coverage outside of the USA. Will I get coverage while visiting the USA?

DavidShield’s insurance programs define specified geographic coverage areas. Under most DavidShield insurance programs, emergency coverage is offered for countries that are not included in the defined area. Thus, a short-term stay in the USA for no more than 90 days consecutively would be eligible for emergency coverage. Preplanned (elective) medical treatment would not be included in plans that do not specifically cover the USA.


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Does the policy cover pregnancy services and childbirth?

Absolutely. The expenses for pregnancy, childbirth and all postnatal care will be covered up to the maximum benefit defined in your plan, following a 12-month waiting period from your joining date .


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What does the policy not cover?

Services not covered by the policy are detailed in chapter 5 in the polic, exceptions. For instance, expenses will not be covered in case of accidents or injuries during the client’s army service, treatment for drug addiction or alcoholism, attempted suicide or intentional self-injury, sex-change operations, voluntary (not medically required) abortions, extreme sport injury and dental work, among other costs.


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How can I choose my medical supplier?

 

Generally, the policy allows the client free choice of medical suppliers. In certain countries DavidShield maintains direct billing arrangements with chains of medical suppliers, where you identify yourself with the insurance card and pay a participation fee only. In other countries, no co-payment is necessary with contracted medical suppliers.

More information on contracted medical suppliers can be found on the company’s website and through the call center.
 


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What should I do to receive a refund for medical expenses I paid to medical suppliers?

If you’ve received medical services from a non-contracted supplier, you must fill out the claim form (which was mailed to you when you joined the insurance and can be downloaded from the DavidShield website). The form will ask for your personal details, diagnosis and medical treatment received (to be filled out in part by the supplier), as well as your preferred refund mode  – credit card compensation, bank transfer, check, etc. You must include receipts for payment and transfer them via fax or as a scanned email attachment to the call center. Please maintain the original documents as you may be asked to mail them to the company.
 


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Will I receive written authorization that I joined the plan?

 

Immediately upon joining, a personal authorization with policy and additional information for your country of stay will be sent to your email.

Insurance details, the health questionnaire with your answers, your acceptance conditions and a personal insurance card will also be sent via mail to your present address abroad.


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Is DavidShield insurance suitable for work visas or studies abroad?

Mostly yes. The scale of coverage and the terms of the DavidShield policy are among the most extensive. In order to receive visa authorization and studies approval, you will have to transfer the desired forms and we will produce the authorization accordingly. Each state or country has its own forms for the insurance company or its representatives. Please make sure you have the appropriate form.
 


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What determines the insurance fees?

The insurance fees are determined by the country of stay, and type of program, as well as the client’s age group and sex. Additional fees might be required depending on the client’s medical situation as reflected by the health questionnaire provided upon joining.


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How can I pay the insurance fees?

The most common means of payment is an Israeli international credit card billed every month. It’s also possible to pay with certain non-Israeli international credit cards. If you prefer, you can pay through bank transfers or checks – DavidShield accepts quarterly, annual or bi-annual payments. If you’ve been insured for a period of time that is longer than your actual time of stay abroad, you will be compensated for the “unused” time.
 

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Can the insurance fee change after joining?

Yes. The insurance fee will change according to the change of age group during the insurance period. Also, as it is customary in the global health insurance field, insurance fees can be updated subject to the approval of the Insurance Commissioner in Israel.
 


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What is the insurance period?

Normally, the DavidShield policy is not time-restricted, and you can be insured for as long as you stay abroad. This is a major benefit, since the insurance company cannot cancel the policy even if the client’s medical status has changed for the worse. However, the client may cancel the insurance at any time.

 


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Who supervises the DavidShield policy?

The policy answers to Israeli laws and is supervised by the Ministry of Finance, Capital Markets, the Insurance and Savings Division and the Insurance Commissioner in Israel. This means that the company’s clients benefit from a whole list of rules and regulations that are designed to guarantee their rights under the policy and the law. In the unusual case of legal dispute between the client and the insurance company, the case will be conducted within the Israeli legal system.


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If my place of residence does not have a medical supplier, can I get funding for travel expenses to a different city?

No. The policy only covers medical expenses and will not cover expenses involving travel for medical treatment. However, in case of emergency (defined by the policy criteria), evacuation expenses will be covered according to the coverage table.
 


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What is UCR? Is it possible that I will not get a refund for what I actually paid?

UCR stands for Usual, Customary and Reasonable. This term relates to the degree of medical expenses considered usual, customary and reasonable where the medical service is given. The policy coverage is calculated according to the UCR in order to prevent abuse or over-pricing of medical treatments. If your service suppliers are not within the agreement, it is best to inquire or even pre-plan the service with the call center in order to estimate the refund to be provided. This will prevent any distress over unreasonable expenses.


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Which insurance company does DavidShield work with?

That would be The Phoenix Insurance Ltd. – one of the leading insurance groups in Israel. The organization serves most of the leading companies in the Israeli market.

 


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Who are some DavidShield clients?

Among DavidShield’s clients are emissaries of the Ministry of Foreign Affairs and the Ministry of Defense, the Jewish Agency, Chabad representatives all over the world, El-Al representatives, Amdocs, IAI, banks and many other organizations and, of course, thousands of private clients all over the globe.


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What are the service hours for the call center?

The call center is available 24/7, 365 days a year. DavidShield representatives are available by email, phone, Facebook and toll-free numbers from almost everywhere in the world, as well as through the website.
 

 


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When can I call the physician help line?

The physician help line is an exclusive service for all DavidShield clients available 24/7 all year long. You can call the physician help line to talk to Israeli family doctors, pediatricians and other doctors and experts. The service provides unique support in English and Hebrew for clients who are in a foreign and unfamiliar surroundings and who seek guidance regarding a medical condition, or other lifestyle health-related issues. Please note, however, that physician help line is for informational purposes only and is not a replacement for seeking medical advice in your country of residence.


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Should I get pre-authorization before receiving medical treatment?

Your doctors and medical condition alone should determine the need for medical treatment. You are not required to get pre-authorization from DavidShield before procuring medical care and you have the right to choose any medical supplier, although the policy does demand that you pre-notify the service center in case of pregnancy, planned hospitalization and other conditions, as detailed in the table of benefit maximums. Moreover, it is recommended to contact the call center before receiving medical treatment in order to understand the coverage included for the medical procedure you are about to engage in.


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USA:

The USA health system is different from others around the world, based mostly on private medicine. Information provided in the General section above is relevant for the USA unless stated otherwise.

When seeking insurance for medical services in the USA, please note the issues raised by the following questions:


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What is the difference between PPO, HMO and other programs?

A vast diversity of insurance programs exists in the USA, all different in terms and almost impossible to compare to one another. Generally, however, two main systems operate:

HMO- Health Maintenance Organization

HMO insurance is basic and limited to a specific network of physicians. Most  programs require that you use a “gatekeeper” or primary care physician, who will refer you to specialists or additional treatment. This is similar to the system that used to be practiced in Israel, where a family doctor had to refer you to an expert in order to make an appointment. HMOs provide no free choice of medical suppliers. The insurance may limit the geographic area in which medical service is given and the benefit maximums may be lower than other insurance plans.  All of these restrictions tend to make HMO insurance cheaper.

PPO - Preferred Provider Organization

PPO is a more flexible type of insurance that allows the client free access to any supplier from a contracted supplier network, which includes hospitals, clinics, labs, doctors, pharmacies, etc.  In addition, the member may choose to use an out-of-network provider subject to additional member cost-sharing. The medical services in this program are usually unlimited in geographic scope within the USA.


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Which of these methods does DavidShield practice?

DavidShield operates within the PPO program. Its network of medical service suppliers in the USA – UHC (United Health Care) – is one of the largest networks in the USA, with nationwide availability. It allows for services to be provided by merely presenting the insurance card. DavidShield is also connected to the Medco network, which includes most of the pharmacy chains in the USA. Your DavidShield insurance card also enables purchase of any prescribed medication.


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How does cost sharing in the DavidShield USA programs differ from other programs?

Client co-payment in the USA program is customized to the USA system. In the other programs, participation is relatively low and is accumulated every calendar year (see above), but client participation in the USA is comprised of different factors:

  • Deductible: The amount you must pay before the plan begins paying for covered expenses. The deductible varies based on the plan you choose ($500 or $1,500) You must meet the deductible each calendar year, and physician office visits are not subject to the deductible.
  • Coinsurance: The percentage of the cost of care you must pay after you have paid the deductible, typically 20%. You share in this cost with the insurance company. The amount of coinsurance you will pay is capped at a maximum, as defined in your policy.

For example: in the PPO500 plan, if the expense for an incident of hospitalization was $11,500, participation would calculated be as follows:

  1. The first $500 is the deductible.
  2. Co-insurance calculation: 20% of the remainder is $2,200. However, coinsurance is capped at $2,000, so that is the actual amount to be paid by the client.
  3. The remainder of the sum, $,8000, would be paid by the insurance company.
  4. If the client were to be hospitalized again in the same year, the insurance company would pay the full amount, since the deductible was paid and the co-insurance was maxed-out. 
  •  Maximum out-of-pocket limit– the maximum sum that a client will pay in a calendar year for both the deductible and the co-insurance.
  • Office visit co-pay– doctor or expert visits require patient fees from $15 to $50 according to the plan. These fees are unrelated to the other participation fees and are not accumulated to the calendar year total.

Note: coverage for pregnancy and childbirth bears additional cost sharing.


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Can I get service all over the USA?

Yes. The DavidShield program allows for UHC services throughout the USA. You are also covered for emergencies outside of the USA.


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I would like to choose a UHC supplier near my residence, how can I find out if they’re a part of your agreement?

Full and updated information can be found in the DavidShield website under the “doctors’ search.”  Doctors can be found by field of expertise, zip code, language, gender, distance from residence and other criteria. Our call center representatives will also be happy to help.

For any other question, please do not hesitate to use our multilingual call center 24/7 or look up the Facebook page. DavidShield is always there for you.


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שלח פניה

DavidShield international medical insurance is the best medical insurance abroad for Israelis living worldwide, with tens of thousands of Israeli customers in over 140 countries around the globe. The DavidShield policy is suitable for relocation, addressing the specific needs of Israelis abroad, and covers members for any medical treatments customary in Israel all over the world – with no fine print.