Supplemental Insurance Plans: Developments in the Service Packages a Decade after Implementation of the National Health Insurance Law

Since the National Health Insurance Law came into effect in 1995, there has been a considerable increase in the ownership of supplemental insurance policies among the public, the insurance plans have become more complex and there have been changes in the coverage offered. The Knesset Research and Information Center therefore asked the Myers-JDC-Brookdale Institute to examine the supplemental insurance plans offered by the health plans in Israel and the changes to them over time.

The study was conducted in two stages:

  1. A comparative analysis of the insurance plans offered by the four health plans in 2006, which was conducted using uniform measures: type of services offered, terms and restrictions, price, registration process, and the exercising of eligibility (for further information [in Hebrew], see Institute report RR-495-07).
  2. An analysis of the main services that have been added since 1996 (when the health plans offered the insurance plans in their new format). The second stage is the subject of the current report.

The study goals were:

  1. To analyze the additional services according to their relationship to the services in the basic package (i.e., services outside of the package vs. those that augment or enhance those in it); the nature of the services (medical or well-being); their place in the continuum of medical services; and the target population (main recipients of the service) by age and state of health;
  2. To assess the priorities for including the additional services in the basic package with regard to health benefits and economic costs. We were helped in this by members and observers of the committee responsible for prioritizing new technologies for inclusion in the basic package.

The study found that an extensive range of services had been added: Most them enhanced services in the basic package; most were medical services; and most were aimed at the chronically or seriously ill. Only some services (e.g., periodic testing and vaccinations) were given high scores as priorities for inclusion in the basic package and being cost-effective for the system.

The study is important because it contributes to policy discussions on several pressing issues, including, on the one hand: Would it be appropriate to consider transferring some of the services in the plans to the basic healthcare package? And, on the other hand: Should the services added to the supplemental insurance be restricted? Is government intervention required to make the plans more accessible to the entire population? In addition, the information in the study can serve to help the public decide whether to purchase supplemental insurance.

The findings have been presented to a broad audience, including the Ministries of Health and Finance, the Knesset Labor, Welfare and Health Committee, forums of directors of the health system and academics; as well as health consumer groups. The study was conducted in partnership with the Knesset Research and Information Center, which also funded it.

Citations in the professional and academic literature

Kaplan, G., Shahar, Y., & Tal, O. (2017). Supplementary Health Insurance from the consumer point of view: Are Israelis consumers doing an informed rational choice when purchasing Supplementary Health Insurance?. Health Policy121(6), 708-714.

Gamzu, R., & Rosen, B. The commercial challenge to Israeli health care and how it can be addressed.