What are the conditions and benefits of each of the supplemental health plans and how do they differ? What are the main areas they cover and what are the terms of eligibility? What is the nature of the services and how do they correspond to those in the basic basket? When is state intervention necessary to regulate the conditions and make it easier for members of the public to exercise their eligibility and compare the different plans?
In light of these and other questions, the Myers-JDC-Brookdale Institute was asked by the Knesset Research and Information Center to examine the supplemental insurance plans offered by the health plans in Israel in 2006 and the changes that have been made to them over the course of time.
The study had two goals:
To analyze and compare the supplemental health insurance plans offered by Israel’s four health plans in 2006
To compare the main services offered by the supplemental insurance plans during the preliminary period, when the plans were constructed in their new format (1996), with those currently offered.
The study was implemented in two stages. In this report we present the findings of Stage 1, in which we made a comparative analysis of the seven supplemental insurance plans offered by the health plans in 2006 (excluding the Platinum plan, which had not yet been made available to the public). The findings from Stage 2, in which we compared the services offered by the supplemental insurance plans during the two periods, will be published shortly.
The analysis was conducted using uniform measures for the type of services offered, the terms and restrictions, the price, the registration process, and the exercising of eligibility. The analysis revealed that the health plans have constructed baskets that include elements that are medically important, as well as welfare services. It also reveals that the legal jargon, the unfamiliar use of concepts, and the overwhelming quantity of details probably make it difficult for people to understand for themselves what their supplemental insurance entitles them to – what the terms are and which areas are covered. Members can get answers to specific questions from the health plans’ information services, but only if they know what to ask, and a large proportion of the population does not know. Situations may therefore arise in which members do not fully exercise their rights.
The study identifies possible ways to improve the plans for the consumer, including steps that could be taken to make it easier to exercise eligibility, to understand and compare the various plans, to make the public aware of the problem of duplicate insurance, and to encourage competition among the health plans.
The study findings were communicated to the managers of the supplemental insurance plans at the health plans and several corrections and additional observations have been included in the report. The managers also confirmed the accuracy of the analysis of the plans. The findings have been presented to the Knesset Labor, Welfare, and Health Committee and the most salient have appeared in the media.
The report was prepared in the framework of the Cooperative Program in Health Policy Research of the Government of Israel and the Myers-JDC-Brookdale Institute and was financed with the help of the Knesset Research and Information Center