Nursing Care Law

 The National Insurance in cooperation with the Ministry of Social Affairs and Clalit Health Services execute the Nursing Care Law. According to the law, nursing benefits are granted to those who have reached the age of retirement, live at home and are in need of assistance in performing daily tasks (dressing, bathing, feeding, getting around the house, etc.), as well as to the elderly who are in need of safety supervision in the home. Nursing services will be provided for those eligible in order to assist them in their daily tasks and in managing their homes, as well as making their care and supervision easier on the family

Conditions of Eligibility

 

Five conditions determine the eligibility of nursing benefits:

  1. The applicant is a resident of Israel who has reached the age of retirement
  2. The applicant resides in the community and not in an institution. Anyone who is residing in a nursing home or home for the aged (institutions that require a Ministry of Health or Ministry of Social Affairs license) are not eligible for benefits (a retirement community is considered residing in the community)
  3. The applicant’s income does not exceed the following:

Income

Benefit

Individual

Individual to 7,663NIS (from 01.01.2008)

Full benefit

Individual

Over  7,663NIS (from 01.01.2008) to 11,495NIS (from 01.01.2008)

Reduced benefit of 50%

Couple

Couple to 11,495NIS (from 01.01.2008)

Full benefit

Couple

Couple over  11,495NIS (from 01.01.2007) to 17,243NIS (from 01.01.2007)

Reduced benefit of 50%

4. The applicant does not receive a service pension (a disabled person injured at work, or generally disabled) from the National Insurance, and does not receive other benefits for personal treatment or supervision from the State Treasury (if receiving such benefits the applicant will decide between this benefit and the nursing benefit according to the Nursing Care Law).

5. The applicant is found to be in need of assistance in performing daily tasks (dressing, bathing, feeding, incontinence, getting around the home, etc.)

How to Submit a Claim

 

After the National Insurance Institute receives a claim form for nursing benefits, a nurse or social worker checks the applicant in his home, in order to determine the level of dependency, or the level of supervision needed. (According to the ADL test)

According to the results of the nurse’s test, the National Insurance Institute will decide if the applicant is eligible to receive nursing benefits, and will determine the level and period of time of such benefits he is entitled to. In cases of temporary disability, the benefits will be granted for a temporary period of time.

The local committee (a social worker from the Ministry of Social Affairs, a nurse and representative from the National Insurance Institute) will determine the services to be granted to the applicant as well as who will administer such services, and all in accordance with the benefit rate  determined by the National Insurance Institute, and according to the judgment of the professionals treating such applicant (social worker and nurse).
In order to determine the services suitable for the applicant and his family and who will administer such services, a social worker from the Ministry of Social Affairs or a nurse from Health Management Organizations will visit the applicant in his home. The nursing services will be provided by Matan Welfare Services Ltd.

Services Provided to those Eligible to Receive Nursing Benefits

 

According to the Nursing Care Law, an applicant eligible to receive nursing benefits, will receive such benefits that will assist him and his family in performing day-to-day tasks, in home management, and in the care and supervision of the applicant – and all according to the needs and choice of the applicant within the framework of his eligibility.
Services available under the Nursing Care Law, under condition that such services can be provided at the applicant’s place of residence:

  • Assistance from a homecare specialist in the applicant’s home
  • Day care center for the elderly
  • Supply of disposable adult diapers
  • Distress signal
  • Laundry service

These services will be provided according to the decision of a professional local committee for social welfare, according to the needs of the applicant.

Maximum Period of Eligibility

 

The eligibility for nursing benefits is not granted permanently, and the condition of the applicant is reassessed from time to time by the National Insurance Institute, as well as his eligibility for such benefits and the rate of these benefits.
If there has been any deterioration in his condition, he and his family have the right to ask the National Insurance Institute to have the situation reassessed by submitting a claim of deterioration.

Benefit Rates

 

The benefit rate paid by the National Insurance Institute for nursing services is determined by the level of dependency or the level of supervision needed:
A. Eligibility of 168% nursing benefits, will receive 18 hours weekly, or 9 hours weekly for those eligible to reduced benefits as a result of level of income.
B. Eligibility of 150% nursing benefits, will receive 16 hours weekly, or 8 hours weekly for those eligible to reduced benefits as a result of level of income.
C. Eligibility of 91% nursing benefits, will receive 9.75 hours weekly, or 5 hours weekly for those eligible to reduced benefits as a result of level of income.
* Holocaust survivors with eligibility of at least 145% nursing benefits are eligible to receive an additional  9 hours weekly granted by the Foundation for the Benefit of Holocaust Victims. To realize these benefits a separate claim form must be submitted.

To Appeal a National Insurance Institute Decision

 

If you do not agree with the National Insurance Institute decision, you are entitled to appeal such decision to the Labor Court. The appeal is to be submitted to the Labor Court within 6 months of receiving the written notice from the National Insurance Institute regarding their decision.

Matan Welfare Services Ltd. is at your service for consultation and instruction in dealings with the National Insurance Institute at all times, to assist in realizing your rights.