Private Surgery
If you require private surgery for medical needs, you can be reimbursed
What is private surgery?
A private surgery is one that is not fully or partially funded by the HMO or supplementary insurance provider. Reimbursement for private surgery expenses can be obtained.
For your attentionThe reimbursement is provided for surgeries arising out of medical necessity only. We may request a document that clarifies the medical necessity.
What can you receive?
Reimbursement up to a maximum amount of 17,155 ₪Last updated on 1.1.2026 per calendar year, after deducting the copayment amount of 2,874 ₪Last updated on 1.1.2026.
The reimbursement amount you can receive is the difference between the amount you paid for the private surgery and the amount that can be received from your HMO and insurance company, even if you did not actually receive it. It does not include the copayment.
For example:
If you paid 20,000 ₪ for the surgery and your insurer or HMO reimbursed you 5,000 ₪ - the actual cost of the surgery is 15,000 ₪. Out of this amount, your copayment is 2,712 ₪, meaning you are entitled to receive the difference of 12,288 ₪ from us.
If you paid 20,000 ₪ for the surgery and did not receive reimbursement from your insurer or HMO, you are entitled to a maximum reimbursement of 16,192 ₪ from us.
If you paid 5,000 ₪ for the surgery and your insurer or HMO reimbursed you 4,000 ₪, the actual cost of the surgery is 1,000 ₪. Out of this, your copayment is 2,712 ₪, meaning in this case, you cannot receive reimbursement from us.
Bereaved parents experiencing a second lossThe parents can receive reimbursement without deduction of the copayment, or alternatively, 200% reimbursement for one surgery, with double deduction of the copayment, or two 100% reimbursements with one copayment deduction - at their choice.
How to apply?
To receive reimbursement, submit an application through your account:
Medical certificate indicating the nature of the surgery
Certificate describing the type of surgery, signed by the attending physician.Declaration of receipt or non-receipt of payment from another source
Before submitting an application to exercise your eligibility, you must first exhaust your rights with any other funding source and attach a declaration indicating whether a payment was received or not from that source.Receipt or tax invoice
You must attach an original receipt or tax invoice in your name, or a certified copy in case the original receipt was submitted to the supplementary insurance provider.
If necessary, we will contact you and request additional documents.
What happens after you apply?
- We will respond within 25 business days from the receipt of all required documents. If there is any delay, we will make sure to inform you.
- After eligibility is approved, the reimbursement will be transferred via the monthly benefit slip.
