Social Security Lawyers
Nursing Allowance From the National Insurance Institute
Many people assume that long-term care insurance is exclusively a private product, but in fact, every Israeli citizen is insured for long-term care through the National Insurance Institute. The Institute pays eligible individuals cash disability benefits, nursing services, or a combination of the two.
By Igal Mor, Adv. & Notary
Accuracy in Legal Advice. Excellence in legal support.
Who Is Entitled to a Nursing Allowance?
Any individual who has reached retirement age and requires nursing care may be entitled to a nursing benefit from the National Insurance Institute, provided they meet the following five eligibility conditions:
1. Residency and age: The insured must be a resident of Israel who has reached retirement age (62 for women and 67 for men).
2. Place of residence: The insured must live in their own home or in sheltered housing. Hospitalized individuals may qualify under additional conditions.
3. Nursing situation: the insured needs assistance in performing daily activities or requires supervision most hours of the day for his safety, or that of the environment.
4. Non-duplication of benefits: Certain benefits cannot be received simultaneously with the nursing allowance. For example, individuals receiving a special services benefit must choose between the two.
5. Income test: Eligibility for a full benefit, reduced benefit, or no benefit is determined based on income thresholds for individuals and couples.
Six Levels of Nursing Eligibility
The nursing benefit is paid as cash, nursing services, or a combination of the two. Benefits are divided into six levels based on the degree of the insured’s dependency. Each level determines how the allowance is paid. For example, individuals rated at Level 1 may choose between personal care at home, nursing services without personal care, a cash benefit, or a combination. Those rated at Level 2 are entitled to 10 hours of care per week without the option of a cash allowance. At Levels 3 through 6, the insured may again choose between receiving care hours, a cash benefit, or a combination of the two.
How to Apply for the Nursing Allowance
The insured must submit a claim to the National Insurance branch in their area of residence, accompanied by all relevant medical documentation and income certificates for both the insured and their spouse. If the insured meets the eligibility conditions, the National Insurance Institute may render a decision based on the submitted documents alone or may require the insured to undergo an in-home functional assessment (ADL test). This test evaluates six activities of daily living: eating and drinking, lying down and standing up, dressing and undressing, bathing, mobility, and sphincter control. The assessment determines the extent of the insured’s dependency on others and whether they qualify for a nursing benefit.
Is Private Nursing Insurance Necessary?
As detailed above, every Israeli citizen in a nursing situation may be entitled to a benefit from the National Insurance Institute. Given this universal coverage, the question arises: is additional private long-term care insurance necessary? This is ultimately a personal decision, but the need arises from the fact that the National Insurance nursing allowance provides only basic coverage. It typically does not cover the full cost of nursing care and certainly does not include medical expenses. Private long-term care insurance is designed to provide comprehensive financial coverage, paying a monthly allowance according to the policy terms to finance all health-related expenses.
Why Legal Representation Is Essential
Our firm specializes in insurance law and handles numerous claims with both the National Insurance Institute and private insurance companies. We will manage the entire claims process on your behalf—from initial filing through appeal proceedings when necessary—and work to ensure that you receive the maximum benefits to which you are entitled.
Have you reached retirement age and require nursing care? You may be entitled to a nursing allowance from the National Insurance Institute. Contact us to schedule a legal consultation to evaluate the full scope of your rights.
With years of experience navigating the complexities of National Insurance proceedings, Mor & Co. understands the challenges involved. Our deep legal knowledge and extensive experience representing clients before the National Insurance Institute and the Labor Court equip us to deliver outstanding results. Unlike rights-extraction companies that lack the legal authority to represent clients before medical committees, our attorneys personally accompany you to hearings and ensure that due process and natural justice are upheld. From the initial claim filing through the preparation of your complete medical file, we protect your interests at every stage. Contact us today at 02-595-3322 or via WhatsApp at 050-441-1343.