Long-Term Care Benefit from National Insurance: Eligibility, the Dependence Test and the Six Levels
The long-term care benefit is paid to anyone who has reached retirement age, lives at home and needs help with daily activities or supervision. Entitlement is determined by a dependence assessment carried out by an Institute assessor, and an income test decides whether the benefit is full, reduced or denied. Six entitlement levels translate dependence points into care hours, cash or a combination.
“In long-term care the decision is made in one home visit. What the assessor sees and hears that morning is the benefit.”
Adv. Yissachar Leibowitz · Head of the Social Security Department
Who is eligible: four conditions
The long-term care benefit is the benefit of the third age. It does not depend on how the need for help arose, but on how much help is needed. Four cumulative conditions apply:
- Age and residency: an Israeli resident who has reached retirement age.
- Place of residence: the claimant lives at home or in sheltered housing. Anyone in a nursing institution is not eligible, and separate rules apply to hospitalisation.
- Dependence: the claimant needs help with daily activities, or supervision for most of the day for their own safety or that of others.
- Income test: the income of the claimant, and of their spouse, does not exceed the set amounts.
Anyone receiving the special services benefit cannot also receive the long-term care benefit; one must be chosen. Whoever became entitled to special services before retirement age keeps that entitlement afterwards, so the choice is made according to what serves the claimant best.
The income test: full, reduced or denied
The income examined is gross income from every source: work, pensions, National Insurance benefits, assets and other income under the Income Tax Ordinance. The amounts as of 1 April 2026, per Institute publications:
- Single person: up to ILS 13,769 - full benefit; between ILS 13,769 and 20,654 - benefit reduced by 50%; above ILS 20,654 - no entitlement.
- Couple: up to ILS 20,654 - full benefit; between ILS 20,654 and 30,980 - reduced by 50%; above ILS 30,980 - no entitlement.
Not counted, among others, are benefits for victims of Nazi persecution, private long-term care insurance payments, the mobility benefit and maintenance for orphans. Deducted from income are court-ordered maintenance, a spouse’s institutional care costs, and rent paid against rental income. These details sometimes change the outcome from reduced to full, so it is worth checking them before filing.
The dependence assessment: what the assessor examines
Entitlement is not determined by a medical committee but by a functional assessment. An assessor on behalf of the Institute, usually a nurse, comes to the claimant’s home and examines the degree of dependence on others in six activities: eating and drinking, lying down and getting up, dressing and undressing, bathing, mobility at home and continence. The need for supervision is examined as well.
Each activity is scored according to the help needed, and the total of dependence points determines the entitlement level. In some cases the Institute decides on the documents alone, without a visit.
The visit is short, and it takes place on one morning that may be unusually good or bad. Preparation is therefore an accurate description, not a display of ability: what the claimant does alone, what with partial help, and what not at all, as on an ordinary day. The presence of a family member who knows the routine, and medical documents describing the impairments, help the assessor see the full picture.
The six entitlement levels: hours, cash or a combination
Dependence points are translated into one of six levels, and each level grants a basket of weekly care hours. The lowest, level 1 (2.5 to 3 points), grants 5.5 care hours a week; the highest, level 6 (9.5 to 10.5 points), grants 30 hours a week, or 26 hours for someone employing a foreign worker.
At every level one may choose between care services and a partial or full conversion to cash. Each care hour is worth ILS 248 a month (as of 1 April 2026). At level 1 the whole benefit can be taken in cash, ILS 1,705 a month. At the higher levels up to 4 weekly hours can be converted to ILS 992 a month, and with a social worker’s approval up to 10 hours to ILS 2,480.
The basket also includes day centres, absorbent products, an emergency button and laundry services, which can replace part of the personal care hours. The choice is made with the branch social worker, and can be changed later.
The claim process: from filing to the entitlement letter
The claim is filed at the Institute branch with medical documents describing the condition, and confirmations of the income of the claimant and spouse. After the formal conditions are checked, the assessor’s visit is scheduled, and the dependence points are set there.
Next, a social worker on behalf of the Institute contacts the claimant and family and builds the care plan with them: carer, hours, complementary services, conversion to cash. Finally an entitlement letter is sent detailing the level and the service basket. The benefit is paid retroactively from the date of filing, so there is no reason to wait until the condition deteriorates before filing.
Appeal and re-examination
Anyone rejected, or assessed at a level lower than their condition justifies, may appeal to an advisory committee, consisting of a physician and a nurse who are not Institute employees, within 60 days of receiving the notice. The appeal is filed at the branch that handled the claim, and one may ask for the hearing to take place in the claimant’s presence or on the documents.
A claim against the Institute’s decision may also be filed in the regional labour court, and in proceedings against the Institute the claimant is entitled to state legal aid with no means test.
A third route is a request for re-examination due to deterioration (form BL/2620): anyone whose condition has worsened since the assessment requests a new dependence assessment, with medical documents. That is the right route when the condition has changed, as opposed to an appeal, which is meant for a case where the original assessment did not reflect the condition.
Private long-term care insurance: what it covers and what it does not
The National Insurance long-term care benefit is a basic basket of care hours. It does not cover the full cost of a live-in carer, and it does not cover medical expenses. Private long-term care insurance, through a health fund or an insurance company, pays a monthly allowance under the terms of the policy, usually for a limited period, and its payments are not counted in the income test for the long-term care benefit.
The two routes are not substitutes for each other, and they are examined under different dependence tests. Anyone with a policy should check it alongside the National Insurance claim, because the policy’s definition of a “nursing condition” is not identical to the Institute’s dependence points.
In summary
In summary, the long-term care benefit is paid to an Israeli resident who has reached retirement age, lives at home and needs help with daily activities or supervision, subject to an income test: a single person up to ILS 13,769 for a full benefit, a couple up to ILS 20,654. A home dependence assessment by an assessor sets the points, and the points set one of six levels, from 5.5 to 30 care hours a week, with the option of conversion to cash at ILS 248 per hour. An appeal to the advisory committee is filed within 60 days.
The complexity is that the decision rests on a single visit, that the income test contains deductions many are unaware of, and that the choice between long-term care and special services, and between hours and cash, affects the outcome for years. A lawyer who knows the six activities and the income rules knows what needs to be seen at the visit and what to deduct before filing.
If a parent or family member of yours needs help at home, or has been assessed at a level that does not reflect their condition, contact us with the medical documents and income confirmations and we will tell you frankly which level they are entitled to and what is worth doing.
What comes up most about the long-term care benefit
From what age is one entitled to the long-term care benefit?
From retirement age. Anyone below retirement age who needs help with daily activities is examined along a different route, the special services benefit, and if their entitlement to special services began before retirement age, it is preserved afterwards.
What is examined in the dependence assessment?
An assessor on behalf of the Institute comes to the home and examines six activities: eating and drinking, lying down and getting up, dressing and undressing, bathing, mobility at home and continence, as well as the need for supervision. The total of dependence points sets the level.
How much is received?
By level: from 5.5 care hours a week at level 1 to 30 hours at level 6. Each hour is worth ILS 248 a month (as of 1 April 2026); at level 1 ILS 1,705 can be taken in cash, and at the higher levels up to 4 hours can be converted to ILS 992 or, with a social worker’s approval, up to 10 hours to ILS 2,480.
My parents have a pension. Does that rule out the benefit?
It depends on the amount. A single person with gross income up to ILS 13,769 receives a full benefit, up to ILS 20,654 a benefit reduced by 50%, and above that there is no entitlement. For a couple the amounts are ILS 20,654 and 30,980. Private long-term care insurance payments and benefits for victims of Nazi persecution are not counted.
Can one receive both special services and long-term care?
No. One of the two must be chosen. Whoever became entitled to special services before retirement age keeps that entitlement afterwards, so the choice is made according to what actually serves the claimant best.
A low level was set. What now?
File an appeal to the advisory committee, a physician and a nurse who are not Institute employees, within 60 days of receiving the notice. If the condition has worsened since the assessment, the route is a request for re-examination due to deterioration on form BL/2620, with medical documents.
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