Assistance Funding Rehabilitation and Ambulatory Assistance Devices
Service
Description
About the Service
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The following are the main points of the process. The binding Procedure for this, according to which the process is conducted, is the Medical Administration Circular: Approval of Rehabilitation and Mobility Devices by the Ministry of Health (01/2014). In case of a contradiction between the information below and the text of the Procedure, the process will be conducted in accordance with the Procedure.
Who is eligible for assistance?
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Eligible for assistance
- Residents with a permanent disability, living within the community, are eligible for the rehabilitation and ambulatory assistance devices as defined in the third addendum to the national health insurance law.
- Disabled persons hospitalized in nursing institutions, hospitals and institutions run by the Ministry of Social Affairs and Social Services, are entitled to receive walking aids and artificial limbs only - these are provided by the Lewis Institute.
Ineligible for assistance are
- Individuals who do not require these devices in perpetuity and who do not have a permanent disability.
- Pensioners: disabled of the IDF, the Ministry of Defense, victims of hostilities, work-related accidents, traffic accidents from 1975 onwards, and victims of Nazi persecution. These disabled persons receive assistance from another source.
- Disabled individuals who are hospitalized in institutions under the responsibility of the Ministry of Social Affairs and Social Services.
The rehabilitation Devices for which the Ministry Provides Funding Assistance
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The list of devices has been specified in the third addendum to the national health insurance law, 1995.
A. Rehabilitation Devices
- For children and youths up to age 18:
- For the general public:
B. Ambulatory Assistance Devices
C. Devices provided to pension recipients only, and who do not have an additional source of income (such individuals are exempt of a copay)
- Regular walkers, various walking sticks, styrofoam cushions for wheelchairs, standard styrofoam mattresses (“egg platters”)
D. Walking aids and prosthetic limbs - detailed below.
Funding Policy
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A. Rehabilitation Devices
Ministry of Health Participation
The Ministry of Health participates in the funding of rehabilitation devices, to the extent of 75% of the cost of the device or of the participation ceiling determined in the Procedure (whichever is lower), depending on the type of device:
- Devices for which a price cap has been defined, and which is not necessarily the full cost of the device.
- Devices for which at least three price quotes are required. The quotations are taken by the Ministry of Health, which checks them. The price of the device will be determined by the cheapest of the quotations.
Note: When tenders are issued, the device price will be determined in accordance with the terms of the tender.
Patient participation
The patient participates in the purchase of rehabilitation devices to an amount of 25% of the cost of the device or of the participation ceiling.
A patient who requests greater participation, or a patient who is entitled to exemption from co-payment, should apply to the social worker at the Health Bureau.
Conditions and criteria for increasing the Ministry of Health’s participation (i.e. reduction of the resident’s participation) in funding the rehabilitation devices
Fulfillment one of the following criteria:
- A device was purchased in the same financial year with 25% copayment (if the applicant purchased more than one device at the same time, copayment is calculated as 25% of the cheaper of the two and 10% of the more expensive device).
- There are a number of disabled persons in the family who needed devices in the last 12 months.
- The person in need of the device presents documentation of other expenses connected to his disability, such as personal home treatment, special accessories etc., and no other party is participating in meeting these expenses.
- The family has an obligation to fund the stay of another child in an institution and/or participation in the hospitalization of a first degree relative in a hospitalization institution.
For increasing the Ministry’s participation where the criteria are not met, or at a level that exceeds 90%, the social worker shall submit a written application to the Regional Committee.
For the documents required for approval of increased Ministry participation - see below under “Required Documents”.
B. Ambulatory Assistive Devices
Ministry of Health Participation
The Ministry of Health participates in the funding of ambulatory assistive devices, to the extent of 90% of the cost of the device or of the participation ceiling determined in the Procedure (whichever is lower), depending on the type of device:
- Devices for which a price cap has been defined, and which is not necessarily the full cost of the device.
- Devices for which at least three price quotes are required. The quotations are taken by the Ministry of Health, which checks them. The price of the device will be determined by the cheapest of the quotations.
Note: When tenders are issued, the device price will be determined in accordance with the terms of the tender.
Patient participation
The patient participates in the purchase of ambulatory assistive devices to an amount of 10% of the cost of the device or of the participation ceiling.
A patient who requests greater participation, or a patient who is entitled to exemption from co-payment, should apply to the social worker at the Health Bureau.
Remarks
Approval of the participation of the Ministry of Health in the purchase of the rehabilitation and ambulatory assistance devices is conditional upon submission of an application and receipt of approval prior to, and not after, the purchase of the device.
For your information: The recommendation specification, which will be approved at the Health Bureau, contains functional and medical information. If necessary, following the approval, the specification will be sent to the suppliers to solicit quotations. A patient wishing to maintain confidentiality in the data transfer, must contact the Health Bureau near his/her home.
Procedure for obtaining the assistance / financing
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A. Initial application to the HMOs or to the special education facilities, requesting participation in the purchase of the device
For Ambulatory Assistance Devices
The patient must contact the family physician at the HMO (children studying in special education institutions may apply via the institution). The family physician or specialist shall forward the application to a physiotherapist or occupational therapist (authorized to provide a recommendation), through the unit, for continued handling or for other handling, in order to evaluate the eligibility for participation in the funding of the rehabilitation and mobility device.
The professional authorities at the HMOs will guide the patient regarding the forms to be submitted and the procedure for applying to the Ministry of Health.
For Rehabilitation Devices
In applications for rehabilitation devices, the patient must contact the relevant physician at the HMO to receive a recommendation.
Documents as detailed below must be attached to the application.
Note: The HMO’s recommendation does not necessarily amount to confirmation of eligibility. The final decision as to whether or not to approve the device is taken at the Ministry of Health.
B. Submitting the application to the health bureau
The request, along with the documents detailed below, must be submitted to the health bureau near the patient’s home - to the devices coordinator in the department of protracted diseases and rehabilitation. With the exception of cases in which original invoice and receipt documents are required - see details in “Cases in which the resident receives certification of eligibility to purchase a rehabilitation / mobility device to be purchased independently” below.
C. Discussion at the Local Committee at the health bureau
A local committee will discuss each request which it is authorized to discuss. The committee’s decision (to approve or reject the application), including guidelines for continuing the process, will be reported back to the applicant by the devices coordinator.
D. After receiving approval of assistance
- Upon receiving approval from the Ministry of Health, the patient will be sent to receive the device according to written instructions, which will be provided.
- The approval remains valid for half a year from its date of issue.
- Ambulatory Assistance Devices, for which the Ministry of Health pays a part, are the property of the Ministry of Health and must be returned when they are no longer used, or after receiving a different device of the same kind or upon institutionalization of the patient in a nursing home.
Upon receiving the device, the resident and another guarantor, or a guarantor only, must sign an undertaking form and a promissory note, ensuring the return of the device once it is no longer used.
The following devices must be returned to the health bureau after they are no longer used:
- Manual wheelchairs (of all kinds)
- Toilet wheelchairs
- Motorized wheelchairs
- Hand-powered wheelchairs with detachable power drive assemblies
- Walkers
- Beds
- Lifts
- Stair climbing aids to be attached to a wheelchair / mobile stair elevators
- Rollators
- Standing wheelchairs
Return of the device
- Regular seats and toilet seats supplied to eligible persons by 31-Dec-2013 shall be returned by family members to the health bureau during public reception days and hours.
- Beds, lifts for bed to chair transfer, motorized chairs and stair climbing devices supplied by 31-Dec-2013 will be recollected by a health bureau representative. The family shall convey, via the Health Voice call center, a request to the health bureau to return the device, specifying the reason for the return, and an appointment will be made for a bureau representative to collect the device from the family’s home.
- All types of devices supplied by authorized suppliers whose tenders were accepted from January 2014 - the family shall convey, via the Health Voice call center, a request to the health bureau to return the device, specifying the reason for the return. The authorized supplier will arrange collection of the device from the resident’s home, by prior appointment.
Note: The device will be delivered only via the authorized suppliers whose tender was accepted, except for devices for which an invitation for tenders has not yet been conducted.
Procedure for applying for additional devices - walking aids and prosthetic limbs
Additional devices - walking aids and prosthetic limbs (provided via the Lewis Institute).
Orthoses (walking devices), prosthetic limbs, prosthetic hand gloves, special medical shoes, stump socks - in the event that a stump housing or prosthesis has been replaced.
People requesting these devices should contact Lewis Institute, which operates a national Appointments Call Center to schedule appointments for licensed doctors in phone 03-7575660 or fax 03-5757659.
Ministry of Health participates in financing 75% of the device’s cost. Persons wishing to expand participation or who are entitled to receive it with no deductible, should contact the social worker at the Ministry of Health. They will be directed by the Ministry of Health to a licensed doctor with a card stating the Ministry’s participation rate. Additional information regarding expansion of participation and exemption from deductibles appears in the walking aids and prosthetic limbs procedure in the chapter “Social policy and participation levels”.
Service
Details
Reception Area
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The service is provided to the public via the district health bureaus - the departments of chronic illness and rehabilitation.
Required Documents
ServiceConditionsParagraph4 Documents that must be attached to the application for assistance in purchasing ambulatory assistance devices- Up-to-date medical / nursing report, signed by a physician and a nurse
- Specification and/or recommendation from a physiotherapist occupational therapist from the insuring HMO
- Social report, signed by a social worker (in case of motorized / electrical ambulatory assistance devices or upon the bureau’s requirement)
- ID photocopy
- Applicants requesting a reduction of their copay - must apply for a consultation with the social worker at the health bureau.
Notes:
- Residents who are in a rehabilitative framework, or who were in such a framework in the past year, shall submit a summary report / discharge report. The summary shall include all the forms received at the time of discharge, including a medical report, nursing report, physiotherapy summary, occupational therapy summary and social work report.
- For applications regarding children up to the age of 18 years, it is advisable to attach a social work report.
- In cases of complex illnesses such as muscular dystrophy, multiple sclerosis, ALS and others, it is recommended to include the assessment of a specialist physician.
Documents that must be attached to the application for assistance in purchasing rehabilitation devices
- Hearing aids - referral from an eye, ear and nose doctor and recommendation from a speech therapist, together with an audiological test result.
- Visual aids, including prosthetic eyes - recommendation from an eye doctor
- Prosthetic breast - recommendation from a family physician / specialist in internal medicine / oncologist / surgeon. In any re-application, authorization will be given on the basis of the Declaration Form that appears in the Approval of Rehabilitation and Mobility Devices Procedure.
- ID photocopy
- Applicants requesting a reduction of their copay - must apply for a consultation with the social worker at the health bureau.
Documents to be attached in case of purchasing independently
In cases where the citizen is recognized as being eligible for purchasing a rehabilitation / mobility device, to be purchased independently, that person must submit the following documents to the health bureau in order to be reimbursed for the expense:
- The certificate of eligibility
- The confirmation of receipt form (stamped and signed)
- Original invoice and receipt
- Bank account details for remitting the refund by bank transfer (via a photocopy of a cancelled check)
Documents Required for approval of increased Ministry participation (i.e. smaller copayment by the resident)
- Payslips of both partners (3 most recent payslips)
- Certification of allowances or pensions from the National Insurance Institute
- Most recent complete tax assessment from the tax office (for the self-employed)
- Pension from Israel and from overseas
- Payments from the Ministry of Defense
- Payments from the Ministry of Finance to victims of Nazi operations
- Presentation of documents showing other expenses connected to the disability / obligation to fund the stay of another child in an institution, as specified in the clauses above.
Approval of the participation of the Ministry of Health in the purchase of the rehabilitation and ambulatory assistance devices is conditional upon submission of an application and receipt of approval prior to, and not after, the purchase of the device.
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This information is also available in the following languages:
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The service is provided to the public via the district health bureaus - the departments of chronic illness and rehabilitation. |
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Publications and Legislation (Hebrew) |
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