25 מרץ 2017 כ"ז אדר תשע"ז

Services

The services provided by the "Well Come" Plan are included in the health services determined by the National Health Insurance law and are only available to members when they are in Israel. All services provided correspond to the health services mandated by law, with the exception of several restrictions given below, subject to the terms and conditions of the Plan.
In any event, members of the "Well Come" Plan will not be eligible for more than the health services determined by law.


Which Health Services?

Primary Care Services: Family doctor, women's health, pediatrician.
Specialist medical services.
Emergency medical services, hospitalization, referral to ER.
Elective hospitalization services.
Examinations in Maccabi's specialist clinics, including
imaging
, diagnostic, and
gastroenterology
clinics.
Laboratory tests.
Medications covered by the National Health Insurance Law.

Plan Restrictions

Below are details of the services not covered by the "Well Come" Plan.
  1. Hospitalization during the first three months of membership, with the exception of emergency hospitalization.
  2. Treatment of pre-existing conditions, including further deterioration.
  3. Treatment of serious and chronic diseases, as defined by the Israeli Ministry of Health, if diagnosed within the first six months of membership.
  4. Any treatment involving pregnancy and birth, including labor and delivery expenses, treatment of the
    newborn
    (including premature births), hospitalization due to pregnancy monitoring, miscarriage, abortion, and so on.
  5. Fertility treatments.
  6. Treatment of conditions directly or indirectly linked and/or derived from a road accident in Israel or overseas.
  7. Treatment of conditions directly or indirectly linked and/or derived from a work accident in Israel or overseas.
  8. Treatment and hospitalization due to impotence or sexual dysfunction.
  9. Treatment involving psychiatric health, premeditated self-injury, or suicide attempt.
  10. Treatment due to injuries caused by scuba diving, skydiving, hunting, skiing, and all other extreme sports.
  11. Treatment of injuries caused by a terror attack, war, hostilities, sabotage, or a criminal act.
  12. Treatment of diseases that are a result of drug or alcohol use.
As said, in any event, members of the "Well Come" Plan will not be eligible for more than the health services determined by law.





The restriction of Article 1 above does not apply to a member who has maintained continuous rights from the period he was a resident, and joined the "Well Come" Plan within a month from the date he was notified in writing of the cancellation of his residency, and only if he registered with the Plan before the need for hospitalization or before a chronic/severe disease was diagnosed.
In the event of a discrepancy between the wording used in this document and the original Hebrew version, the Hebrew version will prevail.