Once you have joined a health fund you are entitled to Medical assistance. You should choose your general family physician (GP) from the list of doctors provided by the Fund. You can choose a GP on the basis of recommendation, location, hours, languages spoken etc. Most doctors require that you make an appointment ahead of time, but some will say “just come”. An appointment with a GP is generally 10 minutes long. As it is generally impossible to keep to such a timetable, be prepared to be kept waiting.
Not all doctors rooms are well organized, some have administrative staff, some do not. If there is an assistant he/she will manage the doctor’s diary and call you in for your appointment. If there is no assistant, things become a bit more complicated. Be prepared for anything. In some of the doctor's rooms you will be allocated a number and then patiently wait your turn. Sometimes, someone will walk into the room and ask “who is last?” (mi acha’ron?) – the last person will identify himself and all is well, everyone takes his turn in a calm and well behaved manner. You may also be asked “what time is your appointment?” (le ay’ze sha’a ata mooz’man?). Be careful, sometimes you can get into a “heated discussion” with someone who came after you, but insists his appointment is before yours. Be prepared to negotiate the situation and try not to get too upset. That is just the way it is.
When you finally get to see the doctor, he will ask you for your Health Fund membership card. Depending on the Health Fund you are with you may be required to pay a nominal fee of a few shekels to the doctor. You are only required to pay this fee quarterly, irrespective of the number of visits you make in that quarter. Should you want to change doctor in the middle of the quarter, you may have to pay for that privilege. Check with your Health Fund and verify their rules and regulations.
Visits to specialist physicians cost a little more. There is also a participation fee for out-patient services, home visits, other therapies and treatments. Check out the costs for the type of treatment you require before becoming a member of a particular Health Fund.
You have the choice to go privately if you can afford it. For instance, the Health Fund may only pay for a specified number of visits to the gynecologist when you are pregnant - if you want additional care you can go privately. Some doctors affiliated to the Health Funds also have private practices and some doctors are not affiliated to the Health Funds at all.
Private visits are expensive but are sometimes necessary. The Health Fund has rules regarding private doctors too. You may be eligible to receive a reimbursement for part of the cost of the private visit. You are not entitled to the Health Fund discount on medications prescribed by a private doctor. You can sometimes ask your Health Fund GP to give you a prescription for the medication stipulated by the private physician.
When dealing with private doctors you may be able to hasten treatments and surgeries that otherwise would have taken some length of time through the Health Fund.
Generally speaking, there is a wide enough choice of doctors and specialists in each Health Fund. Happily, we have the privilege of being able to obtain good care from the national health and we can go privately if we so choose.