Meuhedet See Regulations

Meuhedet See Regulations
The Supplementary and Comprehensive Health Insurance
Contents Chapter A
Clause 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.
Page
Preface ............................................................................................................................................. 5 Definitions and Interpretations ................................................................................................... 6 Legal Status ..................................................................................................................................... 9 Membership in the Meuhedet See Program .......................................................................... 10 Registration .................................................................................................................................. 10 Waiting Periods ............................................................................................................................ 11 The Membership Commencement, its Termination or Renewal ........................................... 12 Members Payments .................................................................................................................... 13 Betterment of the Health Maintenance Organizations Damage and Recourse to a Third Party Double Insurance .................................................................................... 14 Restrictions on Eligibility ........................................................................................................... 15 General Terms .............................................................................................................................. 16 An Insured Staying Abroad for a Prolonged duration ............................................................ 18 Incidence ...................................................................................................................................... 18
Chapter B
Surgeries
1. Treatments/surgeries at Private Hospitals ................................................................................ 19 2. Plastic Surgery ............................................................................................................................. 25 3. Supply of medication which is not Included in the Organizations Medication Package .... 25
Medical Treatments Abroad

4. Medical Consultation prior to electing Of a medical center Abroad .................................... 27 5. Surgeries Abroad According the Insureds Choice .................................................................. 28
Novel Treatments
6. 7. 8. 9. 10. Anti Aging treatments ................................................................................................................ 29 Shock Waves Treatment .............................................................................................................. 30 Periodic Survey Examination ..................................................................................................... 30 Oncogenetic Examinations ........................................................................................................ 31 Laboratory Services at the Insureds Home .............................................................................. 31
Life style
Clause
Page
11. Nutritional counseling ................................................................................................................ 31 12. Workshops and courses .............................................................................................................. 32 13. Rehabilitation exercise pursuant myocardial infarction ......................................................... 32
Consultation
14. Second Opinion In Israel ....................................................................................................... 33
Child Treatment
15. Treatment of nightly enuresis ..................................................................................................... 34
Pregnancy and Birth

16. Early discovery of congenital defect of fetuses ......................................................................... 35 17. Blood of the umbilical cord ........................................................................................................ 36
Recuperation and Recovery

18. Recovery after a complex operation .......................................................................................... 36
Additional Services
19. Treatment of hemorrhoids and fissure.... ................................................................................... 37 20. Treatment of sexual malfunction ............................................................................................... 37 21. Therapeutic riding; Hydrotherapy; music, art and animal therapy ....................................... 37 22. Cesarean Section ........................................................................................................................... 38 23. Food substitutes not included in the health benefits package ................................................ 38 24. Treatment of snoring and sinusitis ............................................................................................. 38 25. Rehabilitation of sports injuries .................................................................................................. 39 26. Child development ....................................................................................................................... 39 27. Nuchal translucency screening ................................................................................................... 39 28. Doctors house visitations ............................................................................................................ 39 29. Dental transplantation ................................................................................................................. 40 30. Diagnosis of Attention Deficit Disorders (ADD) ..................................................................... 40
Contents
Clause
Page
31. Alternative medicine .................................................................................................................... 40 32. Parturient recuperation ................................................................................................................ 40 33. Childrens dental treatments ........................................................................................................ 41 Appendix A Monthly payments ................................................................................................... 42 Appendix B Medical services given by private hospitals/the Private medical care program ....................................................................... 44 Appendix C A list of hospitals in agreement with the health maintenance organization, for performing operations by surgeon included in the agreement .................... 49 Appendix D Medical benefits package for the Meuhedet See policyholders ..................... 52 Appendix E A list of medical appliances and medical equipment for the Meuhedet See and the Meuhedet Adif policyholders ............................................................... 57
Regulations for the Meuhedet See additional medical services program
Chapter A
1.
1.1
Preface
Meuhedet See is an additional medical services program (hereinafter: Supplementary insurance) which constitutes an additional strata of the services offered to the policyholders of the united health maintenance organization, who are also members of the Meuhedet Adif policy. The program includes a wide variety of medical services, beyond those offered by The basic medical benefits package which is an obligatory service by virtue of the National Health Insurance Law (First level), and those offered by the Meuhedet Adif Policy (Second level). 1.2 As stated in the National Health Insurance Law: The right of the health maintenance organizations policyholders to receive all the cervices, to which they are entitled by virtue of the National Health Insurance Law, will not be effected by whether or not they join additional medical services programs offered by the organization or the corporation it controls. It is all as stated 10-21of the National Health Insurance Law (1994), which state that: (10) (A) The Health Maintenance Organization is entitled to offer its members additional services programs; which are not included in the health benefits package and the organizations payments plan (hereinafter: Additional Services Program), neither by itself nor through a sub-company belonging to it (hereinafter in this clause: The Organization). Any alteration in the additional services program must be approved by the Minister of Health. (B) The additional services program will be offered to members of the organization only as a cooperative and mutual balance settlement, subjected to the following rules: (1) The services in the program will only be granted within the framework of the fees already charged from those who joined the program (hereinafter: The Colleagues). (2) The organization is entitled to occasionally alter the colleagues rights and payments within the program. (3)... (C) (1) The Health Maintenance Organization will include in the program any member who wishes to join it with no regard to their medical or financial state, and it will not limit their membership or their rights at the time of the association by any conditions, apart from any reasonable eligibility periods. Such periods will be determined for all colleagues by a program for the availability of various services under the condition that no eligibility period will be determined, as stated, for services that were included
5
Chapter A
in the organizations services package, referring to members of the organization who joined the program no later than one year following the alteration in the services package and the organization payment. (2) The organization may determine with regards to the eligibility periods, as stated in the paragraph, various instructions regarding members transferring from programs of another organization. (D) As stated in the small clause, (C) The organization will not discriminate among colleagues of in the program, neither in the moment of their joining the program nor at times of providing the services granted by it. The program fee will be the same for each age group, with no regard to the membership seniority, or to the colleagues financial or medical state.
(E) (F)...
(21) (A) The Health Maintenance Organization will grant all those it is responsible for, as stated in clause 3, all the health services they are entitled to by virtue of this lawi, whether by itself or through its service givers, without discrimination. The organization will not condition the availability of the services included in its benefits package in its members joining other service programs, as stated in clause 10ii. (B)...
2.
2.1
Definitions and interpretation

The definitions of these regulations will have the following interpretation:
Supplementary Insurance or See Additional health services as defined by clause 10 of the National Health Insurance Law (1994). Family Members The children of the Meuhedet See policyholder, who have reached the age of 18. This includes both guardian and foster children. The age of the policyholder Will be calculated in whole years, as the difference between the policyholders birth date and the date on which their age must be determined according to these regulations. Insurance Fees Monthly payments that the policyholder must pay to the United Health Maintenance Organization, every month or once every stated period, for themselves and
i ii
The National Health Insurance Law (1994). To the National Health Insurance Law (1994).
their family members as the condition under which they are granted their rights by virtue of this regulations. The Management The management of the Health Maintenance Organization, or whoever was authorized to act on its behalf. Overall Expense The sum of all existing payments made by the policyholder, or by any third party, to the service givers for the overall price of an event, for which the policyholder is requesting either medical or some other type of aid. The Certifying Authority The organizations medical or administrative authority, authorized to certify whether the policyholder entitled or not to receive medical services and/ or indemnities by virtue of this regulations. Agreement The communication made by the United Health Maintenance Organization and any medical supplier, for the purpose of granting medical services to the members of the Supplementary Insurance program. Statement of Health A form filled by the policyholder, to declare their medical state, and the medical state of their family members and anyone insured on behalf of them. The Organization The United Health Maintenance Organization, or any other establishment operating on its behalf under the observation of the law. Self-Participation A fee that the policyholder is obligated to pay, as condition for the fulfillment of their rights, prior to receiving service from the service givers mentioned in these regulations. Organization Member A citizen, who is at least 18 years of age, and who registered at the Health Maintenance Organization. The membership is authorized as long as the members name is included in the registry of the National Insurance Institute of Israel, according to the instructions of the National Health Insurance Law. A Month A months period according to the Gregorian calendar. A Months Membership A month, for which membership fees to the Meuhedet See had been paid. Abroad A country or territory beyond Israels jurisdiction. The Health Law The National Health Insurance Law, 1994, including the regulations and/ or decrees that have been issued by virtue thereof Soldier A person in service of the regular military forces, according to the Security Service Law, (hereinafter: A soldier in mandatory service), or by way of enlistment to permanent service. Double Insurance It is the right of the insured, due to the existence of an insurance agreement or a indemnity agreement from any third party including the insurance company, to receive medical service or medical indemnity due to medical service, which is included in the Meuhedet See benefits package. Waiver of Medical Confidentiality A form by which the insured states that they waiver in advance any medical confidentiality regarding their health, or the health of their under aged family members or anyone insured on their behalf. The waiver allows Meuhedet,
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Chapter A
among other things, to receive vital information for the purpose of maintaining the continuity of the medical service. The waiver and its validity will be subjected to future lawsuits concerning the supplementary insurance alone. Meuhedet Adif The program constituting the first stage of the supplementary insurance program. The rights and obligations of the insured according to this program are detailed in the Meuhedet Adif regulations. Insured Anyone, whose entitlement to be included in the Meuhedet See program has been validated by virtue of these regulations. Consumer price Index or The Livelihood Costliness Index The consumer price index (including fruit and vegetables), issued by the Main Bureau of Statistics, or any other index that may be issued in its stead. The Health Costliness Index The index indicating the costs of health, as it is defined in the fifth addition to the National Health Law. The Services Guide A booklet, updated every once in a while, listing all the medical service givers connected to Meuhedet by agreement. An Authorized Institute An institute or service giver, which is connected to Meuhedet by agreement and whose details are listed in Meuhedets Medical Services Guide. Companion A person over 22 years of age, accompanying the insured on a trip abroad to receive medical care, by virtue of this regulations. The companion is authorized by a recommendation of a medical professional and a pre-authorization by the Certifying Authority. An Entitling Event The circumstances under which the insured is entitled to medical care and/or aid, according to the conditions listed in these regulations. Implants Medical equipment that is being inserted into the patient by an operation, and which stays inside the patients body, temporarily or permanently, according to that which is stated in clause No.1 of chapter B of this regulations. The Meuhedet See Medical Service Package A variety of examinations, medical treatments, medical care and all it entails; which Meuhedets insured is entitled to receive by virtue of these regulations. The Basic Medical Service Package A variety of examinations, medical treatments, medical care and all it entails; which Meuhedets insured is entitled to receive by virtue of the Health Law. Indemnity A monetary payment to the policy holder, constituting the funds participation in their overall expanse, for the purpose of the medical care they are entitled to by virtue of these regulations. A Years Membership 12 months of continuous membership in the program, the first of which begins on the first day of the Insureds joining the program, which are already prepaid by the insured.
Insurance Period or Membership Period The period, during which the member was defined as insured by the Meuhedet See program, either consecutively or sporadically according to this regulations, and fulfilled all of its conditions. Waiting Period A consecutive period of membership in the program, during which the insured is included in the program and must pay the membership fee, but they are not yet entitled to the rights listed in these regulations. Regulations The United Health Maintenance Organizations regulations. These Regulations The Meuhedet See regulations, as valid for that particular time. Medication A preparation listed in the medicine and preparations register, conducted according to the Pharmacists Ordinance 2.2 Interpretation In this regulations: 2.2.1 The masculine form of address also includes the feminine from, and the singular also includes the plural, apart from cases in which it is particularly stated otherwise or that another meaning may be deduced from the text. The division of these regulations to parts and chapters, as well as to the names and titles of the parts and chapters are for the readers convenience only; and they should not be taken into consideration for construing of these regulations. Anytime a sum of money is stated, that the insured should pay, in foreign currency; it is intended to describe an amount equal to the amount in NIS, according to the foreign Currencys exchange rates on the day of the payment.
2.2.2
2.2.3
3.
3.1 3.2
Legal Status
Meuhedet See is owned, run, and supervised by the Health Maintenance Organization. The management is entitled, by an authorization of the Minister of Health, to transfer all or some of the rights and duties imposed upon it according to this regulations, to another administration/corporation, in any way shape or form that it may choose (including by manner of cooperating with another corporation). All under condition that it wouldnt harm the Meuhedet See rights of the insured, and as long as it is done according to the National Health Insurance Law. For avoidance of doubt it will be stated, that the program is subjected to the instructions of the National Health Insurance Law (1994). In any case of contradiction between these regulations and its appendices, and the instructions of the National Health Insurance Law, the instructions of the law will take precedence.
3.3
Chapter A
4.
Membership in the Meuhedet See Program

4.1 Any member of the United Health Maintenance Organization, listed in it by virtue of the National Health Insurance Law and insured by Meuhedet Adif , is entitled to submit a membership request to Meuhedet Adif , and be accepted into the program without being faced with restrictions due to their age or medical state, according to that which is stated in this regulations. A member is entitled to include his children, who are listed in the United Health Maintenance Organization, in the program. Meuhedet will include the minor without restrictions of age or medical state. In the event that a family member has terminated their membership in Meuhedet See, the rest of the family members are entitled to register/remain in the program according to their choice. Separated spouses are each entitled to continue their membership as a single insured, paying their insurance fee separately.
4.2
4.3
4.4
5.
5.1
Registration
An insured of Meuhedet Adif over the age of 18, requesting to become a member of Meuhedet See, will be required to fill out a Membership Form and sign it. THE date of signing will be considered as the date of the new members joining the program, according to that which is hereinafter stated in clause 5.7. At the time of joining, the insured will be required to sign a direct debit form for the bank and by the insurance fee for the first month of membership. The insured will sign both their and their childrens names on the form. Insured members are also entitled to sign on behalf of their spouse. The membership request to the program may be submitted by another person on behalf of the insured, so long as they produce a power of attorney letter on behalf of the insured. A request to include a child or anyone else unaccountable by law should be submitted by a legal guardian. The United Health Maintenance Organization will notify the new member that their request forms have been received and that his membership has been registered on the said date. Meuhedets notification, as is stated above, will be sent with the program regulations and the signed membership form. An insured who has signed a membership form, will deliver it to the authorized party at Meuhedet. Meuhedet will notify the insured of their acceptance into the program, on the date of their registration or no later than 30 days following their registration. If the insured has not receive notice from Meuhedet of their registration within 30 days of the
5.2 5.3 5.4 5.5
5.6 5.7
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registration date, as stated above, they will be regarded as having joined the program on the date of signing the forms. 5.8 The insured must notify their local United Health Maintenance Organization branch of any changes made to their name, address, status and family status; in a regular manner and no later than 30 days following their last notification. 5.9 A minor will be considered a member in the program, so long as at least one of their parents is a member, and their membership fee has been paid as requested. A minor with a legal guardian will only be considered a member if they were registered by the legal guardian. Termination of a minors membership due to unpaid insurance fees would be done according to clause 8. A minor will be included by Meuhedet without restriction of their age or medical state. 5.10 On the date of joining, the insured will be entitled to sign a Medical Statement form as well as a Waiver of Medical Confidentiality form. Use of these forms will only be made in case of indemnity law suits on behalf of the insured, by virtue of these regulations.
6.
6.1
Waiting Periods
During the waiting period detailed in chapter B of this regulations, neither the insured nor anyone insured on his behalf, will have the right to receive medical services by virtue of this regulations. They will also have no right to receive indemnity for these services. An insured will have the right to receive medical services and/or indemnity, by virtue of these regulations, only for those medical services which they required after the waiting period. Anyone joining the program will be billed for the waiting period as is stated in every chapter of these regulations. To remove any doubt, it must be stated that the waiting period stated in this regulations will apply to the insured even in the event that they might have been, for whatever reason, exempt from the waiting period in the time of joining Meuhedet Adif . Despite that which is stated in clause 6.1 above, a soldier discharged from the IDF after completing their mandatory service, who had not been insured by Meuhedet prior to their enlisting in the army, will be entitled to join the program upon their discharge with full benefits without any waiting period what so ever. This right is granted to soldiers on condition that they join the program within 90 of being discharged from the army. A colleague of the supplementary insurance, who has been jailed for a period of over 90 days and has therefore lost their place on Meuhedets insured list, and who prior to the termination of their membership had completed most of or the entire necessary waiting period according to this regulations; will be exempt upon their release and Meuhedets renewal of their membership from the waiting period, which they had already completed (mostly or entirely). This is according to the duration of the waiting period by virtue of
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6.2
6.3
6.4
6.5
Chapter A
6.6
6.7
this regulations and it applies to this specific service. All this under condition that they were not removed from the program due to an unpaid debt prior to the termination, and subjected to the fact that they had renewed their payments to the supplementary insurance program within the first 90 days of the temporary termination. Whoever terminated their membership in another organization and joined the United Health Maintenance Organization after having completed most or the entire required waiting period of the second level of the other organizations supplementary insurance, due to the right granted to them by virtue of this regulations; will be exempt from most or the entire waiting period, according to the duration required in this regulations for that same service. This right is granted to the insured, as stated, under condition that they join this program within 90 days of joining the supplementary insurance programs. All that is stated above is under condition that the insured has proved their membership in the other organizations supplementary insurance programs. It must be stated, to remove any doubt, that Meuhedet will approve the Insureds indemnity, as is stated in clauses 6.3, 6.4, 6.6, only for medical services purchased by the member after their joining the SI program, and only if there exists an indemnity benefit for that service, by virtue of these regulations.
7.
7.1
The Membership Commencement, its Termination or Renewal

The membership begins from the date of the Insureds signing the Meuhedet See membership form, and under condition that the membership fee had been paid as requested, according to that which is stated in clause 8. Any insured interested in terminating their membership will notify Meuhedets offices and sign the appropriate form. The termination of their membership and of the membership of anyone insured on their behalf will commence a month following the Insureds notification of the termination of their membership, as is stated above. An insured who is bedridden or who, for reasons beyond their control, is unable to arrive at Meuhedets offices is entitled to terminate their membership, as is stated above, via a party that will produce a power of attorney letter and an identifying certificate. It is hereby clarified that a termination of membership does not indicate a waiver on behalf of Meuhedet of the Insureds monetary debts for the entire period during which they had been a member in the program. A member owing insurance fees due to them being a member of Meuhedet See and terminating the membership without settling their debts will not be permitted to join the program or Meuhedet Adif until the debt had been settled. Meuhedet is entitled to suspend or hereby terminate the Insureds membership in Meuhedet See, due to failure to pay membership fees as is stated in clause 8 hereinafter and/or in any case of: inappropriate behavior including violent behavior towards a doctor or any of
7.2
7.3
7.4
12
7.5
7.6
Meuhedets employees; a false or partial notification regarding one of the Insureds medical expenses, or the rights of the insured by virtue of an agreement with any third party and/or any other cause enabling Meuhedet to terminate the membership according to the National Health Insurance Law or any other law. The termination of any members membership, as is stated in clause 7.4 above, is not followed by the automatic termination of the membership of a minor or of anyone unaccountable by law. The termination of an Insureds membership is however followed by an immediate termination of their membership in each one of the SIs programs. The termination of an Insureds membership in Meuhedet Adif is followed by termination of their membership in Meuhedet See.
8.
8.1
Members Payments
The Meuhedet See SI program rates (hereinafter: Monthly Payments), as are detailed in Appendix A, are determined by Meuhedets management, as subjected to the permits required by law. The monthly payments are determined according to the Insureds age and their family status as registered in Meuhedet (single/family). A member transferring from one age group to a higher age group will pay according to the accepted rate for the new age group. Meuhedet is entitled to determine a family rate, which would be updated from time to time. The family rate which applies to the family of the insured will be determined according to the age of the older spouse. Meuhedet is entitled to bill a new member for a registration fee, as subjected to the required permits, by virtue of the National Health Insurance Law. In the event that the insured cancels their membership in the program, the registration fee would not be returned to them. The insured is obliged to pay all the monthly fees required for themselves and their children, every month or once every stated period; all as it is detailed in the Payments Table in Appendix A of these regulations. The said Payments Table will be updated from time to time, according to that which is stated in clause 8.6 hereinafter. Given that the monthly payments have been collected in a concentrated manner from the employer, it constitutes the fulfillment of that which is stated in clause 8.4 above. At the same time, this manner of collecting does not exempt the insured from the liability in any case, in which the membership fees have not been paid by the employer. The Insureds payments will be updated once every two months according to the rise in the Consumer price Index or the Health Costliness Index; the highest of the two. Meuhedet is entitled, by an authorization of the Minister of Health, to alter the Insureds rights in the SI program from time to time and their payments.
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8.2
8.3
8.4
8.5
8.6 8.7
Chapter A
8.8 8.9
Monthly payments that were moths overdo, will be paid with interest attached to the Costliness of Livelihood Index. The insured who is in debt due to unsettled payments for themselves and their families, for a period of four months and over, will have their rights temporarily terminated, and a clarifying notice will be sent stating that if the debt will not be paid within 60 days of the notice having been sent (Hereinafter: Notification Period), their membership in the program will be permanently terminated. 8.9.1 Given that the insured has paid their entire debt within the notification period, with the extra interest as is stated above, they will be entitled to continue their membership in the program with all the rights. For the period of termination, the insured will only be entitled to an indemnity, given that such a privilege exists by virtue of these regulations. Given that the insured has not settled their entire debt during the notification period, their membership will be permanently terminated at the end of the notification period, as subjected to the right for a hearing, as stated in clause 7.4.2 above. Meuhedet will be entitled to sue the insured for the unpaid debt, including the collection expenses.
8.9.2
8.10 Failure to collect the monthly payments from the Insureds bank account due to reasons depending upon the bank or upon some other third party; do not exempt the insured from the responsibility of settling their debts in Meuhedets offices. 8.11 In the event of a human error performed in good faith causing the bank to continue to bill Meuhedets insured for membership fees even after their membership had been terminated by their own initiative, the insured will be refunded the entire sum that had been mistakenly collected from them, plus interest attached to the Costliness of Livelihood Index. The insured and their family will have no rights, by virtue of this regulations, during the period following the membership termination even if they had paid the membership fee for it, as stated above.
9.
9.1
Betterment of the Health Maintenance Organizations damage and recourse to a third party Double Insurance
In any case an indemnification duty exists towards the Insured by virtue of any agreement whatsoever, due to a service included within this regulations, a liability will apply on Meuhedet in the rate of the relative part out of the entirety of plans or policies applying on the matter. Each Insured must upon filing an indemnification/service application by virtue of this regulations, to bring to the Certifying Authoritys knowledge if an indemnification duty
9.2
14
9.3
9.4
9.5
on part of any third party whatsoever, exists towards itself, including the existence of a private insurance policy at a commercial insurance company and/or of the existence of any other Supplementary Insurance whatsoever covering the subject medical service in whole or in part (Double Insurance). All that in an affidavit to be signed by it upon approaching to receive the service or indemnification. Additionally, an Insured must point to an Injuring Factor (if such exists) that caused the event due to which the Insured requires the medical service and to give all details known to it regarding the Injurer. In any case as provided in the foregoing Sections 9.1 9.2, Meuhedet will provide the medical service to the Insured. Meuhedet will condition the medical services provision or the indemnifications execution as provide in this Regulations, in that the Insured will empower Meuhedet by signing an irrevocable power of attorney, according to which Meuhedet is entitled to approach the insurance company or any other third party whatsoever, in the Insureds name, in order to settle the betterment of the monetary damage caused to it due to the medical assistances provision, all within the framework of the indemnification cap to which the Insured is entitled by virtue of any agreement/contract. Had an Insured directly received payment from any third party, including in insurance company, as indemnification due to expenses it had due to an Insurance Event, regarding which Double Insurance exists, the Insured is obligated to notify Meuhedet regarding same and to immediately transfer to Meuhedet its share due to the expenses caused to it due to the event. Had an Insured and/or its spouse refused to sign a power of attorney as provided in the foregoing Section 9.3, or failed to restore funds to Meuhedet, or it was retrospectively proven that it concealed information as aforesaid, it will not be entitled to the rights imparted to it by virtue of this Regulations. In parallel Meuhedet is entitled to take legal measures at its disposal against it including the provisions of the foregoing Section 7.4.
10. Restrictions on eligibility

10.1 Without derogating whichever of this Regulations instructions, Meuhedet will not be obligated to provide medical help/assistance and/or on coverage or indemnity due to medical expenses caused to an Insured due to an Entitling Event, which is included within This Regulations Medical Service Package, in each one or more of the following events: 10.1.1 If the service sought by the Insured according to this Regulations is linked to an additional entitlement of the member by virtue of the Road Accident Indemnity Act, the Defense Service Law, the Police Law Handicapped and Killed, the Prison Authorities Law - Handicapped and Killed, the Victims of Hostilities Indemnification Law, the National Insurance Law (Work Injured), the Invalids Compensation and Rehabilitation Law, the Invalids Nazi Persecution Law, the
15
Chapter A
Invalids War Against Nazis Law, the Zion Prisoners and their Families Indemnity Law, which entitle medical assistance upon the injury, and any other law entitled for medical assistance due to the injury. Had the entitlement been revoked according to that same law, the Insured will be entitled to medical services according to these Regulations. 10.1.2 If the Insured or whoever of its behalf acted with intention of fraud, provided Meuhedet with erroneous facts, or concealed facts/findings relating to the required medical service and to the Insureds eligibility by virtue of this Regulations. 10.1.3 If the Entitling Event had occurred as a result of activity in dangerous sports skydiving, gliding, diving, close combat or of sports activity of any sort in which framework an insurance obligation is imposed on the Insured, or on any sports organization and due to same whichever insurance program was not purchased by Meuhedet or the Insured, Meuhedet will condition the assistance provided by virtue of this Regulations in the Insureds signing of a power of attorney as specified in the foregoing Section 9.3. 10.1.4 An Insured will not be entitled for medical service and/or indemnification due to medical service that was provided to the Insured prior to commencement of its entitlement period in accordance to This Regulations or pursuant termination thereof.
11. General terms

11.1 All the Medical Services specified in Chapter B to This Regulations, are given to the Insured in the plan for as long as they are not included within the Basic Medical Service Package which obligates Meuhedet by virtue of the National Health Insurance Law. A Medical Service which is included within the plan and which will be added in the future to the legally binding Medical Services Package, will automatically be subtracted from the plan and Meuhedet will not be obligated to supply it within the plans framework. 11.2 When the need for Medical Service as included within this Regulations arises, the Insured must approach Meuhedets branch in his place of residence, whether by itself and whether by its proxy, for ascertaining of its rights and to provide the entire medical information and the documents required for handling of its request. 11.3 Meuhedet is entitled to conduct any examination or investigation for purpose of ascertaining its obligation according to This Regulations, all as it will find suitable, and subject to that the examination procedure will not hider the medical treatment of the Insureds by manner that may injure its health. 11.4 Meuhedet will be entitled to condition the execution of any payment to the Insured by virtue of its liability by force of This Regulations, in submission of documents and proofs
16
to its satisfaction, including anamneses, original invoices from service providers and original receipts for proof of any payment actually paid by the Insured due to the subject medical service. 11.5 Had an Insured which was found eligible for indemnification demised, prior to receipt of the indemnification due to it and it did not note a beneficiary, Meuhedet will pay the amounts to which the Insured would have been entitled due to receipt of the medical assistance to the legally determined inheritors or the manager of estate, subject to the provisions of This Regulations. 11.6 For avoidance of doubt, the entitlement for indemnification due to medical service according to This Regulations exists solely if the Insured had acquired and received a medical service which is included within those same services regarding which it was expressly noted in This Regulations that the Insured is entitled for indemnification due to their acquisition, and only in case the Insured fulfilled the terms stated in This Regulations as condition for the indemnifications receipt. 11.7 An Insured who extracted the waiting period according to this plan in relation to a specific service upon the time in which it was in the midst of receipt of a parallel service by virtue of its eligibility according to Meuhedet Adif regulations, its eligibility for indemnity/Self-Participation will be the more benefiting one of the two plans. 11.8 The Members rights by virtue of this Regulations are limited to services provided within the boundaries of the State of Israel solely, unless it was explicitly otherwise determined in This Regulations. 11.9 Meuhedet is entitled to update, to add or to subtract from the provisions of This Regulations and/or to terminate the plan provided that the addition, the subtraction or the plans termination were approved as required by the National Health Insurance Laws provisions, and were brought to the Insureds attention. 11.10 Updating of the monetary refund to the Insured table will be executed in accordance to the rate of the index rise upon the insurance fees updating dates. 11.11 For avoidance of doubt it is herewith clarified and agreed, that election of a treating physician or any other medical service provider under the Insureds initiative, without it receiving a referral and written and advanced approval on Meuhedets behalf, is being done according to its own accord, on its own account subject to This Regulations directives and under the Insureds full liability. Meuhedet is not liable to the quality of the medical service and to its consequences and to any corporal and/or mental damage to be caused to the Insured as a result of a treatment or service as aforementioned. 11.12 Meuhedet will not be committed to any promise, publication, statement and undertaking, not given by and out of Meuhedets initiative. 11.13 A notice sent to the Insured by Meuhedet to its last known address according to Meuhedets registrations will be considered as a notice duly delivered.
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Chapter A
12. An Insured staying Abroad for a prolonged duration

12.1 An Insured or whoever of its family members leaving Israel of their own initiative for staying Abroad, will not be entitled for coverage/indemnity by Meuhedet due to medical assistance they will receive, in time of need, in the duration of their stay Abroad. 12.2 Upon they period of their staying Abroad they must insure a health insurance for themselves and on their account through a commercial insurance company, with insurance rights as wide as possible subject to their health condition. 12.3 Safeguarding of the Insureds rights by virtue of This Regulations is conditioned by regular payment of the insurance fees for the duration of their entire stay Abroad.
13. Incidence
These regulations are effective as of the date of their publication they will apply on the entirety of the Insured who are eligible for medical assistance by virtue of This Regulations.
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Chapter B The Medical Services Package for Meuhedet Sees Insured

In this Chapter the Medical Services Package of Meuhedet See will be specified including the variety of examinations, treatments, surgeries and assistance to which the insured are entitled and additionally the eligibility terms will be defined as well as the manner of the services supply in each of the subjects included in the Package.
Surgeries 1. Treatments/Surgeries in private hospitals
An Insured is entitled to be hospitalized in a private hospital due to a medical service which is included with those specified in Appendix B to This Regulations. Additionally its right is reserved to choose a Treating Physician (as henceforth defined), all those with reasonable availability, under the terms and restrictions as detailed in This Regulations and subject to the agreements existing between Meuhedet and the service provider, all as will be henceforth specified. Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : Alternative Improved.
1.1 Definitions
In this Chapter the following terms will have the meanings listed opposite same: Hospitalization The hospitalization of an Insured in a hospital for purpose of receipt of medical treatment which is included within those to which it is eligible by virtue of This Regulations. Supportive Hospitalization The hospitalization of an Insured in a hospital or an institution which are intended for the hospitalization of patients who suffer from chronic or incurable diseases, who are acting on account of the Ministry of Healths license, and which main object is providing assistance by a fellow person to a patient who is incapable to function by itself, and medical treatment is not expected to improve its condition. Complex Supportive Hospitalization The hospitalization of an Insured who is suffering from a chronic disease of whichever type, that according to Meuhedets opinion requires receipt of daily medical assistance, and being under constant and prolonged medical observation in a hospital or in a ward intended for these patients and which is operating under the Ministry of Healths license.
19
Chapter B
The Medical Services Package for Meuhedet Sees Insured
Psychiatric Hospitalization The hospitalization of an Insured in a mental hospital which is operating according to the Ministry of Healths license for purpose of receipt of medical treatment due to a mental disease. Rehabilitative Hospitalization The hospitalization of an Insured in a rehabilitation ward and/or in a hospital intended for treatment of patients whose health condition may improve, who are suitable for rehabilitation and solely that the hospital is operating under the Ministry of Healths license and it has an agreement with Meuhedet. Hospital a hospital, including its medical and paramedical staff, operating within the State of Israels boundaries, operating under the Ministry of Healths license, and Meuhedet is engaged in an agreement with it (as specified in Appendix C). A Private Hospital A Hospital (as afore described) under private ownership. Medical Treatment Examination or conservative treatment of any type whatsoever, which is being executed within the framework of Hospitalization in a Hospital, in each of the fields specified in Appendix B to This Regulations. Private Institute An Institute under private ownership including a medical and/or paramedical staff, acting according to the law and equipped with appropriate medical equipment, which object is provision of a variety of medical services to the programs Insured, and solely that the Institute owners have a valid engagement agreement with Meuhedet and the Institutes name appears in Meuhedets Medical Services Books. Surgery Chirurgical action in each of the fields specified in Appendix B to This Regulations, which is being performed by open invasive manner or through an endoscope. Nursing Help, as its meaning in the Nursing Law, which main objective is provision of assistance by a fellow person to an ill individual in its home, who is unable to function by itself. Treating Physician a physician who by the virtue of its engagement in an agreement with Meuhedet, provides medical services to the plans insured, subject and in accordance to the provisions of This Regulations and solely that its name is included in the Authorized Physicians List as specified in Meuhedets Medical Services Books. The Certified Medical Services List the list of services specified in Appendix B to This Regulations, and which includes the variety of examinations, treatments, surgeries, and other services, to which an Insured is entitled by virtue of This Regulations. Rehabilitation Medical assistance which main objective is the improvement of the patients functional condition and its reinstatement as close as possible to the condition prior to its illness. PHS (Private Health Services) a Medical Service out of those specified in Appendix B to This Regulations, which is performed by a physician who was privately chosen by the Insured, within the framework of one of the public hospitals in Jerusalem in which such service is customary as specified in Section 1.5 henceforth.
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1.2 General
1.2.1 An Insured will be eligible for Medical Treatment as specified in Sections 1.3-1.5 henceforth, provided it reached 12 months of membership in the plan (Waiting Period), provided that the treatment is included within the Certified Medical Services List and subject to the agreements between Organization and service providers who have an agreement with Meuhedet. The Certified Medical Services List as specified in Appendix B to these regulations, constitutes an inseparable part of this Regulation, and constitutes the sole document obligating Meuhedet to the matter of the medical assistance offered to the Meuhedet See insured, by virtue of Section 1 to This Regulations. The coverage according to Chapters 1.3 and 1.4 henceforth, does not include implants inserted into the patients body during the surgery, except as provided in Section 1.6 henceforth.. The participation of Meuhedet See in the costs as specified in Sections 1.3-1.6 henceforth, substitutes Meuhedets participation, if exists, in the Services Package as defined by the National Health Insurance.
1.2.2
1.2.3
1.2.4
1.3 Acquisition of medical service at a Private Hospital through physicians engaged by an agreement with Meuhedet
1.3.1 An Insured who requires Surgery/Treatment included within Appendix B to This Regulations, which was certified by Meuhedet, is entitled to choose for itself a Private Hospital and a Treating Physician, out of the Private Hospitals list and out of the list of physicians having an engagement agreement with Meuhedet (Treating Physician). The list of physicians who are in the agreement is available to the Insured at Meuhedets branches and is updated from time to time. An Insured who requires surgery or treatment as aforesaid, must confirm prior to the surgery with Meuhedet and with the Treating Physician, the being of the physician authorized on Meuhedets behalf to perform the aforesaid surgery. Had the Insured chosen a Hospital and a Physician as aforesaid in Section 1.3.1, Meuhedet will cover the overall expense due to the Medical Treatment by direct payment to the Hospital, except for the self participation in the rate of 25% of the self participation as required according to Section 1.3 to the Meuhedet Adif Regulations, and solely that the Insureds self participation will not be diminished then NIS 100 and will not exceed NIS 800 per treatment. Expenses due to services rendered to the Insured according to its request, not in accordance to the agreements existing between Meuhedet and the service providers, who were not included within the Certified Medical Services List, such as:
21
1.3.2
1.3.3
1.3.4
Chapter B
hospitalization in a preferred room or ward, installation of radio, telephone or television nearby to the Insureds bed, nursing assistance by a private nurse and/ or special safeguarding (except that to which it is entitled by virtue of Section 18 to the Meuhedet Adif Regulations), all those will fully apply on the Insureds account.
1.4 Acquisition of Medical Services in Private Hospitals and Physicians not engaged by an agreement with Meuhedet
1.4.1 Had an Insured been hospitalized of its own initiative at a Private Hospital and it chose a private treating physician for itself who is not engaged by an agreement to Meuhedet and without prior coordination with the Certifying Authority, it must cover the entirety of hospitalization and treatment costs out of its own pocket. The Insured is entitled to approach with an application for indemnification due to the expenses as henceforth detailed: 1.4.1.1 Upon its release the Insured will approach the Certifying Authority in a request for Meuhedets participation in its expenses and will attach to its application: a. A detailed anamnesis. b. Original receipts regarding moneys it paid for acquisition of the medical assistance. 1.4.1.2 The Certifying Authority will examine whether the aforesaid surgery is included within the surgery list in Appendix B to the Meuhedet Adif Regulations and the Insureds entitlement for indemnity by virtue of this Regulations. If its entitlement was certified, Meuhedet will indemnify the Insured due to its expenses for the Hospitalization, including the surgeons and the anesthetists wages, up to a cap as specified in the Refunds Table available to the Insured in Meuhedets branches. The refunds amount according to this Section will be 20% higher then the refund amount to which an Insured is entitled due to identical service according to the Meuhedet Adif Regulations. Updating of the Refunds Table will be performed in accordance to the index rise rate upon the insurance fees updating date.
1.4.1.3
22
1.4.1.4
Meuhedet will not bear professional liability due to medical treatment acquired by the Insured without advanced consultation with it, as provided in Section 11.12 to Chapter A of This Regulations, that even if it received indemnification from Meuhedet due to its expenses for the aforementioned treatment.
1.5 Acquisition of medical services with the framework of PHS (Private Health Services) in a public hospital
15.1 An Insured who was operated on within the framework of PHS (Private Health Services) in the public hospitals in Jerusalem in which such service is customary (Hadassa, Shaarey Tsedek), and solely that the surgeon and the required treatment are included within the agreement between Meuhedet and the hospital, will be entitled for coverage of the entirety of the hospitalization costs according to the Ministry of Healths tariff, and additionally, to coverage of the expense due to the PHS by direct payment of Meuhedet to the hospital, subject to the Insureds self participation by a rate not exceeding 50% of the operations cost, of which the Insured would have been charged according to the hospitals tariff. The list of the services included in each one of the agreement will be brought to the Insureds attention, and in any case it will not be diminished then the Certified Services List in Appendix B to this Regulations. The updated participation rates will be available to the Insured in Meuhedets branches. 1.5.2 Had the Insured chosen to be operated on as aforesaid by a physician in one of the hospitals mentioned in Section 1.5.1, for purpose of a treatment or by a physician not included in the agreement, Meuhedet will cover the entire hospitalization cost by direct payment to the hospital according to the Ministry of Healths tariff, and will indemnify the Insured for 30% of its total expenditure due to the PHS acquisition, but no in excess of an indemnification cap of 3,000 dollars. Despite the provisions of the foregoing Sections 1.5.1 and 1.5.2, the indemnification due to acquisition of implants which are not in the services package by virtue of the National Health Insurance Law and due to which the hospital exercises legal collection based on a separate tariff, will be executed exclusively according to the provisions of Section 1.6 henceforth.
1.5.3
1.6 Implants
Meuhedet will indemnify the Insured in the rate of 85% of its expense due to Implants which it required during the surgery executed in a Private Hospital, or due to a surgery performed in a public Hospital as provided in the foregoing Section 1.5.3, and during which an Im23
Chapter B
plant which is not covered by virtue of the National Health Insurance law was inserted to the Insured. The eligibility will be limited to one entitling event per year and up to a cap of NIS 17,776 per year. All those provided that the Insured will present to Meuhedet medical documents and original receipts as required and subject to that the Implant was inserted to the Insured during a surgery that is included within the certified medical services list by virtue of this Regulations.
1.7 Restrictions
1.7.1 If in the course of an Insureds hospitalization in a Private Hospital, it will require, due to alteration of its medical condition, continuation of treatment in another suitable framework including Rehabilitative Hospitalization Complex Supportive, Ordinary Supportive, or Psychiatric, Meuhedet is entitled to locate an alternative treatment framework for it for it in a suitable institution. The Insured will be entitled for assistance on Meuhedets part, subject the provisions of the National Health Insurance Law. For avoidance of doubt it will be specified, that the medical services not included in Appendix B to This Regulations, will not entitle the Insured for any monetary indemnification whatsoever, whether it had acquired same in the framework of PHS or in a private hospital. The right according to this Section substitutes, as of the Waiting Periods end, the rights existent to the Insured by virtue of Section 1 of Chapter B in the Meuhedet Adif Regulations. Despite the aforesaid in Section 1.7.3, the Insured will be entitled to choose upon the Waiting Periods end which of the rights to realize due to each entitling event. Had the Insured chosen to realize its right to the an entitling event according to the basic package by virtue of the National Health Insurance Law, it will not be entitled for a right out of the rights specified in this Section, due to the same entitling event.
1.7.2
1.7.3
1.7.4
1.7.5
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2.
Plastic Surgery
Waiting Period: 3 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added.
2.1
Meuhedet See Insured will be entitled to undergo plastic surgery out of those specified in Section 2.2 henceforth in a Private Hospital connected with Meuhedet by an agreement and through a surgeon included in the agreement. The Insured will be required for a self participation in accordance to the type of surgery and hospital chosen by it, as condition for the services receipt. Henceforth are the types of surgeries and self participation due to them: 2.2.1 2.2.2 2.2.3 2.2.4 2.2.4 Nose surgery NIS 6,771 Small liposuction NIS 4,440 Large liposuction NIS 14,208 Breast lifting/reduction NIS 11,544 Breast augmentation NIS 7,992. for avoidance of doubt, the price does not include the implants cost. 2.2.6 Eyelid surgery NIS 7,992 2.2.7 Face and neck lift NIS 13,875 2.2.8 Laser depilation NIS 4,440 for single organ 2.2.9 Treatment for concealing varicose veins NIS 6,105 per foot 2.2.10 Treatment for prevention of palm/feet diaphoresis NIS 5,328.
2.2
2.3
2.4
The Insureds manner of payment will be in accordance to the existing agreement between Meuhedet and the service provider. The list of service providers who are connected to Meuhedet by an agreement for execution of the provisions of this Section will be placed at the Insureds disposal. For avoidance of doubt it will be clarified that an Insured will not be eligible for indemnification due to plastic surgery performed in another medical center, which is not connected with Meuhedet by an agreement for performance of the aforesaid surgeries.
3.
Supply of medication which is not included in Meuhedets Medication Package

25
Chapter B
The Economic Arrangements Law 2008 determined that the additional health services will not include life saving and life prolonging medication. Therefore the provisions of Section 3.1 to 3.5 will apply solely on Insured who joined the plan by 23.12.07 has henceforth: a. Insured who joined the plan prior to the 23/12/07 are entitled for coverage by virtue of Section 3 to the Regulations as its force upon 23/12/07 for duration of 24 months. The commencement of this period, is upon the termination of a 24 months waiting period from the date of their joining of the plan or on 1/1/08, according to the latter of them. Meuhedet See Insured to whom a medication was prescribed during their entitlement period will continue to be entitled for treatment continuity. Meuhedet See Insured in which all of these had fulfilled will be entitled for a discount upon medication purchase according to the provisions of Sections 3.2-3.3 henceforth. 3.1.1 The subject medication is not registered in Israel, or is not registered in the requested indication, and it does not have an alternative, in the medication package determined under the National Health Insurance Law and/or in the medication list in Meuhedet Adif . To this matter alternative medicinal alternative which, according to accepted medical standards, was intended to achieve the same medical outcome which is achieved by the requested medication, and solely that the treatment thereof does not involve bodily outcomes more severe for the patient. Confirmation was provided due to this medication as required in the Pharmacists Regulations (medical preparations) by virtue of the provisions of Section 29a(3) to same Regulations. The medication is intended for treatment cancer. A written recommendation for the use of this medication exists by a physician who is a Department Head or its deputy in a public hospital in Israel. The Insured was given a prescription by Meuhedets doctor who was certified to produce such prescriptions.
b.
3.1
3.1.2
3.1.3 3.1.4 3.1.5
3.2
An insured as aforesaid in the foregoing Section 3.1, will be entitled to acquire the medication via Meuhedets pharmacy. Meuhedets participation due to medication as aforesaid will be situated on the amount of NIS 2,000 per prescription or the maximal consumer price, whichever is the lower, and solely that the Insureds self participation will not be diminished then NIS 280 per prescription. To this matter Prescription prescription to a medication intended for the Insureds use in the duration of a period not exceeding one month. Had the Prescription been intended for a period exceeding one month, the Insureds and Meuhedets participation will be increased by the relative suitable rate.
26
3.3
3.4
3.5
If during the use of a medication as aforesaid in the foregoing Section 3.1.1, the medication was included in the package by a manner entitling the Insured of its receipt in Meuhedets financing within the basic packages framework (including with the Insureds self participation), Meuhedet will cease its participation by virtue of this Section. For avoidance of doubt, medication which is limited for acquisition at a certain site and was purchased by the Insured at another site, and also medication purchased by the Insured according to a prescription which is not Meuhedets, does not entitle the Insured to any discount or refund. The Insureds rights according this Chapters provisions come in addition to the entitlement by virtue of Chapter 3 to the Meuhedet Adif Regulations and they are limited to one preparation and one treatment indication in the entire insurance term, without limitation of the use period and for as long as the provisions of the foregoing Section 3.1 are fulfilled. The Insureds right to receive medication approved according to this Chapters provisions, will remain in force even if it was registered in the preparation registry for the requested treatment indication after the initial date in which it was given to the Insured according to this Chapters provisions and for as long as the remainder of terms provided in the foregoing section 3.1 are fulfilled, according to the matter.
Medical Treatments Abroad

4. Medical Consultation prior to electing of a medical center Abroad
Waiting Period: Waiting Period not required. The services essence in relation to the eligibility according to Meuhedet Adif : added.
Localizing of a consulting factor abroad

4.1 A Meuhedet See Insured requiring to its opinion requiring treatment or consultation abroad due to its medical condition, will be entitled to receive from Meuhedet a list of 3 medical centers abroad who are suitable for treating its medical condition and additionally the names of 3 physicians abroad who are experts on the relevant treatment realm to its medical condition, including details regarding the manner of communicating these physicians. The Insured will not be required to pay any self participation due to the service specified in the foregoing Section 4.1.
4.2
27
Chapter B
Receipt of the Consultation

4.3 An Insured as aforesaid who withstands Section 4.4s provisions henceforth and who will elect to consult with one of the medical centers or doctors abroad with whom Meuhedet is engaged by an agreement, will be entitled to receive the consultation abroad from Meuhedet, all that with self participation of NIS 111 per consultation. The eligibility is up to three opinions for the entirety of the membership term. The aforesaid is conditions in that the requirement for consultation emanates out of one of those: 4.4.1 4.4.2 4.4.3 4.4.4 4.5 There is recommendation by an oncologic advisor on Meuhedets behalf. There is concern for requirement of an open heart surgery or brain surgery. There is requirement in implantation of one of the following organs: heat, liver, bone marrow, lungs. Disease (not due to accident) requiring the amputation of a limb.
4.4
4.6
4.7
Had it so happened and in the subject field it is not possible to receive a medical opinion from one of the medical centers abroad which whom Meuhedet is engaged in an agreement and the Insured was acknowledged as entitled to receive a second opinion abroad by virtue of This Regulations, the Insured will be entitled for indemnification in the rate of 85% of its actual expenses for receipt of the opinion from another medical center and up to a cap of NIS 5,500. The indemnification will be given due to the advising physicians fees expenses and due to expenses of dispatching of the medical material abroad. The provisions of the foregoing Section 4.5 is subject to that the giver of the second opinion is a senior expert in the required field and subject to approval received from the professional authority in Meuhedet. The Insureds rights according to this Sections provisions are added to its eligibility by virtue of Section 6.2 of Chapter B to the Meuhedet Adif Regulations but an Insured will not be allowed to add its rights by virtue of the two plans in relation to the same consultation.
5.
Surgeries Abroad According the Insureds Choice

5.1
Meuhedet See Insured who according to the opinion of the professional factor at Meuhedet requires a surgery out of those specified in the National Health Insurance Law, and which are routinely performed in Israel, will be entitled to perform the operation in one
28
5.2 5.3 5.4
5.5
of the medical centers engaged by an agreement with Meuhedet, without self participation. Had the Insured chosen another medical center, Meuhedets participation cap will be limited to a rate of 150% of an identical surgery performed in Israel according to eh Ministry of Health Tariffs. The Insureds eligibility as aforesaid is limited to one surgery in the insurance period. To this matter, the Ministry of Health Tariff according to the updated Ministry of Healths general managers circular true to the day of the surgerys performance. For avoidance of doubt, it will be clarified that the confirmation of the Insureds eligibility for the surgerys performance abroad according to this Section, does not entitle the Insured for accompaniment expenses according to Section 5.8 of the Meuhedet Adif Regulations. Passengers insurance for abroad 5.5.1 It is herewith clarified that an Insured going abroad by virtue of Sections 4 and 5 aforementioned and those accompanying same are imposed with the duty to purchase a passengers insurance policy for themselves covering the entirety of their period of staying abroad, in order to insure themselves by a health and baggage insurance which are not included amongst Meuhedets liabilities according to this Regulations. The aforementioned insurances premium will apply on the Insured and on the companion, and Meuhedet will not be liable for any coverage whatsoever, full or partial, of the aforementioned expenses.
5.5.2
Novel Treatments
6. Anti Aging Treatments
Waiting Period: 6 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. Meuhedet See Insured will be eligible for discount in performance of anti aging treatments in a medical center dealing in this field and which is engaged in an agreement with Meuhedet. The Insured will be entitled to receive the variety of treatments as specified in the agreement between Meuhedet and the Institution. The treatments list as well as the list of institutions engaged in an agreement with Meuhedet will be available to the Insured in Meuhedets branches. The discounts rate will be 30% off the suppliers ordinary price list and up to a cap in the sum of 2,000 dollars due to one annual treatment series for the entire insurance period.
29
Chapter B
7.
Shock Waves Treatments

7.1 7.2
7.3
Treatment by shock waves is intended for crushing of joints sclerosis (shoulder, elbow), attendance to cases of a spur in the feet, and sclerosis of tendons. An Insured will be eligible to undergo a series of up to 4 treatments for the entire insurance period in accordance to the treating physicians determination at one of the centers specializing in this treating method and which are engaged in an agreement with Meuhedet. The list of institutions in the arrangement will be available to the members at Meuhedets branches. An Insured as aforesaid in the foregoing Section, will be entitled to receive the aforesaid treatment with self participation according to the type of treatment required. The members self participation will be limited to 50% of the suppliers ordinary price list and not to exceed NIS 500 per treatment.
8.
Periodic Survey Examinations

Waiting Period: Waiting period not required. The services essence in relation to the eligibility according to Meuhedet Adif : added.
8.1
8.2
An Insured whose age is over 18 years will be entitled according to its decision to execute once every two years, a series of periodic survey examinations, even if no medical circumstances requiring the performance of such examinations according to the National Health Insurance Law exist in it. The examinations will be performed in one of these: 8.2.1 8.2.2 Meuhedets infirmaries intended for same. Infirmaries connected with Meuhedet by an agreement.
8.3
8.4
The examinations performance at Meuhedets infirmaries is conditioned by the insureds self participation in the amount of NIS 222 for the entire examinations series. Meuhedet will bring to the Insureds attention the list of infirmaries supplying the service as aforesaid. Had an Insured been referred to an institute connected with Meuhedet by an agreement Meuhedet is entitled to charge the Insured for payment of the entire cost directly to the service supplier. In such an event the Insured will be entitled for indemnification in the rate of 75% of the expense and up to a cap of NIS 444 for the entirety examination series.
30
8.5
The examination series will include: Physicians examination, general urinalysis, blood tests (hematology + chemistry) lung functions test and ergometric test.
9.
Oncogenetic Examinations
Meuhedet See Insured will be entitled to perform by one time manner and in accordance to a geneticist physicians recommendation a test for discovery of breast cancer, large intestinal cancer and/or ovarian cancers carcinogenic genes which are not included in the service package according to the National Health Insurance Law. The test will be performed in public hospitals or in an institution connected with Meuhedet by an agreement and provided that recommendation for same exists by a physician who is treating the Insured on Meuhedets behalf. The test will be executed subject to payment of self participation in the amount of NIS 200 for each test.
10. Laboratory Services at the Insureds Home

Waiting Period: Waiting period not required. The services essence in relation to the eligibility according to Meuhedet Adif : added. 10.1 Meuhedet See Insured that a professional factor at Meuhedet determined has to perform a blood test, will be entitled to perform the blood test through a doctor or nurse on Meuhedets behalf, which will be dispatched according to telephone invitation, to its home or to its place of employment according to its choice. The Insured will be able to receive the lab tests outcomes at the computerized information stands existing at the branch, or through the medical secretariat at the branch. 10.2 Due to an examination performed at a site chosen by the Insured as aforesaid, the Insured will be charged self participation of NIS 50. Same will paid upon the occasion of the blood sample drawing.
Life style
11. Nutritional Consultation
Waiting Period: Waiting period not required. The services essence in relation to the eligibility according to Meuhedet Adif : added.
31
Chapter B
11.1 An Insured will be entitled, even if it is not entitled for same according to the National Health Insurance Law, to receive nutritional consultation by a consultant connected to Meuhedet by an agreement. 11.2 An Insured will be entitled for counsel as aforesaid in the scope of two meetings per year and with payment of self participation of NIS 22 per meeting. The meetings referred to in this Section are in addition to its entitlement according to Section 30 of Chapter B in the Meuhedet Adif Regulations.
12. Workshops and courses

Waiting Period: Waiting period not required. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured will be entitled to a 50% discount off the ordinary tariff or NIS 389 per course (the lower of the two) for purpose of participation in courses and workshops in the following areas: reducing weight, childbirth preparation and stopping to smoke and solely that same take place within Meuhedets framework and/or with suppliers connected by an agreement thereto. Meuhedets participation as aforesaid is limited to 2 courses per calendar year. The price list will be published in Meuhedets infirmaries.
13. Rehabilitation exercise pursuant myocardial infarction

Waiting Period: 6 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : Alternative Improved. 13.1 An Insured who underwent a severe myocardial infraction, that requires according to an expert physicians instruction to engage in controlled physical activity at an authorized institution and under medical supervision, will be entitled for Meuhedets participation in the amount of NIS 152 per months due to this expense for a sequential 9 months period (in excess of its eligibility according the National Health Insurance Law) and provided that it commenced the physical activity as aforesaid within 6 months of the occurrence. 13.2 As of the date of the waiting period termination the eligibility according to Section 13.1 substitutes the existing eligibility by virtue of Section 25 to Meuhedet Adif regulations.
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Consultation
14. Second Opinion In Israel
Waiting Period: 6 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : Alternative Improved. 14.1 An Insured seeking a second opinion in Israel, will be entitled as henceforth: 14.1.1 If the counseling physician is engaged by an agreement with Meuhedet, for provision of consultation services within its field of expertise and its name appears in Meuhedets service guide, of if the counseling physician is amongst the expert physicians amongst those acting within PHS Hadassa and solely that same are connected to this matter by an agreement with Meuhedet, the Insured will receive a second medical opinion without any self participation. 14.1.2 When the counseling physician is not connected by an agreement with Meuhedet as henceforth specified, and the Insured approached it under its initiative and on its account, the Insured will be indemnified for 85% of the expense for the Second Opinion acquisition and solely, that the indemnification will not exceed NIS 556 and provided that the opinion was given by a person being an Expert Physician in this Section an Expert Physician a person included in the counseling experts list. This list includes the physicians recognized until 28.6.09 and expert physicians will be added to it according to the committee for acknowledgment of expert Physicians decision for purpose of this Section, according to the committees procedure as certified by the Ministry of Health. The Committee is also authorized to remove physicians off the list. The list will not include physicians who are connected with The United Health Maintenance Organization by an agreement for provision of medical services which are offered to the entirety of Insured by virtue of the package as defined in the National Health Insurance Law, except for the medical departments top advisors at Meuhedet. The lists composition will be available to the Insured at Meuhedets branches. 14.1.3 All the aforesaid will be executed under approval of the certifying authority at Meuhedet, in exchange for delivery of original receipts and medical documents.
33
Chapter B
14.2 Restrictions
14.2.1 An Insured is entitled to receive service/indemnification as aforesaid in Sections 14.1.1-14.1.2 aforementioned, due to up to 4 additional medical opinions in total in the duration of one calendar year. 14.2.2 Medical treatment of which a factor as specified in Sections 14.1.1-14.1.2 had recommended will be given subject to approval on part of the professional authority in Meuhedet. 14.2.3 Had an Insured received an opinion and treatment recommendation that is not accepted to the senior professional authority in Meuhedet in this field, and it had decided to nevertheless execute the treatment, the Insured will bear the treatments costs and the liability for its outcomes. 14.2.4 As of the termination of the waiting period the insureds eligibility according to this Section replaces its eligibility according to Section 6 to the Meuhedet Adif Regulations and solely that if in the duration of that same calendar year the Insured used its eligibility according to the Meuhedet Adif Regulations the consultations it received within the framework of Meuhedet Adif will be counted as part of the quota referred to in this Section.
Child Treatment
15. Treatment of nightly enuresis
Waiting Period: 3 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. 15.1 Meuhedet See Insured requiring treatment of nightly enuresis according to a physicians determination, will be entitled to receive same within the framework of Meuhedets clinics for alternative medicine as provided in Meuhedet Adif Regulations, but in case behavioral treatment was executed for purpose of the aforesaid problems solution by a therapist not engaged by agreement with Meuhedet, the Insured will be entitled for refund of 35% of the expenses and up to NIS 667 for one series of up to 4 treatments for the entirety of the insurance period. 15.2 The rights according to this Section are added to the Insureds rights according to Section 13 to the Meuhedet Adif Regulations, but an Insurer will not be entitled to join its rights by virtue of the tow plans due to the same treatment.
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Pregnancy and Birth

16. Early discovery of congenital defect of fetuses
Waiting Period: 6 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. 16.1 Fetal system scanning ultra sound An Insured who is member of Meuhedet See is entitled according to her choice for an early ultrasound beyond the eligibility according to the package. An ultra sound as aforesaid, will be provided once each pregnancy in the clinics and institutes engaged by an agreement with Meuhedet, and with the Insureds self participation of NIS 110 per examination, and subject to that recommendation of a gynecologist on behalf of Meuhedet exists for same. Had the Insured chosen to execute the scanning in another institution, she will be entitled for indemnification of 50% of the actual expense and up to a maximal amount of NIS 361 (the refund includes the counseling given within the systems scanning framework). 16.2 Had the Insured chosen to execute the scanning to which she is entitled according to Section 14.2 of Meuhedet Adif Regulations, in an institute/clinic not engaged by an agreement with Meuhedet, she will be entitled for indemnification of 50% of the actual expense and up to a maximal amount of NIS 361 (the refund includes the counseling given within the systems scanning framework). 16.3 Restrictions 16.3.1 Meuhedet is not liable for the failure to early discover congenital anomalies following examinations performance as provided in the foregoing Section 16.1, that due to the limitations existent in early discovery of some of the fetal congenital anomalies using the equipment existent at Health System. 16.3.2 Had a pregnant Insured chosen to receive medical assistance as provided in the foregoing Section 20.1 and did so according to her own accord, responsibility and account, without first receiving Meuhedets approval, she will not be entitled for any indemnification whatsoever from Meuhedet due to the expenses caused to her in the matter. 16.3.3 An Insureds rights by virtue of the foregoing Section 20.1 are added from the end of the Waiting Period to the eligibility by the virtue of Section 14.2 to Meuhedet Adif Regulations.
35
Chapter B
17. Blood of the umbilical cord

Waiting Period: 6 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. Meuhedet will participate in the expenses of taking, keeping and preserving the umbilical cord blood for a parturient insured at Meuhedet See, through a vendor who is engaged by an agreement with Meuhedet. The Insureds participation will not exceed 50% of the ordinary tariff of the service provider and up to an overall cap of NIS 2,200 for the entire insurance period, and solely that same will not exceed 15 years.
Recuperation and Recovery

18. Recovery after a complex operation
Waiting Period: 3 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : Alternative Improved. 18.1 An Insured on which was performed a brain surgery, stomach surgery, heart transplant or another operation (except for cosmetic plastic surgery and operations in the obstetrics field), requiring hospitalization exceeding 10 consecutive days, will be entitled for indemnification for the entire expense and up to a cap of NIS 361 for each day of recuperation in an institution which is intended for same, for a period not exceeding 7 consecutive days pursuant the surgery. 18.2 After a severe myocardial infraction, the Insured is entitled to 12 recuperation days (including the recuperation days approved by virtue of the National Health Insurance Law) in an institution engaged by an agreement with Meuhedet and which is intended for rehabilitation and recuperation of heart patients and post operation of a heart transplantation operation, up to a maximal cap of 21 recovery days as aforesaid, and all pursuant the Insureds release from hospital. The participation of an Insured as aforesaid will be limited to a cap of NIS 222 per day, for each additional recuperation day beyond the basic package eligibility. 18.3 The Insureds eligibility as provided in the foregoing Section 4.1-4.2 is subject to that the requirement for recovery was acknowledged in advance by the certifying authority in Meuhedet, and that the Insureds departure for recovery occurred immediately pursuant its release from the hospital or proximate to same (up to the 14th day pursuant its release).
36
18.4 The Insured is obligated to present to the certifying authority with the hospital release letter and original receipts, specifying the name of the person staying at the institution, the recovery days and the cost for the Insured. 18.5 The Insureds eligibility according to this Section substitutes as of the end of the Waiting Period, its eligibility for recuperation expenses pursuant to a complex operation by virtue of Section 9 to the Meuhedet Adif Regulations.
Additional Services
19. Treatment of hemorrhoids and fissure
Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured requiring treatment of hemorrhoids or fissure according to the determination of a physician treating it on behalf of Meuhedet will be entitled to receive the treatment in a private institution engaged by an agreement to Meuhedet. The Insured will be entitled for a discount of 35% off the ordinary tariff of that same provider or indemnification of 70% and not in excess of NIS 3,700 and all according to an agreement made between Meuhedet and the supplier.
20. Treatment of sexual malfunction

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured requiring treatment due to sexual malfunction will be entitled to receive the treatment at a private institution engaged by an agreement with Meuhedet. The Inured will be entitled for discount 35% off the ordinary tariff of that same provider or NIS 56 per treatment (the lower of the two) that, up to 25 treatments for the entire insurance period.
21. Therapeutic riding; Hydrotherapy; music, art and animal therapy

Waiting Period: 12 months from the day of joining the plan. A child, not yet 12 years old, who requires, according to determination of the physician treating it on Meuhedets behalf, therapy out of those mentioned in the foregoing heading, according to the determination of the certifying authority in Meuhedet (a regional physician or whoever was certified by same), will be entitled for indemnification of 75% off and up to NIS 94
37
Chapter B
per treatment. The total treatments in all the realms jointly during the entire insurance period will not exceed 24 treatments. A child, as afore defined, who suffers from a problem related to the child development field and who received indemnification, as afore said, the treatments due to which it received the indemnification will be counted to the number of treatments of which it is entitled by virtue of Section 19 of the Meuhedet Adif Regulations directives.
22. Cesarean Section

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. Women already having 3 children will be eligible upon childbirth of the fourth child and on to an indemnification of 50% of the expense and not more then NIS 2,778 due to a Cesarean Section being performed within PHS framework at the Hadassa Medical Center.
23. Food substitutes not included in the health benefits package

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. A baby up to two years old, who is insured in the plan, will be entitled for a discount of 25% 40% from the consumer price upon purchase at Meuhedets pharmacy, of food substitutes which are required according to the determination of the physician treating the baby on Meuhedets behalf (the amount of discount in accordance to the type of substitute required), and solely that the substitute is amongst the substitutes list which is authorized by Meuhedet. The aforesaid is limited to situations in which according to the aforesaid physicians opinion the food substitutes included in the health benefits package do not correspond to the babys needs. Meuhedets participation according to this Section is limited for a duration of 6 accumulative months.
24. Treatment of snoring and sinusitis

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured suffering from the above conditions will be entitled to receive the treatment with a private supplier connected to Meuhedet by an agreement. The Insured will be eligible to a 35% discount of that same suppliers ordinary tariff or NIS 278 (the lower of the two).
38
25. Rehabilitation of sports injuries

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured will be eligible for rehabilitation following a sports injury, at Meuhedets institute which is certified for treating of these problems. The Insured will be eligible to receive, according the determination of the treating physician on Meuhedets behalf, up to 20 appointments per year with self participation of NIS 44 per treatment.
26. Child development

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. A child 3-9 years old who is eligible by virtue of the National Health Insurance law for the services included upon the child development realm and who extracted the treatments quote to which it is eligible by virtue of the National Health Insurance Law and by virtue of Meuhedet Adif regulations, will be entitled for a supplement of up to 15 treatments per year (in all treatment realms altogether) with self participation of NIS 24 per treatment.
27. Nuchal translucency screening

Waiting Period: months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. A Meuhedet See Insured who is pregnant (even if it is not a multi fetal pregnancy) is entitled between the weeks 11-14 of her pregnancy to undergo a Nuchal translucency screening and solely that the screening is being executed in an institute engaged with Meuhedet by agreement and in consideration of the Insureds self participation of NIS 94. Where no supplier engaged with Meuhedet by agreement exists, the Insured is entitled to undergo the screening in another institute and to receive monetary refund of 75% of the expense and up to NIS 417.
28. Doctors house visitations

39
Chapter B
An Insured requiring doctors services during the night hours when Meuhedets infirmaries are closed and/or on Saturdays and the Jewish holidays, will be able to order a doctors visit at its home through a service supplier engaged to this matter with Meuhedet by an agreement. The Insured will pay self participation of NIS 27 in consideration of the visit.
29. Dental transplantation

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured requiring dental transplantation will be entitled to perform the transplantation at Meuhedets dental clinic supplying this service upon a 35% discount off Meuhedets ordinary tariff due to the transplantation. The Insureds eligibility according to the aforesaid is limited to 4 transplants per membership period.
30. Diagnosis of Attention Deficit Disorders (ADD)

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. Children aged 5-18 years suffering from Attention Deficit Disorders who underwent diagnosis by a psychiatrist or a pediatric neurologist on Meuhedets behalf will be entitled to a one time examination for purpose of specific diagnosis of Attention Deficit Disorders (Tova tests) with the Insureds self participation of NIS 194.
31. Alternative medicine

Waiting Period: 12 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif : added. An Insured who extracted the annual treatment quota in Meuhedets clinics as aforesaid in Section 13.2 to Meuhedet Adif Regulations will be entitled for a series of 18 additional treatments with a 40% discount off the ordinary price.
32. Parturient recuperation

Waiting Period: 6 months from the day of joining the plan. The services essence in relation to the eligibility according to Meuhedet Adif: improved.
40
32.1 A Parturient is entitled to leave for recuperation pursuant childbirth, in an institution intended for recuperation, and solely that she has two children. All that provided that the leaving for recuperation was prior to the termination of a months time from the date of the release of the parturient/newborn (the later of the two) from the hospital. 32.2 The Parturient will be entitled for indemnification of 75% from the actual expense for each full recuperation day, up to an amount of NIS 222 per day. All that for a maximal period of three days and all in consideration for delivery of the maternity hospital release certificate and original receipts attesting of the sums paid to the convalescent home or the motel.
33. Childrens dental treatments

Waiting Period: 6 months from the day of joining the plan. 33.1 A child aged 0 to 12 years will be entitled for conserving teeth treatments (as henceforth detailed), for no payment whatsoever, in Meuhedets dental clinics. These treatments include: Annual checkup Photography which is executed in the clinic Dental assistants treatments (once every six months) Fillings Pulpotomy Pulp capping Tooth extractions Root canal treatments Primary dental crowns This coverage does not include anesthesia costs (sedation and/or general anesthesia) in case required for the treatments execution. 33.2 Insured registered in a branch which is in excess of 30 Km from the dental clinic in which the services as provided in Sections 33.1are available will be entitled for refund due to treatments, to be executed in private dental clinics and which are included within the foregoing Section 33.1. The Insureds entitlement as provided in Section 33.2 is subject to that the treatments were approved in advance by the certifying authority at Meuhedet. The amount of indemnification will not exceed NIS 777 per year.
41
Appendix A
Monthly payments*
Age group 0-24 25-29 30-39 40-49 50-59 60-69 70-79 From 80 and up According 1/5/2009 (after discount of up to 25%) Notes: a. The price noted in the table is for each insured person, according to its age. The debit due to children up to 18 years old in an insured family is limited to three children. The fourth child and onward without payment. b. The monthly payments above specified are after giving of a discount in the rate of 5% to those paying through standing order, credit card or centralized collection. c. For those paying by payment vouchers the payment is executed at all Postal Bank branches across the country or at the Organizations offices. d. Meuhedet See constitutes an additional layer for Meuhedet Adif . Therefore, the tariffs afore mentioned are in addition to payments due to Meuhedet Adif . e. Regular payment of the insurance fees is precondition for realization of all the rights reserved for the SI programs subject to the Regulations provisions. f. Arrears in insurance fees payments as aforesaid, causes impingement of the Insureds rights up to cancelation of their membership in the plan, as specified in the Regulations Section 8. Monthly premium in NIS 11 29 35 51 64 80 99 107
42
Updating of insurance fees

Meuhedet See insurance fees are updated in accordance to the Consumer Price Index published by the Central Bureau of Statistics or the Health Costliness Index, the higher of the two (base index the index known on the month of April 2004). Additionally the insurance fees are updated in accordance to the services package contents and the actual cost of the variety of medical services included within the Meuhedet See services package and based on an actuary calculation performed once per period, and subject to the Ministry of Health certification. Registration fees: Registration fees to the program: NIS 20.
43
Appendix B
List of medical services provided in the framework of private hospitals/PMS for insured Meuhedet See
Orthopedics
Fibula Tibia Reconst. Osteotomy Osteotomy + Fixation Fushion between joints of fingers Exostoses bone growth Exostectomy Exostoses of the meniscus Exostoses of head of radius Acromioplasty (shoulder) Diagnostic arthroscopy Treating arthoscopy Arthroplasty shoulder Bone biopsy Open biopsy bone Open biopsy femur/soft tissues Knee arthrotomy Knee reconstruction ligaments Debridement of joint + synovectomy Dyslocation finger correction Discectomy disc extracting Lumbar disectomy Neck discectomy Lengthening of tendons Extracting screw wire Extracting spine tumor Extracting bone fixation Hallux Valgus unilaterally Hallux Valgus bilaterally Transplantation of knee joint without cement Transplantation hip joint without cement Finger amputation Laminosectomy Joint/wrist synovectomy Drainage touched foot or angle Hand surgery Foot surgery Spinal surgery no discectomy Corrective surgery Hammer toe Scoliosis back rectification Fixation vertebrae sacrolumbar Ankle arthrosis Release tendons trigger finger Release tendons joint Relase spinalic narrowing Release nerve Release carpel tunnel (CTS) Amendment ganglion anesthesiology Amendment tennis elbow
Eyes
Astigmatism (relaxing incisions) Exchange eye fluids (vitrectomy) Cornea transplant /+ extracting cataract + lens Laser treatment (Yag post capsulotomy)
44
Trabeculectomy laser treatment Iridectomy laser treatment Iridectomy (glaucoma) Onuclation with/without implantation Exstoses pterygium
Cornea transplant Inferior cataract (local or general anesthesia) Chalazion Laser break treatment (Lasic or Acsimer only in case of clear anisometropia)
Eyelid surgery to correct ptosis Removel touched- veroca/papilloma Posterior vitrectomy Repair extraocular muscles
Nose Ear Throat

Drainage sinuses endoscopic + spetum FESS Drainage sinusesdouble sided endoscope FESS Adenoids + buttons double sides Extracting adenoids Adenoids for children Ears drainage abscesses or hematoma Exostoses/biopsy Biopsy of ear receiver Bronchoscopic Neck dissection Extraction touched from mouth and/or frinks Turbinectomy amputating tonsils Turibinectomy nose caves + spetum Turibinectomy/conectomy Tympanoplasty Buttons Buttons + tonsils + adenoids Cutting parotid glands Cutting saliva gland under jaw Laryngoscopy Laryngoscopy general anesthesia Laryngoscopy biopsy Miringotomy francesty of timpani membrane Maistodectomy Caves nose Coldwell Lock drainage abscesses/cyste floor of the mouth tonsils and adenoids surgery Stepdactomy, ocecolplasty Polecptomy nose/ outer ear Release tong tie Tonsils cutting
Surgery
Large exsotoses Exsotoses rectal polyp Exsotoses/demolition touched skin/ underskin Artery Venus (A-V) fistula dialyse Biopsy lymph vessels and gland Amputating ecsailair gland Amputating lymph glands Extracting foreign item generel anesthesia Amputating lymph/cyste Lowering testikels Hemeocolectomy Reducing size stomach Abdominalhernia incisional POVH Double sided hernia
45
Surgery
Hernia diaphragm Navel hernia Navel hernia child Hernia crotch famural Hernia crotch day hospitalization Hernia crotch at children Surgery extracting veins from legs varicosis Cutting hemorrhoids anesthesia Cutting gallbladder Cutting gallbladder through laproscopy Left hemycolectomy Cutting stomach Cutting appendix Complete cutting thyroid Laproscopy diagnostic Colon surgery Stomach and small intestines surgery Closing fistula A-V (diabetic patients) Removal cyste Symptomatic Pilonydel sinus cutting Pilonydel cyste (exsotoses) removal Fiss. Ani Fistolectomy anus Parianeli abscesses opening Corrective laproscopy hernia femur/ Hingu Corrective laproscopy hernia femur/ Hingu Du
Chest surgery
Amputating lung lobe or lump Amputating lung Mediastinoscopy Exploring chest opening
Neurosurgery
Creaniotomy Streotcasis diagnostic/surgical Head surgery for entering valve into the brain rooms
Vascular surgery
Angioplastic catheterization PTA endoretractomy - crotis vein Artery Venus (A-V) fistula Bypasses (medium vessles and/or large)
46
Breast surgery
Amputation lump in breast (Lumpectomy) Amputation breast double sided Reconstruction breast double sided Amputation beast and lymph notes Amputation breast + reconstruction one side Geneacosmetic surgery (subject approval medical department) Reconstruction breast after amputation due cancer one sides
Urology
Correction hypospadium + advancement High ligation hydraucel/varicucel Amputation prostate Retro/supra pubic Orthrotomy Biopsy testicles Increasing urethra / myatotomy Lowering testicle Alignment bent penis baby Radical amputation prostate Testicle amputation Testicles amputation Amputation whole kidney (nephrectomy) Amputation prostate through testicle TURP Removal stone +/crushing by orthroscopy Removal urethra tissue/lump Cystoscopy Tying seed vein Mincing stone through lithotripter TURT Correction hypospedias/afisped simple
Gynecology
Orthropacy retrophoby Histroscopy diagnostic Histroscopy treatment Histroscopy correction ligaments Enlarging vagina Endometrial destruction vestibulectomy Laser treatment full anesthesia Partial amputation vagina Amputation external tumor/ condiloma general Amputation external tumor/ condiloma local Amputation putty laprascopic surgery Amputation innate myoma through vagina Amputation polyp cervix Amputation uterus through vagina Amputation uterus abdominal Amputation uterus + correction tearing Amputation uterus + ovaries Amputation ovaries Diagnostic laprascopy
47
Gynecology
Laprascopy and histoscopy Myomactomy Laproscopic surgeries Correction trumpets Cystocel/rectocel Colfory posterior/anterior Ovary gouging cyste Correction urine leakage at women (lifting bladder) Correction urine leakage through tape TVT Cerclage Sawing tear cervix uterus
Skin
Excosis by name of Mohs
Heart
Bypass surgery Valve changing Catheterization diagnostic Catheterization treatment
Neurology
Decompression periphery nerve (neurolosis)
Plastic
Plastic correction
The insured has the obligation to inquire at the secretariat of Meuhedet prior the surgery, which surgeons and private hospitals are associated by agreement to the Kupa for performing the requested surgical activities and what are the conditions required for refund/participation from Meuhedet.
48
Appendix C
List of private hospitals associated by agreement to Meuhedet To perform surgery by a surgeon in an agreement with Meuhedet
Name hospital Eliysha Haifa City Address Yair Cats 12, Har HaCarmel, Zipcode 34636 Sd. Menahem Begin (Calaniot center) HaGvura 3 Telephone 04-8389121 Fax 04-8389121
Asuta Ashdod
Ashdod
08-8677122
08-8677200
Asuta Ashkelon
Askelon
08-6738725
08-6747625
Asuta Beer Sheva
Be'er Sheva
Herzel 91 Bat Etzion
08-6279911
08-6291426
Asuta Haifa
Haifa
Canyon Lev HaMifratz, 3rd floor
04-8810600
04-8810631
Asuta Petah Tikwah
Petah Tikwah
Shpigel 3, bldg Mercaz Hair
03-9053535
03-90535305
Asuta Rishon LeZion
Rishon Lezion
Mazal Eliezer 13 new ind. Area
03-9631631
03-9631666
Asuta Tel Aviv
Tel Aviv
HaBarzel 20, Ramat HaHayal, Zipcode 69710 Hazkiyehu HaMelech 27
03-7644000
Surgical center Jerusalem Mishgav Ledech Herliya Medical center HMC
Jerusalem
02-5637684
Herzliya Pituah
Ramot Yam 7, Zipcode 46100
09-9592555
09-9592919
Horev
Haifa
Horev 15, Zipcode 41600
04-8305222
04-8341279
49
Name hospital M.R.B.
City Bat Yam
Address Sd. Haatsmeout 67, Zipcode 59315 Yehuda HaLevi 36, Zipcode 76534
Telephone 03-500888
Fax 03-5075764
Medili
Rechovot
08-9415268
08-9416891
Medica Beer Sheva
Beer Sheva
Medic Center Beer Sheva
Beer Sheva
Medical center Ramat Aviv
Tel Aviv
Brodetsky 43 canyon Ramat Aviv
03-6421511
03-6401284
NERA Ramat Gan
Ramat Gan
Natanya Medical center
Natanya
Haim Levanon 1 Nave Itamar
09-8848444
08-8841224
Senist
Tel Aviv
Reiness 18, Zipcode 64381
03-522571
03-5239821
Important note: Not all hospitals are licensed to perform all operations from the list specified in appendix B of these regulations. A situation is possible where a hospital is not authorized to perform any operations except in certain limited areas. The Meuhedet reserves the right to periodically update the agreement with the hospitals. The insured has the duty to inquire with the secretariat of Meuhedet before surgery, which of these private hospitals are under agreement with Meuhedet required to perform surgical operation by surgeons in an agreement with the Meuhedet and what are the conditions of participation of Meuhedet.
50
List of medical centers abroad

Contacting of medical centers will be done through Meuhedet
Sick Children Hospital Toronto Canada New York University Medical Center Downstate Medical center brooklin New York The Mayo clinic Minnesota Mount Sinai Medical Center Miami Shandes Medical Center Florida The Florida Hospital Orlando Florida Herman Memorial Hospital Houston Texas Texas Heart Institute Saint Luke Episcopal UCLA Medical Center Los Angeles Stanford University Medical Center California Montefiore Albert Einstein Medical Center New York Columbia Presbyterian Medical Center New York Mount Sinai Hospital New York Memorial Sloane Kettering New York* Temple University Medical Center Philadelphia The Cleveland Clinic Foundation Baylor University Medical Center Dallas Texas Tulane Medical Center New Orleans The Ochsner Foundation New Orleans Germany Essen University Medical Center The North Westfalia Heart Center Bochum University Medical Center The Gamma Knife Center Kerfeld The Leonardis Oncology Clinic Mnchen Germany Hannover University Hospital (ISMETT) affiliated with Pittsburgh University Medical Center, USA Deutches Hezzentrum Berlin Kings College Hospital London
Authorized hospitals according the agreement for providing a second opinion only (section 6.2 of chapter 2 of regulations (Meuhedet Adif )
Important note: Not all hospitals are licensed to perform all operations from the list specified in appendix B of these regulations. A situation is possible where a hospital is not authorized to perform any operations except in certain limited areas. The Meuhedet reserves the right to periodically update the agreement with the hospitals. The insured has the duty to inquire with the secretariat of Meuhedet before surgery, which of these private hospitals are under agreement with Meuhedet required to perform surgical operation by surgeons in an agreement with Meuhedet and what are the conditions of participation of Meuhedet.
51
Appendix D
List of drugs for insured Meuhedet See Drugs with discount up to 85% of the consumers drug price:
ACAMOLI COLD SYR* AKNE MYCIN PLUS SOL* ALENDRONATE TEVA 70 MG* BUSPIROL TAB* CELCOX 100 MG* CELCOX 200 MG TAB* CICLODERM CR SOL* CICLODERM C CREAM* CODIVIS CAP* DURACEF SUSP CAP* EAR CLEAR* ELOCOM CR* ELOCOM OINT* ELOCOM LOT* ESKAZOLE 400 MG* ESTELLE 1,2* FML DROP* FUCICORT CREAM* FUCITHALMIC* FUNGIMON PWD* GARGOL SOL* GINGISAN LIQ* GINGISAN OINT* HAFIF 10 LOT* HAVRIX 1440 VIAL* HAVRIX 720 JN* HEMO OINT* HEMO SUPP* LIPANOR CAP* LOGIMAX TAB* LUSTRAL TAB* NAROCIN TAB* NERVEN DRG* OKACIN SOL* OPTIMA TAB* OPTIMA BEST* PEVISONE CREAM* PROCTOFOAM FOAM* RHINOLAST SPRAY* ROACCUTANE CAP* SALIKAREN OINT* SIMICOL TIPTIPOT* SORBON 5 MG 10 MG 15 MG* SUPRAN SUSP* TILAVIST DROP* VALTREX 500 MG TAB* VARILRIX* VENORUTON GEL* VITA MERFEN OIN 20 GR* VITAMIN B12 1 MG 100 TAB*
52
Drugs with insured discount of 50% of the consumers drug price:

ACAMOL TSIN CLAS.D21+N13C ACAMOL TSINUN 35 DAY+NIG14 ACTIVELLE 28 TAB* ACTONEL ONCE 35 MG 4 TAB ADAFERIN GEL 30 GR ADVIL 200 MG 20 CAP ADVIL 200 MG 40 CAP ADVIL 200 MG 80 CAP ADVIL CHIL FRUIT 100 MG/5 ADVIL CHIL GRAPE 100 MG/5 AERIUS 5 MG 15 TAB* AERIUS SYRUP SYR 0.5 MG/ML* AGISPOR 1% 100 ML AGISPOR ONYCHOSET OIN ALDARA CRM 5% 12 SACHETS 1 AMARYL 1 MG 30 TAB 1 AMARYL 2 MG 30 TAB 1 AMARYL 3 MG 30 TAB 1 ANDROGEL 50 MG SAC ARTHREASE 10 MG/2 ML 3 PR 1 AURICULARUM PWD 300 MG* AVODART SOFT 0.5 MG 30 CAP BABYZIM DRO BATRAFEN NAIL LACQUER 80 BENZAC-AC GEL 2.5% 60 GR BENZAMYCIN GEL 20.3 GR CARBOSYLAN (24+24) 48 CAP* CILOXAN DRO 0.35% 5 ML* 1 CIPRALEX 10 MG 28 TAB CLEAREX 10% COLORLESS 1 CLEAREX 2% LOTION CLEAREX 5% COLORLESS 1 COMAGIS 15 CRM 15 GR* COMAGIS 7 CRM 7 GR* CONCERTA 18 MG 30 TAB 1 CONCERTA 36 MG 30 TAB 1 CRINONE 8% 15 APPLIC 1 CURATODERM OIN 4 MCG/GR 20 CYCLOMED 5% CRM DAIVOBET OIN 30 GR DAIVONEX CRM 50 MCG/GR 30 G*1 DAIVONEX OIN 50 MCG/GR 100*1 DAIVONEX OIN 50 MCG/GR 30 G*1 DETRUSITOL 1 MG 56 TAB 1 DETRUSITOL 2 MG 28 TAB 1 DETRUSITOL 3 MG 56 TAB 1 EFEXOR XR 150 MG 28 CAP 1 EFEXOR XR 75 MG 28 CAP 1 ELIDEL CRM 1% 15 GR ELIDEL CRM 1% 30 GR EVOREL CONTI 8X1 PATCH EVOREL SEQUI 4X2 PATCH EYECON EYE DROPS (20) FEMINET 21T 1,2 FEMINET 63 T 1,2 FELDENE GEL 0.5% 50 GR* FEMINET 21 TAB2 FEMINET 63 TAB FOSALAN ONCE WEEKLY 70 MG GYNO-TERAZOL 0.8% CRM IMITREX NASAL SPR 0.5% 2L1 IMITREX REFILL PACK 6 MG1 IMITREX STARTER PACK INJ 1 INSU NOVOMIX 30 INSULIN HUMALOG MX25/751 KALGARON CHERRY LEM SPR 6 KALGARON FORTE 24 TAB KELO-COTE LAMISIL 250 MG 14 TAB1 LAMISIL CRM 1% 15 GR LANACORT 1% CRM LARIAM 250 MG 8 TAB LIVIAL 2.5 MG 28 TAB MENCEVAX ACWY 1DX 1
53

MERFEN SPRAY NCH MIDRO TEA NARAMIG 2.5 MG 4 TAB 1 NASCOBAL FOR 2MONTH SPR 2 NOVONORM 0.5 MG 90 TAB1 NOVONORM 1 MG 90 TAB 1 NOVONORM 2 MG 90 TAB 1 OMNIC 0.4 MG 30 CAP 1 ORTHOVISC 30 MG/2 ML PRS 1 OXY 10 LOT 10% 29 ML OXY 5 LOT 5% 29 ML OXY 5 TINTED LOT 5% 20 ML OXY COVER LOT 10OZ PERMIXON 160 MG 60 CAP 1 PINK BISMUTH 30 TAB PRIODERM 1% 40 GR NCH - PROCTO WIPES NCH - PROCTO WIPES PROCURE 5 MG 28 TAB 1 REDUCTIL 10 MG 28 CAP REDUCTIL 15 MG 28 CAP RELENZA 5 MG 20 DIS RUBLEX D SPR 180 ML* RUBLEX MASSAGE CRM 80 GR* SPORANOX 100 MG 14 CAP 1 TAMIFLU 75 MG 10 CAP TERBINAFINE 250 MG 14 CPS 1 TIGER BALM OINT-WHITE 1 1 - TIGER BALM OINT STR TILOPTIC XE 0.25% GEL 1 TILOPTIC XE 0.5% DRO 1 URIKAL. SAC 1* VAGIFEM 0.025 MG 15 VAT VENORUTON 500 MG 30 TAB XANAX XR 0.5 MG 30 TAB XANAX XR 1 MG 30 TAB XANAX XR 2 MG 30 TAB ZIDOVAL 0.75 % GEL 1 ZORAC GEL 0.05% 15 GR 1 ZORAC GEL 0.1% 15 GR 1 ZOSTRIX 0.025 % CRM ZOSTRIX HP 0.075 % CRM

ACAMOL TSI LIQ 30+10 40C AFALPI TIPTIPOT 15 MG/ML ALDOLOR TIPTIPOT DRO 100M ALRIN KIDS 0.025 % SPR ALRIN SPRAY 15 CC ANTISTIN PRIV EYE DROPS ARCOXIA 120 MG 7 TAB ARCOXIA 60 MG 10 TAB ARCOXIA 90 MG 10 TAB BECOZYM FORTE 20 TAB BEN GAY 4 OZ OINT BEN GAY OINT 1.25 OZ BEN GAY OINT 2 OZ
54
BEN GAY ULTR.STR.4OZ OINT BEN GAY ULTRASTRENGTH CRM BEPANTHEN LOT 200 ML BEPANTHEN PLUS CRM 30 GR CALAMANERVIN TAB 20 CIALIS 10 MG 4 TAB CIALIS 20 MG 4 TAB CIALIS 20 MG 8 TAB DESITIN 2 OZ OINT DESITIN OINT 1.25 OZ DESITIN OINT. 4 OZ EBIXA 10 MG 56 TAB EVISTA 60 MG 28 TAB
EVRA 1X3 PAT EZETROL 10 MG 30 TAB FEMULEN 84 TAB FUNGIMON POWDER 30 GM GENTEAL EYE DRO GYNERA 21 TAB GYNERA 3 X 21 TAB HARMONET (NEO) 21 TAB HARMONET 3X21 (NEO) 63 TAB HYPOTEARS E 30X0.4ML SOL IOPIDINE 0.5 % SOL 1 KALGARON FRUIT MIX 24 TAB KALGARON LEMON 24 TAB KALGARON MINT 24 TAB KALGARON ORANGE 24 TAB KALGARON STRAWBERRY 24 TAB KIDDI SYR LEVITRA 10 MG 4 TAB LEVITRA 20 MG 4 TAB LEVITRA 5 MG 4 TAB MEDIJEL GEL 15GR MERCILON 21 TAB MERCILON 3X21 TAB MICRODIOL 1 STRIP X 21 T. 2 MICRODIOL 3 STRUPS X 21 T MICROGYNON 63 TAB MINESSE 28 TAB (NEO) 28TA MINESSE 84 TAB (NEO) 84T MINOXI 2 2 % SPR MINOXI 2 WOMEN 80 ML MINOXI 2 WOMEN X 2 BOXES MINOXI 5 5 % SPR MINOXI 5 X 2 BOXES MINULET (NEO) 21 TAB 2 MINULET 3X21 (NEO) 63 TAB MUCOLIT TIPTIPOT 75 MG/ML NEOGYNON 21 TAB NICORETTE 18 10 MG/DOSE I NICORETTE MINT 2 MG 30 TA
NICORETTE MINT 2 MG 90 TA NICORETTE MINT 4 MG 30 TA NICORETTE MINT 4 MG 30 TAB NORDETTE TAB 38 X 3 NUROFEN COLD & FLU 24 TAB NUROFEN LIQUID 20 CAP NUROFEN LIQUID 40 CAP OKACIN. SOL 3 MG/ML 5 ML 1 ORTHO-CYCLEN 21 TAB 2 ORTHO-CYCLEN 63 TAB OXY PADS MAXIMUM 1 OXY PADS SENSITIVE 1 POLYTAR LIQ 150 ML PROTOPIC OIN 0.03% 30 GR PROTOPIC OIN 0.1% 30 GR REDOXON 1GR 10 TAB REFRESH 30X0.4 ML REGAINE FEMALE REGAINE FEMALE X 2 REGAINE FORTE SOL 5% 60 ML REGAINE FORTE X 2 RENNIE DIGESTIF 48 TAB RENNIE DIGESTIF 96 TAB RITALIN LA 40 MG TAB 1 RITALIN LA 20 MG TAB 1 RITALIN LA 30 MG TAB 1 SONGHA NIGHT 30 TAB STREPSILS HONEY LEMON 24T STREPSILS LEMON&HERB TAB STREPSILS PLUS 24 TAB STREPSILS VIT C SUPRADYN N 10 TAB THYROGEN INJECTION 1.1MG TRIDERM CRM 15 GR TRINORDIOL 28 28 TAB TRINORDIOL 28 X 3 84 TAB UNISOM 25 MG 8 TAB VIAGRA 100 MG 4 TAB VIAGRA 100 MG 8 TAB
55

VIAGRA 25 MG 4 TAB VIAGRA 25 MG 8 TAB VIAGRA 50 MG 4 TAB VIAGRA 50 MG 8 TAB VISCOTEARS GEL VSL3. LACTIC ACID BACTERIA XENICAL 120 MG 84 CAP YASMIN 21 TAB ZOVIRAX CREAM DMC 2G P CR Remarks: Drugs included in this Annex shall be provided in the pharmacy of Meuhedet. Drugs which are marked with an asterisk (*), discount available for purchase in the pharmacy of the Meuhedet and in private pharmacies associated with Meuhedet by agreement. Drugs which are marked in 1 require approval of a specialist. Drugs which are marked in 2 approved for women age 20 and over only.
56
Appendix E
List of medical accessories and medical equipment for the insured Meuhedet Adif and Meuhedet See
Accessories Prosthesis External breast prosthesis (in case there is no coverage from the Ministry of Health) Prosthesis sex organ in case of impotence (through its medical instructions and approval of the medical department only) Maximum participation of t he insured - $75 Eye ball (in case there is no coverage from the Ministry of Health) Scleral lenses for the eye 50% 50% Participation rate of insured
50% 50%
Essential medical accessories Belts for use of crotch crack in abdominal wall* (one a year) Orthopedic foot support by size and by special ordering (twice a year) Elastic stockings for pregnant women and those suffering from blood vessel diseases (by prescription) VARILIND Orthopedic equipment for stabilization joints/fractures/fractures prevention treading/partial treading (once a year) Contact lenses, only in case of disease of the front chamber Inhalator for asthma or C.F. patients including humidifiers (recommendation of lung physician) Wig (after chemotherapy/oncology
Participation rate of insured 50% 50% 50%
Supplier Internal pharmacy only Agreement supplier Internal pharmacy only
Maximum participation of Meuhedet
452 NIS
50%
Agreement supplier
$600
50% 50%
Internal pharmacy only Internal pharmacy only
$600
50%
Agreement supplier
1,357 NIS
57
Essential medical accessories Wig (after chemotherapy/oncology) Inhalator for asthma or C.F. patients including humidifiers (recommendation of lung physician) Glucometer or piercer* Device for measuring blood pressure* Sunglasses for albinos (once a year) and glasses not included frame for suffering of astigmatism higher than 7 Orthopedic shoes, special order, aimed for equivalent lower extremities or height adjustments (twice a year) Walking shoes set Any kind of orthopedic belts not restricted by age (once a year) Voice amplifiers for larynx victims Earplugs after transplantation drum buttons Telescopic glasses for adults (above 18 years) Feeding button for babies Strip or abduction device for babies Pressure bandage Hearing device (above 18 years)
Participation rate of insured 50% 50%
Supplier Agreement supplier Internal pharmacy only
Maximum participation of Meuhedet 1,357 NIS
50% 50% 50%
Internal pharmacy only Internal pharmacy only Agreement supplier $500
50%
Agreement supplier
$250
1500 NIS 50% 50% 50% 50% 50% 50% 15%
Epos Agreement supplier Agreement supplier Agreement supplier Agreement supplier Agreement supplier Agreement supplier Agreement supplier/ central warehouse
One in three years
$750 $80 $750 $175 $100 $750
For insured Meuhedet Adif maximum participation for eligible member by law up to 2,270 NIS per ear
* Will not be given if purchased at private pharmacy. ** The refund amounts mentioned in NIS will be periodically updated according the raise of the index on the date of updating of premiums.
58
Accessories CPAP device* (not included in cases in which the indication is snoring problems) Oxygen supply, including balloons and/or oxygen generator Facility to create oxygen will be purchased by the Meuhedet/Fund (with the approval of the medical department) and will be given for usage to the patient. The device will be returned to the Meuhedet after usage Paragon pump bags and bags for KANGURO Urine bags Phanurose (accessory to transport urine into a collection for men) Purchase of bladder catheter for emptying the urine poli-catheter silicone catheter Accessory used by patients with Penile barrel to ensure proper airflow to the lungs Accessories for inhalers (once a year) Accessories for sprinkling insulin pumps Plugs for tear pipes
Participation rate of insured 50% 0% 15%
Supplier Agreement supplier Agreement supplier Agreement supplier
15% 0% 0% 0% 50% 15% 15% 15% 50%
Internal pharmacy Internal pharmacy Internal pharmacy Internal pharmacy
Central warehouse Internal pharmacy Internal pharmacy or agreement supplier Agreement supplier
* Participation of the Meuhedet beyond the entitlement by law is limited up to 1,778 NIS Remark: For the avoidance of doubt, the discount rate on the list of this appendix is the maximum participation of the Meuhedet by law, the insured is not entitled to cumulative discount discount Meuhedet Adif is also embodied in the discount by law.
59
Waiting Periods Table

Waiting Periods for the different rights within Meuhedet See framework*
With no Waiting Period Medical consultation prior to choosing a medical center abroad Periodic survey examinations Laboratory Services at the Insureds Home Nutritional counseling Workshops and courses Plastic surgery Medical accessories Oncogenetic examinations Treatment of nightly enuresis in children Nuchal translucency screening Recovery after a complex operation Anti Aging treatments Shock Wave treatments Rehabilitation exercise pursuant myocardial infarction Second Opinion in Israel Early discovery of congenital defect of fetuses Blood of the Umbilical Cord Free dental care for children 0-12 years old Surgery / treatments in private hospitals Acquisition of medical services within PHS framework Implants Treatment of hemorrhoids and fissure Treatment of sexual malfunction Hydrotherapy treatment Music and art therapy Caesarean Section within PHS framework (birth of fourth child) Participation in funding food substitutes not included in the health benefits package Treatment of snoring and sinusitis Rehabilitation of sports injuries Child development Doctors house visitations Dental transplantation Diagnosis o Diagnosis of Attention Deficit Disorders (ADD) Alternative medicine Therapeutic riding Supply of medication not included within the Organizations Medication package Surgeries abroad according the Insureds choice
Three months' Waiting Period
Six months' Waiting Period
Twelve months' Waiting Period
24 months' Waiting Period
*Waiting Period: A consecutive period, as noted in the Table, as of the month of joining Meuhedet See and up to the date upon which the Insured is entitled for extraction of its rights by virtue of Meuhedet See Codex. Attention should be paid to that there is no impingement whatsoever in the rights it accumulated as Meuhedet Adif member prior to joining Meuhedet See, in case same joining was performed upon a later date.
60
For Notes
61
For Notes
62
For Notes
63

Meuhedet See Regulations

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Meuhedet See Regulations

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Meuhedet See Regulations

The Supplementary and Comprehensive Health Insurance

Medical Treatments Abroad

Pregnancy and Birth

Recuperation and Recovery

Regulations for the Meuhedet See additional medical services program

Regulations for the Meuhedet See additional medical services program

Definitions and interpretation

Regulations for the Meuhedet See additional medical services program

Regulations for the Meuhedet See additional medical services program

Membership in the Meuhedet See Program

5.2 5.3 5.4 5.5

Regulations for the Meuhedet See additional medical services program

The Membership Commencement, its Termination or Renewal

Regulations for the Meuhedet See additional medical services program

10. Restrictions on eligibility

Regulations for the Meuhedet See additional medical services program

11. General terms

Regulations for the Meuhedet See additional medical services program

12. An Insured staying Abroad for a prolonged duration

Chapter B The Medical Services Package for Meuhedet Sees Insured

Surgeries 1. Treatments/Surgeries in private hospitals

The Medical Services Package for Meuhedet Sees Insured

The Medical Services Package for Meuhedet Sees Insured

The Medical Services Package for Meuhedet Sees Insured

Supply of medication which is not included in Meuhedets Medication Package

The Medical Services Package for Meuhedet Sees Insured

3.1.3 3.1.4 3.1.5

Medical Treatments Abroad

Localizing of a consulting factor abroad

The Medical Services Package for Meuhedet Sees Insured

Receipt of the Consultation

Surgeries Abroad According the Insureds Choice

5.2 5.3 5.4

The Medical Services Package for Meuhedet Sees Insured

Shock Waves Treatments

Periodic Survey Examinations

10. Laboratory Services at the Insureds Home

The Medical Services Package for Meuhedet Sees Insured

12. Workshops and courses

13. Rehabilitation exercise pursuant myocardial infarction

The Medical Services Package for Meuhedet Sees Insured

Pregnancy and Birth

The Medical Services Package for Meuhedet Sees Insured

17. Blood of the umbilical cord

Recuperation and Recovery

20. Treatment of sexual malfunction

21. Therapeutic riding; Hydrotherapy; music, art and animal therapy

The Medical Services Package for Meuhedet Sees Insured

22. Cesarean Section

23. Food substitutes not included in the health benefits package

24. Treatment of snoring and sinusitis

25. Rehabilitation of sports injuries

26. Child development

27. Nuchal translucency screening

28. Doctors house visitations

The Medical Services Package for Meuhedet Sees Insured

29. Dental transplantation

30. Diagnosis of Attention Deficit Disorders (ADD)

31. Alternative medicine

32. Parturient recuperation

33. Childrens dental treatments

Updating of insurance fees