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Individual care at home

Long Term Nursing Care Benefit from the National Insurance Institute as Part of the Long Term Care Law

Matan Healthcare Services was selected by the National Insurance Institute to provide services as part of the government’s Long Term Care Law.  The Long Term Care Law was legislated in April of 1986 and it determines the eligibility for long term nursing care and/or a long term nursing care benefit granted to  Israel’s senior citizen population in the community.

What long term nursing care services are provided as part of this law?

The government long term nursing care law offers a basket of services to nursing care patients that is provided by private companies or associations.  These services include: assistance from a caregiver at home to perform daily tasks, management the household, supervision of the caregiver in the patient’s house, providing disposable products for incontinence, care at daycare centers and supervision using panic buttons.

Who is eligible to submit a request for a long term care benefit?

Seniors who require the assistance of others in performing daily tasks or services and supervision to prevent situations of danger to themselves or others and who meet the following criteria:
  1. A senior Israeli resident who has reached retirement age - age 67 for men and 64 for women.
  2. A senior who is in considerable need of assistance from others in his daily functioning:  dressing, bathing, eating, going to the bathroom and mobility and/or a mentally frail senior who requires supervision.
  3. A senior whose income exceeds the sum set down in the protocol (the sums are updated on the National Insurance Institute).
  4. A senior who does not receive an allowance for special services from the National Insurance Institute or an assistance benefit from the Ministry of Finance or Defense.
  5. A senior who meets the  National Insurance Institute’s Dependency Test.
  

How is Eligibility Determined for the Long Term Nursing Care Benefit?

 
Only the National Insurance Institute determines eligibility for the long term care benefit and its scope in terms of weekly hours.  In addition to meeting the criteria, by virtue of the law, the National Insurance Institute will conduct a personal evaluation at the senior’s home to assess his situation and his need for assistance in performing daily tasks.  The test is called the Dependency Test and it consists of an interview, an assessment of the medical condition, reading the medical history and current medical report, etc.  The Dependency Test is administered to the senior by a nurse who is sent by the National Insurance Institute, after 2 weeks from the time the request is submitted.  The test examines the senior’s competence in a number of categories:  bathing, dressing, mobility, eating, bladder and sphincter control and a need for supervision.
 
The National Insurance Institute will determine whether the senior is eligible for the long term nursing care benefit based on the results of the test and the state of his functioning and not the medical condition.  If the senior is found eligible, the National Insurance Institute will assess his economic income and subsequently will determine the scope of the nursing care services to which he is entitled, based on the A.D.L. -Activity Daily Living Scale, which determines the percentage of the benefit:
  • 100% benefit, eligible for 9.75 weekly hours
  • 150% benefit, eligible for 16 weekly hours
  • 168% benefit, eligible for 18 weekly hours
 
Determining the services to which the senior is eligible is handled by the local professional committee.  This committee includes social workers from the local social services, a nurse from Kupat Holim and a claims official from the National Insurance Institute.  The committee determines the services for the senior and also the service providers and supervises the providing of services.
 
For more information, visit the National Insurance Institute website.
 
 

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