There are several prominent insurance companies in Israel. Each offers different insurance policies and has different attitudes towards the trans community. Private insurance can help cover the expenses involved in gender-affirming treatments, and can also assist with payment for medications, hormones, consultations for surgeries, and surgeries or procedures.

This article will go over the important things to note when purchasing medical insurance and making use of the policy.
Note that this article does not constitute medical or legal advice.

Purchasing Private Insurance

Many different types of private insurance can assist when medical procedures are not included in the drug formulary covered by the HMO, or if HMO coverage is not enough for one’s needs. It is important to note, however, that the public healthcare system is supposed to provide trans people with relevant healthcare, and it isn’t necessary to use private insurance.

However, public healthcare can sometimes create obstacles in the path of receiving adequate care, which is why buying private health insurance when possible can save a lot of time on the path to gender-affirming care or other medical treatments, and can save money when turning to private healthcare options.

Before purchasing private insurance, it is recommended to compare prices and make sure that you are purchasing a policy that covers all of the things you may need, such as:

• Surgery in Israel (for example, private top surgery in Israel)
• Surgery abroad (for example, private bottom surgery abroad)
• Medications

Important points before purchasing insurance:

• It is important to purchase insurance before starting medical transition.
  After medical transition has begun, the insurance company will exclude medical procedures related to medical transition from the insurance policy (as a previously known condition). It is worth consulting with the insurance company regardless, as there may be certain situations in which it is possible to receive approval for coverage after starting medical transition.
• Waiting period – private insurance has a waiting period which can vary in length from one company to another, but is usually several months. You cannot use the private insurance during the waiting period, you will need to wait until the end to start any processes with the insurance. Therefore, it is important to purchase insurance early enough before you will need to make use of the policy.
• Double insurance – before purchasing private insurance, it is recommended to check what insurance coverage you already have to avoid double insurance situations. This can be checked on Har HaBituach website.

Using Private Insurance

The process of using private insurance usually involves payment via the insurance company, or private payment and an insurance claim later on. To make sure the insurance company approves the claim, it is important to note:

1. The private insurance policy must include a clause that covers surgeries in Israel (if you wish to have surgery in Israel) or abroad (if you wish to have surgery abroad). Note that gender-affirming surgery is not considered cosmetic surgery, and the insurance company cannot deny coverage with that reasoning. If an insurance company denies your claim due to that reasoning, you can contact community organizations for assistance.
2. Different insurance companies work with different providers. That is, they have a list of surgeons and doctors that they work with. If your surgeon isn’t on the list of covered providers for your insurance, you may need to write a letter explaining your choice and obtain special approval.

Insurance claims can be submitted through the website of the insurance company. The required documents may vary by company. Some of the documents usually required are:

• A letter from your Primary Care Provider confirming your gender identity and stating that there is no objection to undergoing surgery.
• A letter from a psychologist/psychiatrist confirming your gender identity and that you are mentally capable of making the decision to undergo surgery.
• A letter from a specialist if needed (if other medical conditions necessitate it).
• Insurance forms (available on the insurance company website).

After the claim is approved, you can undergo surgery with the private surgeon.

For further reading about private health insurance on Kol-Zchut website.