Managed Care Insurance
Managed care policies offered by private insurance companies provide a a complementary level of coverage o the supplementary managed care plans offered by the National Health Plans (“kupot”). Typically they will make up the payments not covered by the kupot and may not be limited to a set time period.
Managed care insurance provides payments to assist with the high costs of nursing home or home-based nursing care. The number of people aged 70 years or over in Israel is expected to double over the next two decades to 1.24m people in 2035. In order to be eligible the insured must be in need of another person in order to perform activities of daily living which are known as ADL’s. The ADL’s are:
- Ability to move from bed or chair
- Bathing and showering (washing the body)
- Dressing
- Self-feeding (not including chewing or swallowing)
- Functional mobility (moving from one place to another while performing activities)
- Toilet hygiene (completing the act of urinating/defecating)
Policies will typically require proof of inability of a defined number of ADL’s before allowing for payments. However typically there are override provisions; mental impairment such as Alzheimer’s disease can qualify on its own regardless of ADL ability. The ability to perform “half” of a ADL is typically defined as the ability to perform the ADL. Policies are regulated by the Insurance Commissioner and various definitions and provisions of policies require approval.
Managed care policies provide peace of mind in knowing that future needs at advanced ages are taken care of while assets are protected.