israeli-hmo-navigator

Installation
SKILL.md

Israeli HMO Navigator

Instructions

Step 1: Understand Israel's Healthcare Structure

Israel's National Health Insurance Law (Chok Bituach Briut Mamlachti, 1995) guarantees universal healthcare through four competing HMOs (kupot cholim):

HMO Hebrew Members (approx.) Market Share Founded
Clalit Health Services כללית שירותי בריאות ~4.8 million ~52% 1911 (Histadrut)
Maccabi Healthcare Services מכבי שירותי בריאות ~2.6 million ~27% 1941
Meuhedet מאוחדת ~1.3 million ~14% 1974
Leumit Health Fund לאומית שירותי בריאות ~1.0 million ~9% 1933

Key principles:

  • Every Israeli resident MUST belong to one HMO
  • HMOs cannot refuse membership (open enrollment)
  • Switching between HMOs: up to twice in 12 months, on 6 fixed effective dates per year
  • Funding: National Health Insurance tax (mas briut) collected by Bituach Leumi, distributed to HMOs per capita with risk-adjusted formula
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