All the information and answers regarding the Long-Term Care Benefit

WHO IS ELIGIBLE TO RECEIVE THE LONG-TERM CARE BENEFIT?

The Long-Term Care Benefit is a benefit for older adults, funded by the National Insurance Institute. The benefit is provided to men and women above retirement age who live in their own homes and need assistance in performing activities of daily living or require supervision.
The purpose of the Long-Term Care Benefit is to enable persons who have reached retirement age to receive support and assistance according to the eligibility level approved for them.
Those eligible for the benefit may choose to receive services from a package that includes: personal care, attendance at an elderly day-care center, absorbent products, a distress alarm device, Supportive Community services, or laundry services.
Personal care and nursing services are provided by caregiving staff in accordance with a personalized care plan. In addition, every eligible individual receives personal guidance from professional staff such as social workers and registered nurses.
The care services are provided by organizations and companies recognized by the National Insurance Institute as authorized providers of long-term care services.

“Matav” Association is the largest and most professional organization in Israel for the provision of long-term care services. The association provides long-term care services to more than 40,000 persons who have reached retirement age throughout the country.

WHO IS ELIGIBLE TO RECEIVE THE LONG-TERM CARE BENEFIT?

To be eligible for the Long-Term Care Benefit, five conditions must be met:

1. Residence and age: An Israeli resident who has reached retirement age (for the retirement age table – see the National Insurance Institute website).
2. Living in the community: The applicant must reside at home, in the community, or in sheltered housing. A person living in a long-term care institution may be eligible for the benefit only if they are in a ward for the independent or the frail. A person who is in a nursing ward, a complex nursing ward, a ward for the cognitively frail, a long-term ventilation ward, or a rehabilitative facility supervised by the Ministry of Health is not eligible for the Long-Term Care Benefit. In addition, a person living in an institution where most maintenance expenses are funded by a public body (government ministries, local authorities, etc.) is also not eligible for the benefit.
3. Level of dependence: To be eligible for the Long-Term Care Benefit, the person of retirement age must require significant assistance from another person in performing activities of daily living (dressing, bathing, eating, etc.) or must require supervision.
4. Income: The income of the eligible individual and of their spouse serves as a criterion both for approval of eligibility and for determining the scope of the benefit  (see the income table).
5. Receiving other benefits: A person of retirement age is eligible to receive the Long-Term Care Benefit on the condition that they are not receiving from the National Insurance Institute a Special Services Allowance for the Disabled, or a personal care allowance from the State Treasury, or a benefit from the Ministry of Defense for assistance or accompaniment.

For advice regarding eligibility and the possibility of receiving the Long-Term Care Benefit, contact the “Matav” branch in your area of residence or the national call center at *3391

HOW ARE ELIGIBILITY AND THE SCOPE OF THE BENEFIT DETERMINED?

Eligibility for the benefit and its scope are determined by the National Insurance Institute through an individual assessment of the applicant. The purpose of the assessment is to examine the applicant’s level of dependence and need for assistance, or the need for supervision. The eligibility assessment is uniform, professional, and objective.
After submitting the application, a professional representative on behalf of the National Insurance Institute will contact the applicant by phone. Based on the content of the conversation and the documents attached to the application, the claim will be approved or denied, and the level of eligibility will be determined. In cases where required, the eligibility assessment will be carried out in a home visit.
If a home visit is conducted, a family member is entitled to be present.
If the applicant suffers from cognitive decline, a family member must be present during the meeting.
If the applicant has a temporary functional limitation (following surgery, an accident, etc.) – temporary eligibility for the benefit will be determined.

Important Information

Dependence assessment for persons aged 90 and above
A person aged 90 years or older may choose to undergo a functional assessment by a specialist geriatric physician instead of an assessor from the National Insurance Institute. The examination by the specialist geriatric physician will be performed free of charge, as part of the physician’s work in a hospital or a public clinic only.

WHAT ARE THE EXISTING ELIGIBILITY LEVELS?

There are six levels of the Long-Term Care Benefit, and the eligibility level is determined according to the higher of the two scores:

•  The dependence assessment score (ADL)
•  The supervision-need score

Dependence assessment score

•  The score ranges from 0 – for those who do not need any assistance at all, and up to 9+ – for those who are completely dependent on another person to perform activities of daily living at all hours of the day.
•  The minimum score required to be approved for the Long-Term Care Benefit is 2 points for a person living alone and 2.5 points for a person who does not live alone (i.e., living with a spouse or a family member).

Supervision-need score

•  Applicants who require partial supervision will receive 4 points
•  Applicants who require full supervision will receive 9 points

Weekly eligibility units according to eligibility level

•  Persons with high income will receive half of the approved eligibility units for that level.
•  It is possible to convert the care hours, or part of them, into attendance at an elderly day-care center, absorbent products, a distress alarm device, Supportive Community services, or laundry services.
•  It is possible to convert the eligibility units (all or part of them) into a monetary benefit according to the eligibility level.

Holocaust survivors with 6 points or more are entitled to an additional 9 hours of care per week (subject to approval and funding by the Foundation for the Benefit of Holocaust Victims in Israel).

Important Information

Approval of the benefit for a limited period of time

•  In certain cases, where the need for assistance is temporary, the eligible person will be approved for a benefit for a limited period.
•  Service recipients who wish to continue receiving assistance after the end of their eligibility period must proactively submit a request for a reassessment.
•  “Matav” clients receive, as part of the service, a notification and reminder before the eligibility period expires.

WHAT SERVICES ARE PROVIDED TO THOSE ELIGIBLE FOR THE LONG-TERM
CARE BENEFIT AS PART OF HOME CARE?

Those eligible for the Long-Term Care Benefit receive assistance in performing activities of daily living and in managing the household, through a nursing caregiver who assists them according to the assigned work schedule.
The assistance includes: help with bathing, cooking, dressing, collecting medications from pharmacy and accompanying the person to the doctor, help with household management, cleaning the immediate living environment, laundry, ironing, and shopping.
In addition, every person eligible to the Long-Term Care Benefit and receiving caregiver services from “Matav” association is accompanied by a professional staff member who serves as a regular personal contact for information, guidance, and support.
The professional staff member visits the eligible person for routine home visits and maintains ongoing communication with the service recipients, their family members, and of course with the caregiver.
The professional staff members at “Matav” supervise the care and also instruct and support the caregivers.

Important Information

•  Applicants who receive 4.5 points or more are entitled to request a permit to employ a foreign caregiver.
•  A request to employ a foreign caregiver must be submitted on the Population and Immigration Authority website

HOW DO YOU SUBMIT A CLAIM FOR THE LONG-TERM CARE BENEFIT?

To receive the Long-Term Care Benefit, you must complete a Long-Term Care Benefit claim form at the National Insurance Institute.
When completing the forms, you must describe the applicant’s functional condition and functional difficulties, and attach medical documents and income certificates.
After completing the form, it must be submitted to the National Insurance Institute digitally or by mail.

Important Information

Submitting a claim before surgery or during hospitalization

•  A person who is about to undergo surgery may submit a claim for the Long-Term Care Benefit during the month prior to the surgery.
•  A person who is hospitalized may submit a claim even during hospitalization.
  Eligibility will be examined without needing to wait for discharge. The claimant will be asked to provide the interim summary or the discharge summary as soon as it is available. In this case, there is no requirement to present a medical printout as in a regular claim. If eligibility for the benefit can be determined based on the medical documents, eligibility will be determined through a fast-track procedure without a dependence assessment.

Important Information

Submitting a request for a temporary Long-Term Care Benefit (up to two months)
In cases where there is a temporary decline in functioning or a temporary need for assistance, it is possible to submit a request to receive the Long-Term Care Benefit on a temporary basis (“short-term benefit”). This procedure is intended for first-time applicants who, as a result of a sudden medical event, require temporary assistance for up to two months, provided that they do not suffer from a permanent mental, intellectual, or cognitive impairment. A request of this type must include a certificate from the treating physician confirming the need for assistance.
The decision to approve this benefit will be made by the National Insurance Institute based on the medical documents submitted, without the need for a dependence assessment by a National Insurance Institute assessor.

PRE-CARE: WHAT HAPPENS UNTIL APPROVAL IS RECEIVED?

Sometimes, when there is a sudden deterioration in functioning, there is an urgent need to receive care services immediately. The “Matav” association may, at its professional discretion, provide the care services even before the National Insurance Institute approves the application, and this is done at no charge. This period is called “pre-care”.

WHAT HAPPENS WHEN THE PATIENT’S CONDITION DETERIORATES?

In situations where the elderly person’s condition changes and there is a deterioration in their functional and/or cognitive state, it is possible to submit a request for a reassessment of the eligibility level due to “claim of deterioration.” In this case, it is mandatory to attach an up-to-date certificate signed by the treating physician/family physician and/or a hospitalization summary from the past three months.
After submitting the request, a renewed dependence assessment will be conducted. Based on the results of the assessment, it will be determined whether there will be a change in the patient’s eligibility level and whether an eligibility level will be established that allows issuing a permit to employ a foreign caregiver.

WHAT HAPPENS IF THE APPLICATION FOR THE LONGTERM CARE BENEFIT IS NOT APPROVED?

An elderly person whose application for the Long-Term Care Benefit has been rejected by the National Insurance Institute may submit an appeal to the National Insurance Institute Appeals Committee.

IS IT POSSIBLE, AND WHEN IS IT ADVISABLE, TO PURCHASE LONG-TERM CARE SERVICES PRIVATELY?

A person who wishes to add care hours, or someone who is not eligible for the Long- Term Care Benefit from the National Insurance Institute, may purchase and receive private care and assistance services. In such cases, the “Matav” association will find and match the most suitable caregiver for the patient, and will also appoint a social worker or a nurse who will be responsible for the care.
The caregiver will be employed by “Matav,” and all employment conditions will be paid by “Matav,” including social benefits. The service recipient is not required to be the employer of the caregiver or to handle any employment-related responsibilities.
Private care services may also be ordered for a short period, for example, during hospitalization or after discharge, to support the recovery and rehabilitation process.

WHAT SCREENING AND TRAINING PROCESS DO CAREGIVERS UNDERGO?

Caregivers at “Matav” begin working only after they have completed a screening and onboarding process.
Each caregiver who wishes to work at “Matav” undergoes a professional interview and an employment acceptance process, during which their suitability is assessed. Immediately upon starting work, the caregiver is invited to a group training and orientation session, followed by a comprehensive training course, “The Skilled Caregiver”, which includes theoretical studies on a variety of topics related to longterm care. The purpose of the course is to provide caregivers with the professional tools and skills needed for optimal care.
Later on, caregivers participate in training days and focused instructional sessions, as needed, on topics such as caring for a person with dementia, nutrition in older age, fall prevention, and more.

Important Information

Continuity of service during hospitalization
Persons eligible for the Long-Term Care Benefit may continue receiving care services even when they are hospitalized, for a period of up to 30 days.
If the eligible person is hospitalized far from their home, a substitute caregiver from the “Matav” branch closest to the hospital will come to them. This will take place after the caregiver has received guidance and instructions from the eligible person’s care manager.

WHY IS IT WORTHWHILE TO RECEIVE CARE SERVICES FROM THE “MATAV” ASSOCIATION?

The “Matav” association is the largest and oldest organization in Israel in the field of long-term care services. “Matav” operates as a non-profit association, whose goal is to assist and contribute to the community through the development and implementation of a wide range of welfare projects.
The organization employs hundreds of professional staff members (social workers, registered nurses, and gerontologists), as well as more than 30,000 nursing caregivers.
The association’s professional staff support caregivers through guidance, ongoing instruction, training courses, and professional development programs.
At “Matav,” great emphasis is placed on the well-being of caregivers, and they are offered a wide range of welfare activities and various benefits.
The goal of “Matav” is to ensure peace of mind and personal security for its clients by maintaining the professionalism and responsibility of the staff and providing supervised and closely monitored services. The association operates in accordance with ISO 9001:2015 standards for quality and service reliability.

To order professional and high-quality care services, contact the “Matav” branch nearest to you.
“Matav” has branches throughout the country, at your service.
To find the details of the branch closest to your place of residence,

call: *3391

*This document alternates between masculine and feminine forms and is intended equally for all genders.