In Israel, basic Kupat Cholim coverage for residents is financed through mandatory health-insurance contributions paid to Bituach Leumi.

There is no separate “basic membership fee” paid directly to the Kupah for the statutory basket; the required payment is the health-insurance contribution collected by Bituach Leumi.

Who must pay?

• All Israeli residents aged 18+ must be insured under the National Health Insurance Law and pay health-insurance contributions via Bituach Leumi, except women classified as “housewives” according to the law (and not just any married woman who doesn't work)
• Retirees are not exempt just because they are retired. As long as they are residents and are not “housewives,” they must be covered and must pay.
• In this context “resident” means someone whose center of life is in Israel and who is recognized as a resident by Bituach Leumi, not a tourist or short-term visitor

No separate fee to the Kupah

• The Kupah does not collect the basic statutory health premium directly for Israeli residents; the health-insurance contribution is collected by Bituach Leumi and then distributed to the Kupot according to law.
• The only direct fees to the Kupah are usually for supplementary plans (e.g., Meuhedet Si, Macabi Sheli), which are separate from the national health-insurance payment.

Bituach Leumi looks at two main factors:

Status:

• Salaried worker (employee)
• Self-employed
• “Person who does not work” (e.g., many retirees without current employment)
• Students and yeshiva students
• Pensioners receiving an Israeli old-age or other Bituach Leumi benefit

Income type and amount:

• Income from work (salary, self-employment)
• Other income (pension, rent, investments)
• Whether the person receives an Israeli benefit (old-age pension, disability, survivors’ pension, etc.)

The official rates (percentages, fixed amounts, and minimums) are updated periodically and appear in Bituach Leumi’s “Health insurance rates” page (linked above). Always check the current table before relying on specific number

A retiree who is an Israeli resident, does not work, and has no income will generally pay the minimum monthly health-insurance contribution to Bituach Leumi. If there is any income that Bituach Leumi counts for health-insurance purposes (for example, a foreign pension or rental income), the person will usually not be in this “no income” category and will instead be treated as a “person who does not work with income”.

Now to your central scenario: an oleh whose only income is a foreign pension.

If the Oleh does NOT yet receive an Israeli old-age pension

Scenario:

• New or returning oleh, recognized as Israeli resident.
• Retired, not working in Israel.
• Has only a foreign pension (US, UK, etc.) as income.
• Does not yet receive Israeli old-age pension or other Bituach Leumi benefit.

Classification:

Bituach Leumi status: “Person who does not work,” with income.

The foreign pension is treated as income for health-insurance purposes, regardless of its country of origin.

Payment:

• According to the health-insurance rate table, a “person who does not work” with income pays a fixed percentage of that income, up to the contribution ceiling. For example, in recent years this rate has been around 5.17% for non-working persons with income, but you must check the current table as the exact percentage can change.
• If your only income is a foreign pension and you do not receive an Israeli old-age pension, Bituach Leumi will usually charge you health-insurance contributions as a ‘person who does not work with income,’ based on a percentage of your foreign pension, up to a legal ceiling.

Scenario:

• Oleh is now receiving an Israeli Kitzvat Zikna - קצבת זקנה -old-age pension from Bituach Leumi
• May also have a foreign pension and/or other income

For this group, Bituach Leumi has a special rule:

Recipients of an old-age pension generally have their health-insurance contribution deducted at fixed monthly amounts from the Israeli pension, depending on family situation (single, couple, income supplement, etc.). In most cases, recipients of an old-age pension are exempt from paying additional health-insurance contributions on other income, including foreign pension income.

Once you start receiving an Israeli old-age pension from Bituach Leumi, your health-insurance contribution is usually deducted automatically from that pension at a fixed monthly rate. In most cases, you will not pay separate health-insurance contributions on other income, including a foreign pension.

For current rates and minimums, always check the official Bituach Leumi ‘Health insurance rates’ page linked above.

This guide is for general informational purposes only and does not replace official information or personal advice from Bituach Leumi or a professional advisor.