"Prematurity allowance from National Insurance"

The main rules for determining entitlement to an allowance from National Insurance for premature infants

Based on the Yildan Circular updated on 12/21/20 and the National Insurance website

An examination carried out by the National Insurance shows that the treatment of premature babies in the first period after birth involves a great burden on the parents, since many of the premature babies suffer from problems that require supervision and/or routine treatments and follow-ups on various issues (such as: eating difficulties, problems arising from various infections, problems arising from immaturity systems for example breathing breaks etc.).
Therefore, it was decided on several grounds for which eligibility can be established for receiving a temporary disabled child's allowance (for 6 months):

השגחה חלקית (בשיעור של 50%, גובה הקצבה- 1,676 ₪ נכון לינואר – 2023):

Premature babies born up to week 6+32 or with a birth weight of less than 1750 grams - temporary entitlement for 6 months from 3 months chronological age to 9 months chronological age. Determining eligibility will be done without summoning the child to the committee

Premature babies who stayed in a nursery for a period of 30-44 days - granting temporary entitlement for 6 months, from the age of 91 chronological days to the age of 9 chronological months. Determining eligibility will be done without summoning the child to the committee

Premature babies who have stayed in a nursery for a period of 45 days or more - granting temporary eligibility for 9 months, from the age of 91 chronological days to the age of one year chronologically. Determining eligibility will be done without summoning the child to the committee.

טיפול מיוחד (בשיעור של 100% גובה הקצבה- 3,295 ₪ נכון לינואר – 2023)

In cases of premature babies who accumulate 3 sections - "monitoring in a specialist clinic", hospitalization for 45/30 days, as well as "partial supervision", or if a specific section exists such as oxygen, gastrostomy, ileostomy, anticonvulsant drugs and more.

"טיפול רפואי קשה" (בשיעור של 188% גובה הקצבה- 6,194 נכון לינואר – 2023)

In the case of premature babies who have stayed in a nursery for at least 3 months in a row. The benefit will be given from the day of birth until the end of the calendar month in which they were released to their home.

"From January 2022, there are five levels of eligibility for a disabled child's allowance"

Three as detailed above, and two more:

  1. 112% – רמת זכאות חדשה מינואר 2022. סכום הקצבה הוא 3,882 ש"ח .
  2. 235% – סכום הקצבה הוא 7,873 ש"ח .

ילד שיש לו יותר מבעיה רפואית אחת המזכה אותו בקצבה, תשולם לו הקצבה לפי הבעיה הרפואית המזכה בסכום הגבוה ביותר.

For current information from National Insurance click

A summary of the possible reasons for eligibility to expire

Please note that:

Determining eligibility for prematurity benefit will be done without the need for a summons and/or examination of the child by the committee. Eligibility for this benefit will be determined based on documents up to the chronological age of 9 months.

Were you invited to the committee anyway? Apparently the doctor who handled the claim and the documents you submitted thinks there is reasons Other than abortions that should be examined by the committee.
There is nothing to fear from the committee, in the end additional reasons can earn you higher percentages.

A family with two or more "disabled" children is entitled to an increased allowance of 50% for each child, according to the allowance established for him. For example, in a family with two disabled children, for one child eligibility was determined at rate 100% and for the other at rate 50%, for each child an increased allowance will be paid at rate 50%. That is, for the first child the increased allowance rate will be 150%, and for the second child 75%.

The allowance will be paid up to one year retroactively from the date of filing the claim. Applicability of the circular and eligibility for payment: 1.1.2020. That is, in cases of a retroactive claim, the circular is relevant to any premature baby who meets the criteria of a week or birth weight as indicated in section 1 above, and was less than 9 months old on 1.1.2020. If he was more than 3 months old on 1.1.2020, he will only receive for the period from that date until the date he turned 9 months old.

A future claim can be submitted, even before the child is 3 months old. But in any case, the entitlement and benefit will only be given from the age of 3 months.

At the end of the temporary period, you can send current medical documents about the child's condition and the treatments he receives, for the purpose of examining developmental delay and/or other reasons that qualify for a different allowance.
If during the temporary period there is an aggravation or a new medical condition, it must be filled outForm for re-examination and send along with medical documents accordingly.

How to submit the application

A form must be downloaded from the National Insurance websiteDisabled child benefit"

The form must be accompanied by a letter of release from Pagia and any other relevant document.
In our experience, it is useful to attach any document that may be relevant because there may be additional reasons that qualify for a higher allowance (in this case, you will likely be summoned to the committee).

In the form, write the word "prematurity" in section 4 in the last line (medical complaints).

The form can be filled out Online. Another option is to send through National Insurance website, by fax, mail or put in the service boxes in the branches.

For detailed inquiries and additional questions regarding claim handling and rights and service issues:
National Social Security Hotline *6050 or 04-8812345 (Sunday-Thursday from 8:00 a.m. to 5:00 p.m.)

More information on benefits related to the benefit here

sick days For the purpose of personal assistance of a parent of premature infants recognized by the National Insurance under the "disabled child" allowance - premature infants

To view the circular 

 

Israel is promoting a policy!

From many conversations and requests from parents and family members whom we accompany from the first moments of a premature birth, we are witness to the fact that despite the tremendous improvement in the rights and entitlements of parents of premature babies in Israel, there is still more to improve!
In order to continue to improve the situation, we contacted the National Insurance and asked:
1. That he recognize the special needs of premature babies from the day of their birth (and not from the age of 3 months as the Medical Bureau's circular for a disabled child's allowance for prematures indicates) in order to allow them to benefit from the allowance from the day of birth, thereby easing the therapeutic and financial burden that falls on the family.
 
2. Adjust the guidelines in the Prematurity Circular so that they provide an answer and full rights to the residents of Israel, who for whatever reason were caught up in a premature birth abroad, but whose life is centered in Israel.
 
3. Make the information and rights of parents of premature infants accessible on the National Insurance website so that parents of premature infants know their rights, know what the conditions are for receiving a disabled child's allowance, while emphasizing the unique eligibility situations.
 
You are invited to read the letter (in the first comment), give a like, tag people who can help or who are important to know and of course share!

To read the letter in full

 

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