Israel funds long-term care at home first and institutions last. The Bituach Leumi nursing benefit (gimlat siud) pays for 5.5 to 30 weekly care hours at home, worth ₪1,705 to about ₪7,440 a month at the April 2026 rate of ₪248 per weekly hour; about 392,000 Israelis receive it, and the state spends roughly ₪21 billion a year on it. A live-in foreign caregiver costs a family ₪7,500 to ₪9,500 a month all-in, falling to ₪2,000 to ₪5,000 net after a Level 5 or 6 benefit. Private long-term care insurance is sold only through the four kupot cholim and pays ₪3,000 to ₪7,000 a month once you are classified siudi. A private nursing home runs ₪13,000 to ₪22,000 a month (premium homes ₪25,000 to ₪35,000); the Ministry of Health kod subsidy cuts the family’s share to ₪2,000 to ₪6,000. Hospice care is free inside the health basket.
Here is the situation this page is written for: someone you love is losing independence, and you suddenly have to work three separate Israeli systems at once. Bituach Leumi pays for care at home. The Ministry of Health pays for nursing homes. The kupot cholim pay for rehabilitation, home medical visits, and hospice. Each has its own test, its own forms, and its own definition of “needs care,” and nobody hands you the map. This page is the map. It is part of our guide to healthcare and long-term care for retirees in Israel, which itself sits inside our complete guide to retiring in Israel.
Four words that decide everything
- Siudi: the legal classification for a person who needs nursing-level care, either dependent in most daily activities or needing constant supervision; it triggers the NII benefit, insurance payouts, and nursing home funding.
- Gimlat siud: the Bituach Leumi (National Insurance) nursing benefit: weekly home care hours, cash, or a mix.
- ADL: the six activities of daily living the assessor scores: mobility, bathing, dressing, eating and drinking, continence, and getting up or sitting down.
- Kod: the Ministry of Health geriatric code, the means-tested subsidy that funds a nursing home bed.
Gimlat siud: the benefit that keeps 392,000 Israelis in their own homes
Israel’s long-term care benefits are home-first by law. The Long-Term Care Insurance Law of 1988 obliges Bituach Leumi to fund home care for anyone past retirement age (67 for men; 62 rising to 65 for women by birth year) who lives at home and fails the ADL test. Fail 4 or more of the 6 ADLs and you get the full benefit; fail exactly 3 and you get half. An income test sits on top: a single person earning above ₪15,410 a month (₪23,114 for a couple) gets nothing, and the income band just under those cutoffs pays half. The benefit never pays for a nursing home; institutions run on a separate Ministry of Health track covered below.
| Level | Weekly care hours | What it is worth per month (April 2026, ₪248 per weekly hour) | Weekly hours with a live-in foreign caregiver |
|---|---|---|---|
| 1 | 5.5 | ₪1,705, paid as cash | 5.5 |
| 2 | 10 | ₪2,480 | 10 |
| 3 | 17 | ₪4,216 | 14 |
| 4 | 21 | ₪5,208 | 18 |
| 5 | 26 | ₪6,448 | 22 |
| 6 | 30 | about ₪7,440 in services | 26 |
You choose the form: care hours delivered by a licensed care company, cash, or a mix (from Level 2 up, trading 4 weekly hours for cash pays ₪992 a month). How to claim, in order:
- File claim form 3000 at your local Bituach Leumi branch or online.
- An NII assessor visits the home and scores the six ADLs; from age 90 you may request a geriatrician instead.
- Pick hours, cash, or a mix by phone at *2637, online, or at the branch.
- Expect periodic reassessment; the level moves with the person’s condition.
People with diagnosed moderate-to-severe dementia who need constant supervision qualify regardless of their ADL score; that pathway gets its own section below.
In-home assistance your kupah already owes you
The nursing benefit buys hands-on help; your health fund owes you the medical layer on top of it. All four kupot cholim must provide in-home assistance to members who are home-bound: doctor home visits, nursing, physiotherapy, occupational therapy, speech therapy, and social work, at regular clinic copayments or free. Patients discharged from hospital who cannot reach a clinic are entitled to home visits for a set period, funded by the kupah. A social worker builds each NII beneficiary a customised care programme that can include a day care centre (merkaz yom, paid out of the weekly hour allocation), incontinence products, an emergency call button, and laundry service. How the funds, copayments, and referrals work day to day is in our guide to doctors, hospitals, and medical costs in Israel.
Foreign caregiver permits: the 3 to 5 month path to a live-in
The live-in foreign caregiver is the workhorse of Israeli elder care, and hiring one legally means two permits from two agencies. Foreign caregiver permits go to patients who fail at least 3 of the 6 ADLs, hold a moderate-to-severe dementia diagnosis requiring constant supervision, carry a hospice designation, or hold a high-level NII nursing benefit; from age 90, approval is automatic.
- Employment permit (Israel Employment Service): submit the medical report, ID, health records, and a draft employment contract. Takes 4 to 6 weeks and costs ₪1,270.
- B/1 work visa (Population and Immigration Authority): submit the permit plus the caregiver’s passport, police clearance, medical certificate, signed contract, and proof of health insurance. Takes 4 to 8 weeks, or 10 to 14 working days expedited for an extra ₪750. The visa costs ₪450 and renews yearly at ₪260, up to 5 years and 3 months (63 months in documented exceptional medical cases).
Recruit through a licensed private agency (placement fee capped at ₪2,500; the family is the legal employer) or through the government-to-government track with the Philippines, Nepal, Sri Lanka, and India (no recruitment fee, but 5 to 7 months). End to end, plan on 3 to 5 months from application to arrival.
Being the employer is a real legal role: minimum wage of ₪6,248 a month paid by bank transfer, a private lockable room, health insurance you buy (₪2,800 to ₪3,500 a year), NII registration with employer contributions of about 3.55%, 36 consecutive hours of weekly rest, paid leave and sick days, and severance of one month’s salary per year worked. You may deduct at most ₪1,200 a month for the room and ₪600 for meals. Holding the caregiver’s passport is a criminal offence.
Home care workers: rates, rights, and who is actually the boss
For part-time help, Israeli home care workers (metaplot) cost ₪40 to ₪50 an hour for experienced workers in central Israel, against a legal minimum of about ₪34. Who employs them decides your obligations. Take the NII benefit as in-kind hours and a licensed care company (chevrat siud) employs the worker and carries every employer duty; you carry none. Hire directly and you become the employer, with the same wage, leave, and severance obligations as for a foreign caregiver. Beneficiaries who take the cash option can pay any registered caregiver, including a family member in certain cases. For any employment rights dispute, the address is Kav LaOved, the Workers’ Hotline.
Private long-term care insurance: one channel, and read the renewal clause
Private long-term care insurance in Israel is sold through exactly one channel: the collective siudi plans of the four kupot cholim (Clalit, Maccabi, Meuhedet, Leumit), each underwritten by a private insurer with the kupah as group policyholder. No standalone private long-term care insurer operates in Israel. The plan pays a fixed monthly cash benefit, typically ₪3,000 to ₪7,000 depending on tier and enrolment year, once you are classified siudi (dependent in 3 or more ADLs, or needing constant supervision), after a waiting period of 45 to 90 days. Premiums are age-banded with no medical underwriting inside the pool: ₪50 to ₪150 a month for members who joined in their 30s or 40s, ₪200 to ₪400 for those joining in their 50s or 60s, CPI-linked and flat once you are in.
My estimate: a kupah siudi policy taken at 55 costs about ₪43,200 in premiums by age 67, and one claim repays that in under 9 months. Basis: ₪300 a month for 12 years is ₪43,200; a mid-tier benefit of ₪5,000 a month returns it in 8.6 months of a siudi classification.
The fine print bites. The group contract runs for a fixed period and the insurer can decline to renew it; several kupah contracts have been renegotiated or cancelled mid-stream. Some plan versions cap the payout years or the total sum, and most exclude siudi status caused by war or car accidents. The move is to enrol as young as possible and check every year that the contract renewed. New olim should join a kupah and its supplemental plans within 90 days of arrival, when all waiting periods including pre-existing conditions are waived; the full picture is in our guide to medical issues during aliyah: coverage, conditions, and medication.
Dementia and Alzheimer’s care: the pathway that skips the ADL test
About 150,000 Israelis live with dementia or Alzheimer’s disease, a number on track to double within a decade. Alzheimer’s care has its own legal doorway: the Long-Term Care Insurance Law classifies anyone needing constant personal supervision as eligible for the Bituach Leumi nursing benefit regardless of ADL score, and the same diagnosis qualifies the family for a foreign caregiver permit. Dementia care on the ground runs through two veteran nonprofits: EMDA, the Alzheimer’s Association of Israel, with 38 branches, support groups, and caregiver training; and Melabev, whose dementia day centres in Jerusalem and Beit Shemesh are NII-recognised, so attendance is paid from the weekly benefit hours. Each kupah has geriatric specialists and memory clinics reachable through the family doctor, and larger nursing homes run dedicated cognitive wards with structured memory units. One warning from experience: caring for a spouse with dementia is a mental health event for the caregiver too, and English-language support exists; see our guide to mental health and adjustment after aliyah.
Rehabilitation centers: covered, shrinking, worth fighting for
After a stroke, fall, or surgery, post-acute rehabilitation is a covered benefit: your kupah funds the stay on referral and classification by a geriatric specialist, and patients placed in the rehabilitation category pay no copayment. Israel has 29 specialised geriatric and rehabilitation hospitals; the largest, Sheba Medical Center’s rehabilitation hospital, runs 216 beds and treats over 4,200 patients a year. Capacity is the problem: geriatric hospital beds per 1,000 residents aged 75 and over fell 16% between 2020 and 2023, which pushes families home earlier than clinically ideal. Private rehabilitation centers charge ₪1,500 to ₪3,000 a day, partially covered by some supplemental kupah plans. If inpatient rehab is refused, the kupah home care unit owes you physiotherapy and occupational therapy at home instead.
Hospice care: free by law, reaching fewer than 10%
Hospice care sits inside Israel’s health basket: every kupah must provide palliative care around the clock to anyone whose treating physician assesses life expectancy at up to 6 months, at zero cost to the patient. Most families choose home hospice; Sabar Health delivers it fully covered by all four kupot on a physician’s referral, with a team spanning a palliative physician, nurses, a social worker, a psychologist, and spiritual care. The Israel Cancer Association funds home hospice offices nationwide and the Freedman House inpatient hospice at Sheba Medical Center. The catch is uptake, not coverage: Brookdale Institute research shows palliative care reaches fewer than 10% of those who could benefit, so ask the family doctor or hospital social worker for a palliative referral explicitly; it will rarely be offered unprompted. A siudi insurance payout continues alongside hospice care.
Nursing homes: six tiers, one licence, and the kod
Israeli nursing homes (beit avot siudi) sit at the top of a six-tier Ministry of Health classification that runs from independent living through partial and full nursing wards, a dedicated cognitive impairment tier, complex nursing care, and long-term ventilation. Siudi nursing care, the full nursing tier, means continuous supervision and medical monitoring in a designated ward. The bottom tier, independent living, is not a nursing home at all: that is Diur Mugan, covered in our plain-language explanation of what Diur Mugan is, with prices in our detailed Diur Mugan cost guide. Every facility must hold a current Ministry of Health operating licence; placement in an unlicensed facility is illegal.
The cost of nursing homes, fully private: ₪13,000 to ₪22,000 a month is typical across northern, central, and southern Israel, with premium facilities at ₪25,000 to ₪35,000. Fees cover the room, meals, personal care, and nursing staff; medications and specialist visits are often billed separately.
The kod is the escape hatch. The Ministry of Health subsidy funds a licensed bed for applicants aged 60+ (women) or 65+ (men) whose need is confirmed by a regional geriatric classification committee, who have exhausted the NII nursing benefit, and who pass a means test counting the applicant’s and their Israel-resident children’s income and assets. Approved residents get a double room at a state-set rate, and the family pays a copayment of ₪2,000 to ₪6,000 a month; in full financial hardship the state covers essentially everything. The process takes 2 to 4 months, waiting lists at desirable facilities run 6 to 18 months, and a hospital or municipal social worker is the right guide through it. Holocaust survivors can add funding from the National Authority for Holocaust Survivor Rights.
My estimate: the kod is worth about ₪168,000 a year to a family. Basis: a mid-range private fee of ₪18,000 a month minus a mid-range kod copayment of ₪4,000 leaves ₪14,000 a month, or ₪168,000 a year. That gap is why applying early beats waiting for a crisis.
The cost of elder care, side by side
The cost of elder care in Israel runs from free to ₪35,000 a month for the same person, depending on which system carries the load.
| Care setup | Monthly cost to the family (2026) |
|---|---|
| Bituach Leumi care hours only | ₪0; state-funded care worth ₪1,705 to about ₪7,440 |
| Israeli caregiver, 20 hours a week at ₪40 an hour | About ₪3,500 in wages, plus employer contributions |
| Day care centre | Usually ₪0, paid from the NII hour allocation |
| Live-in foreign caregiver | ₪7,500 to ₪9,500 all-in; ₪2,000 to ₪5,000 net after a Level 5 or 6 benefit |
| Assisted living | ₪8,000 to ₪15,000 |
| Private nursing home | ₪13,000 to ₪22,000 typical; ₪25,000 to ₪35,000 premium |
| Nursing home with the kod | ₪2,000 to ₪6,000 copayment |
My estimate: a live-in caregiver at home costs a family about ₪3,500 a month net, one fifth of a mid-range private nursing home at ₪17,500. Basis: the midpoint of the ₪2,000 to ₪5,000 net outlay after a Level 5 or 6 benefit, against the midpoint of the ₪13,000 to ₪22,000 private fee range. Home care wins on money whenever it is medically viable, which is exactly how the law is built.
Confirm these five things before you sign or file
- The Bituach Leumi level letter is in hand before you price caregivers; the level sets the hour allocation and the offset math.
- Any facility you consider shows a current Ministry of Health licence.
- Any placement agency is licensed and charges no more than the ₪2,500 fee cap.
- Your kupah siudi policy actually renewed this year, and you know its payout cap and waiting period.
- For a kod application: bank statements, income proofs, and the children’s income documents are assembled before the committee convenes.
Questions families ask us
How much does the Bituach Leumi nursing benefit pay in 2026?
₪248 a month per weekly care hour. Level 1 pays ₪1,705 a month in cash; Level 6 delivers 30 weekly hours worth about ₪7,440 a month in services. Above ₪15,410 in monthly income for a single person (₪23,114 for a couple) it pays nothing.
Does the nursing benefit pay for a nursing home?
No. It funds home care only. Nursing homes are paid privately or through the Ministry of Health kod, which leaves the family a copayment of ₪2,000 to ₪6,000 a month.
How long does it take to bring a foreign caregiver?
3 to 5 months end to end: 4 to 6 weeks for the employment permit, 4 to 8 weeks for the B/1 visa, plus recruitment and travel. The government-to-government track takes 5 to 7 months.
Does Alzheimer’s qualify without failing the ADL test?
Yes. Moderate-to-severe dementia requiring constant supervision qualifies for the full nursing benefit and a foreign caregiver permit regardless of the ADL score.
Is hospice really free?
Yes. Palliative and home hospice care are in the health basket at zero cost for anyone with a physician-assessed life expectancy of up to 6 months, through all four kupot cholim.
Sources you can check yourself
- Bituach Leumi: long-term care benefit: eligibility, dependency levels, and claim form 3000.
- Ministry of Health: nursing home licensing, classification, and the kod subsidy.
- Population and Immigration Authority: B/1 foreign caregiver visas.
- Kav LaOved (Workers’ Hotline): caregiver employment rights.
- EMDA, the Alzheimer’s Association of Israel and Melabev: dementia day care and family support.
Your next step
Long-term care happens inside a home, and most Israeli apartments were not built for it: no elevator, no spare room for a live-in caregiver, bathrooms no wheelchair can enter. If care is anywhere on your horizon, fix the real estate before the crisis: tell us your city and budget and we will shortlist homes that work for aging in place, with elevators, level access, and a room for a caregiver.
Last verified: July 2026.
