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Tourist Health Form

Tourist Signup In Israel

I the undersigned (hereinafter, the “insurance applicant”)ask of “Harel” Insurance Company Ltd. (hereinafter, the “Insurer”) to insure me, based on all the infomation in this Application.

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Pre-existing conditions (not included in the basic policy) Details of Coverage.

Sudden Deterioration of pre-existing illnesses/medical conditions where:
In the 6 months preceding the arrival to Israel:

  1. The medical condition has been stable.
  2. No hospitalization.
  3. No change in the dosage of medication being taken.


Coverage: Up to $10,000
Psychiatric emergency: up to $3,000

Exclusions:

  1. Any condition for which the treatment was expected / for which a doctor in the applicant’s home country recommended the applicant not travel to Israel / for which the applicant was on a waiting list for an operation or treatment.
  2. AIDS, transplants, M.S., dialysis, C.F., sexual diseases, heart disease, malignant diseases (such as cancer).
  3. No cover for refills of medications related to the pre-existing condition.
  4. Applicants over 49 years of age.
Contact our office for more details

Pre-existing conditions (not included in the basic policy) Details of Coverage.

Sudden Deterioration of pre-existing illnesses/medical conditions where:
In the 6 months preceding the arrival to Israel:

  1. The medical condition has been stable.
  2. No hospitalization.
  3. No change in the dosage of medication being taken.

Coverage: Up to 35,000 nis
Psychiatric emergency: up to 10,500 nis

Exclusions:

  1. Any condition for which the treatment was expected / for which a doctor in the applicant’s home country recommended the applicant not travel to Israel / for which the applicant was on a waiting list for an operation or treatment.
  2. AIDS, transplants, M.S., dialysis, C.F., sexual diseases, heart disease, malignant diseases (such as cancer).
  3. No cover for refills of medications related to the pre-existing condition.
  4. Applicants over 49 years of age.
Contact our office for more details