Maccabi Health Fund Leads in Justified Complaints, Meuhedet in Overall Complaints
Translated & summarized from Kipa by baba
Israel's Ministry of Health reported that Meuhedet had the highest complaint rate per capita, while Maccabi led in justified complaints. The 2025 report processed nearly 15,000 public inquiries, a 20% increase from the previous year. The majority of complaints concerned the basket of health services, though those about provider choice decreased. The findings aim to improve services and member rights.
The story in 5 lines · by baba
- Meuhedet HMO had the highest complaint rate per 10,000 members in 2025.
- Maccabi Health Fund had the highest rate of justified complaints per 10,000 members.
- Nearly 15,000 public inquiries were processed by the health complaints commissioner in 2025.
- Complaints about the basket of health services constituted 60% of all grievances.
- The number of appeals related to switching between HMOs increased by 15%.
A Ministry of Health report released Thursday reveals that Meuhedet recorded the highest rate of complaints relative to its member base, with 6.03 complaints per 10,000 insured individuals. However, Maccabi Health Fund had the highest rate of justified complaints, at 1.33 per 10,000 members. The report, covering the year 2025, details public grievances against Israel's health maintenance organizations (HMOs) and their handling of these issues. Overall, 14,967 public inquiries were processed, with 5,291 requiring detailed investigation, a 20% increase from 2024. In 64.3% of resolved complaints, the intervention by the commissioner's office yielded direct benefit to the insured.
Further breakdown shows that 20.4% of complaints were found to be justified, and in 25.2% of cases, the issue was resolved during the investigation process or immediately upon receipt of the complaint. An additional 18.7% of complainants received information or guidance to help them assert their rights. Shimon Reifer, marks three decades since the National Health Insurance Law was enacted. It highlights that the basket of health services remains the primary subject of complaints, accounting for about 60% of all grievances.
Conversely, complaints regarding the selection of service providers decreased to 20.9%, attributed to expanded choice options following a 2023 reform. The report also processed 186 requests for financial reimbursements. Appeals related to switching between HMOs saw a 15% rise, reaching 4,996. The Ministry of Health stated that the data aids in identifying areas needing service improvement and better realization of members' rights, emphasizing the commissioner's role in addressing public inquiries and directing individuals to appropriate channels.
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